Preimplantation embryo-endometrial signalling

Gijs Teklenburg
2010 · W1581328388
dissertation OA: green CC0
🔓 Open OA copy View on OpenAlex
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This paper investigates impaired endometrial decidualization as a cause of recurrent pregnancy loss by disrupting embryo selection and placental development, even in cases of apparent superfertility.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

Recurrent pregnancy loss (RPL) is a common and distressing disorder. Chromosomal errors in the embryo are the single most common cause whereas uterine factors are invariably invoked to explain non-chromosomal miscarriages. These uterine factors are, however, poorly defined. The ability of a conceptus to implant in the endometrium is normally restricted to a few days in the menstrual cycle. A limited ‘window of implantation’ ensures coordinated embryonic and endometrial development, thereby minimizing the risk of late implantation of compromised embryos. In this thesis we investigate the emerging evidence indicating that RPL is associated with impaired differentiation of endometrial stromal cells into specialized decidual cells. From a functional perspective, this differentiation process, termed decidualization, is not only critical for placental development but also signals the end of the implantation window and bestows on the endometrium the ability to recognize, respond to and eliminate implanting compromised embryos. Thus, we propose that spontaneous decidualization of the human endometrium, which inevitably causes menstrual shedding in the absence of a viable conceptus, serves as functional “window for natural embryo selection”. Conversely, impaired decidualization predisposes to late implantation, negates embryo quality control, and causes early placental failure, regardless of the embryonic karyotype. This pathological pathway also explains the common observation that many RPL patients seem exceptionally fertile, often conceiving within one or two cycles. Thus, as the clinical correlate of inappropriate uterine receptivity, ‘superfertility’ should be considered as a genuine reproductive disorder that requires targeted intervention.

My notes (saved in your browser only)

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (100)

Source provenance

openalex
last seen: 2026-06-04T00:00:01.174412+00:00
License: CC0 · commercial use OK