Impaired decidualization and angiogenesis in eutopic endometrium of endometriosis: insights from in vitro models

Rongyan Qin, Xinglong Zhong, Jiajing Lin, Chen Li, Xin Liu, Aiping Qin, Fengque Zheng
Biology of reproduction · 2025 · vol. 113(6) , pp. 1539–1548 · doi:10.1093/biolre/ioaf170 · PMID:40747949 · W4412839065
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

Endometrial stromal cells from endometriosis patients exhibit impaired decidualization and reduced expression of decidual and angiogenic markers, leading to decreased VEGFA secretion and impaired HUVEC tube formation.

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Abstract

Endometriosis markedly compromises female fertility, and although endometrial dysfunction likely plays a role in this pathology, its precise mechanistic contributions remain poorly understood. This study aims to investigate the decidualization and angiogenic capacity of eutopic endometrial in endometriosis patients. The study enrolled 30 participants, including 15 infertile patients with endometriosis (EMS group) and 15 patients with benign gynecological conditions who underwent laparoscopic treatment (negative control group, NC group). Immunohistochemistry, F-actin staining, qRT-PCR, Western blot, ELISA, and tube formation assays were used to analyze decidual endometrial stromal cell (ESC) morphology, measure protein expression associated with decidualization and angiogenesis. Secretory phase endometrium from endometriosis patients EMS group showed significantly reduced expression of decidual markers (PRL, IGFBP1, HOXA10, BMP2) and angiogenic-related proteins (ANG2, VEGFA, VEGFR1) versus NC group. Primary ESCs isolated from proliferative phase endometrium tissue of endometriosis patients showed impaired decidualization under hormonal induction, with attenuated morphological transformation, downregulated decidual-related proteins (P < 0.05). Angiogenic dysfunction was evidenced by decreased VEGFA secretion (P = 0.026), reduced angiogenic-related proteins (P < 0.05), and impaired HUVEC tube formation in cocultures (P < 0.05). Overall, endometriosis-associated infertility involves intrinsic defects in decidualization and angiogenesis. This may provide new perspectives for improving the reproductive outcomes of patients with endometriosis.

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Condition tags

endometriosisinfertility

MeSH descriptors

Decidua Decidua Decidua Decidua Decidua Decidua Decidua Decidua Decidua Decidua Decidua Decidua Decidua Decidua Decidua Decidua Decidua Decidua Decidua Decidua

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (48)

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