Decidualization

What are decidua?

transient tissue formed within the endometrium that support implantation of the embryo

What hormone triggers decidualization?

progesterone

T/F Decidualization happens in species with endotheliochorial placentation

False, hemochorial

What triggers menstruation?

loss of progesterone

What hormone proliferates endometrial cells?

estradiol

What hormone differentiates endometrial cells?

progesterone

What cells specifically are decidualized?

fibroblasts within stroma layer

Types of cells within endometrium?

luminal epithelium, glandular epithelium, fibroblasts, immune cells, and endothelial cells

T/F Decidualization only affects fibroblasts

False

When does decidualization occur in humans?

every cycle

What stimulates fibroblasts to decidualize?

Progesterone stimulates protein production and PGE2 activates protein kinase a signaling

Species who decidualize also experience what if no pregnancy occurs?

menstruation

What triggers decidualization in rodents?

physical contact with embryo

What does physical contact with embryo in rodents cause?

opening of ion channels in the epithelium, stimulating PGE2 production

What does PGE2 do?

creates specialized decidual cells

What does the increase in fibroblast metabolism cause?

differentiation of cells, invasion of embryo, and secretion

What does decidualization of fibroblasts increase?

fibroblast metabolism and glucose uptake

What are the five main roles of the decidua?

protects against oxidative stress, provides space for implantation, protects the fetus from the maternal immune system, produces hormones and growth factors, and regulates maternal blood supplied to the uterus

How do decidual cells protect against oxidative stress?

express a lot of anti-oxidant enzymes

Too much invasion during implantation can cause what?

ectopic pregnancy

What are the decidua growth factors?

IGF, prolactin, and relaxin

T/F decidua growth factors only affect the fetus

False

Ateriogenesis

uterine arteries get bigger

Angiogenesis

blood vessels grow into decidua forming spiral arteries

What does insufficient blood flow to the placenta cause?

preeclampsia

What clinical signs are attributed to preeclampsia?

high blood pressure and kidney/liver issues

decidualization and fertility have what kind of relationship

direct

What can happen to women with poor decidualization?

obesity and advanced age

Retrograde menstruation

when blood flows backwards into abdomen

Retrograde menstruation causes what?

endometriosis

T/F There are many treatments for endometriosis

false

Potential hormonal treatments for endometriosis

progesterone, estrogen, or GnRH agonist

symptoms of endometriosis

painful periods, painful urination, heavy bleeding between periods