Decidualization

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Detailed overview of decidualization in human reproduction


Decidualization[edit | edit source]

Decidualization is a critical process in human reproduction, involving the transformation of endometrial stromal cells into specialized decidual cells. This transformation is essential for the successful implantation of the embryo and the establishment of a pregnancy.

Process of Decidualization[edit | edit source]

Decidualization occurs in the endometrium, the inner lining of the uterus. It is initiated in response to the hormonal changes that occur during the menstrual cycle, particularly the rise in progesterone following ovulation.

Hormonal Regulation[edit | edit source]

The process begins in the mid-luteal phase of the menstrual cycle. After ovulation, the corpus luteum secretes progesterone, which acts on the endometrial stromal cells. These cells undergo morphological and functional changes, becoming larger and more secretory. The expression of specific genes is upregulated, leading to the production of proteins and factors necessary for embryo implantation.

Cellular Changes[edit | edit source]

During decidualization, stromal cells transform into decidual cells, characterized by increased cytoplasm, prominent nucleoli, and the accumulation of glycogen and lipids. These changes prepare the endometrium to support the developing embryo.

Functions of Decidualization[edit | edit source]

Decidualization serves several critical functions in pregnancy:

  • Support of Embryo Implantation: The decidualized endometrium provides a receptive environment for the embryo to implant and establish a connection with the maternal blood supply.
  • Immune Modulation: Decidual cells produce cytokines and other factors that modulate the maternal immune response, preventing the rejection of the semi-allogeneic embryo.
  • Nutrient Supply: The decidual tissue supplies nutrients to the developing embryo before the placenta is fully formed.

Clinical Significance[edit | edit source]

Abnormal decidualization can lead to reproductive issues such as infertility, recurrent pregnancy loss, and complications like preeclampsia. Understanding the mechanisms of decidualization is crucial for developing treatments for these conditions.

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Contributors: Prab R. Tumpati, MD