Effects of noncavity-distorting fibroids on endometrial gene expression and function

Area of Science:

• Reproductive biology
• Gynecology
• Genomics

Background:

• Uterine fibroids are common in infertile patients.
• Impaired implantation and decidualization are potential causes of infertility in women with fibroids.
• Limited data exist on the endometrial transcriptome and decidualization potential in women with fibroids.

Purpose of the Study:

• To investigate the endometrial transcriptome in women with noncavity-distorting intramural fibroids compared to controls.
• To evaluate endometrial receptivity, decidualization, proliferation, and apoptosis in women with fibroids.

Main Methods:

• Transcriptome analysis of endometrium throughout the menstrual cycle.
• Assessment of endometrial receptivity markers.
• Evaluation of decidualization, proliferation, and apoptosis in endometrial stromal fibroblasts (eSF).

Main Results:

• Significant dysregulation of numerous transcripts in fibroid endometrium compared to controls.
• No significant differences in tissue-level receptivity or decidualization markers.
• eSF from fibroid uteri showed decreased proliferation and increased apoptosis during decidualization.

Conclusions:

• Endometrial gene expression is altered in women with noncavity-distorting fibroids.
• Implantation and decidualization potential appear preserved at the tissue and eSF levels.
• Altered eSF proliferation and apoptosis may contribute to subfertility in women with fibroids.