Progesterone Resistance in Endometriosis

Poorasamy, Jeevitha; Sengupta, Jayasree; Patil, Amit; Ghosh, Debabrata

doi:10.33590/emjreprohealth/22-00109

Cited by 3 publications

(3 citation statements)

References 71 publications

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“…However, a higher level of tissue estrogen in eutopic endometrium of ovarian endometriosis compared to non-endometriosis group of infertile patients in secretory phase of menstrual cycle was observed in our previous study [4]. Furthermore, we have also proposed an association between estrogen and progesterone receptor subtypes in eutopic endometrium of infertile women with ovarian endometriosis based on our reported data that may lead to increased cell proliferation, cell migration, decidual incompetence, and inflammatory responses leading to failure of embryo implantation [4,10,77]. We now report of an added factor in this scenario, that is increased cellular (membrane and cytoplasmic) expressions of ErbB-1 in glandular, stromal and inflammatory cells of eutopic endometrium.…”

Section: Discussionmentioning

confidence: 75%

Overexpression of ErbB-1 (EGFR) Protein in Eutopic Endome-Trium of Infertile Women with Severe Ovarian Endometriosis during the ‘Implantation Window’ of Menstrual Cycle

Poorasamy¹,

Garg²,

Bharti³

et al. 2022

Preprint

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Several lines of evidence indicate that high proliferative bias in eutopic endometrium during secretory phase is a hallmark of endometriosis and that high occurrence of implantation failure in patients resulting in infertility is often associated with endometriosis. ErbB family of proteins, which regulate the proliferation capacity in mammalian cells, appear as potential group of proteins to cause higher proliferation and endometrial hostility to implantation process in endometriosis. However, we have no concrete knowledge regarding the involvement of ErbB family in human endometrium during the ‘implantation window’, i.e., days 20-24 of a typical ovulatory cycle in endometriosis associated infertility. In the present study, the cellular profiles of immunopositive ErbBs-1 to -4 in endometrium of endometriosis-free, infertile women (Group 1; n=11), and in eutopic endometrium of infertile women diagnosed with stage IV ovarian endometriosis (Group 2; n=13) during mid-secretory phase were examined and compared using standardized WERF EPHect guidelines. Computer-aided standardized combinative analysis of immunoprecipitation in different compartments revealed an overexpression of ErbB-1 in the epithelial, stromal and vascular compartments along with marginally higher ErbB-3 expressions (P< 0.06) in the vascular compartment and ErbB-4 expression (P< 0.05) in the glandular epithelium and stroma in endometrium during the window of implantation of women with primary infertility associated with stage IV ovarian endometriosis compared with disease-free endometrium from women. A global overexpression of ErbB-1 in the endometrium during implantation window may induce anomalous proliferative, inflammatory and angiogenic activities in it, which antagonizes endometrial preparation for embryo implantation.

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Section: Discussionmentioning

confidence: 75%

Overexpression of ErbB-1 (EGFR) Protein in Eutopic Endome-Trium of Infertile Women with Severe Ovarian Endometriosis during the ‘Implantation Window’ of Menstrual Cycle

Poorasamy¹,

Garg²,

Bharti³

et al. 2022

Preprint

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“…Ligands activate PRs, which act as transcription factors [16]. Cell transfection studies have revealed that PR-A and PR-B have variable abilities to activate promoters sensitive to progestin hormones [18]: PR-B appears to be a more effective gene transcription regulator than PR-A. PR-B is essential for cellular proliferation in response to progesterone.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Differential Expression of Progesterone Receptors A & B in Endometriosis Undergoing IVF Treatment: A Personalized Approach for Better IVF Success

Rozati,

Azimi,

Khan

et al. 2023

EJMED

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Objective: Estrogen and Progesterone hormones play a pivotal role in the pathogenesis of Endometriosis. In the present study, relative quantification of PR-A and PR-B expression in eutopic endometrial tissue and endometriotic implants was done. By examining their expression profiles, we aim to gain deeper insights into the molecular mechanisms that can influence IVF success or failure in endometriotic patients. Our study also observed certain ART outcomes in both endometriosis and control groups, to evaluate the IVF success rate. Methods: This study was conducted at MHRT, a tertiary care center, and referral centers from other hospitals. The research encompassed an examination of 125 cases of infertility spanning from January 2019 to January 2023. Finally, biopsy samples were collected from 60 patients with endometriosis during laparoscopic procedures, while control biopsy samples were gathered from 18 patients who exhibited no signs of endometriosis lesions during the same laparoscopic procedures. The biopsy samples were then sent for Progesterone assay and later evaluated for ART outcomes. Results: It was observed from the results of our study that there was a significant downregulation of PR-A in stage III, and IV compared to Stage I and II. However, there was no significant change in PR-B expression in grades I and II, III and IV. Our study also observed certain ART outcomes in both endometriosis and control groups, revealing that women with endometriosis have lower chances of achieving pregnancy than women with other causes of infertility (95% CI, 22/60 vs. 12/18, p-value = 0.024). Conclusion: Our study results shed light on the complex role of progesterone isoforms in endometriosis. Progesterone receptor-A significant downregulation in severe cases challenges existing paradigms and opens new avenues for research.

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“…Estrogen is crucial for different physiological functions, including controlling energy metabolism, mineral balance, stress responses, and sexual development [63]. It is a powerful vasodilator that increases blood flow in several organs throughout the body, with reproductive tissues, particularly in the uterus, experiencing the greatest effects [64].…”

Section: Estrogenmentioning

confidence: 99%

Role of Hormones and the Potential Impact of Multiple Stresses on Infertility

Ramya,

Poornima,

Jananisri

et al. 2023

Stresses

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Infertility has a remarkable global impact affecting approximately about 48 million couples worldwide. One of the most contended concerns in reproductive biology is the prospective influence of psychological stress on pregnancy rates. Individuals struggling to conceive face a stupendous amount of emotional turbulence and have a greater risk for psychological vulnerability. Both stress and infertility reinforce the impact of each other; hence, there exists a reciprocal relationship. Stress may be the major contributor to subsequent infertility. Infertility treatments may enhance stress levels as well as reduce treatment outcomes. The biological mechanisms that interlink stress and infertility are the outcome of the hormonal actions at the brain level, where they stimulate or suppress the hypothalamic-pituitary-adrenal axis (HPA) and have a potential influence on the secretion of the respective hormone by the reproductive organs and the pregnancy outcomes. Sex hormones play an essential role in reproductive biology as well as in general physiology where they generate the cycle and provide a potential environment for pregnancy. This article reviews the impact of stress on reproductive rates and the implications of sex hormones on infertility. Additionally, it suggests strategies to overcome the stress conditions and the scenarios that may lead to stress.

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Progesterone Resistance in Endometriosis

Cited by 3 publications

References 71 publications

Overexpression of ErbB-1 (EGFR) Protein in Eutopic Endome-Trium of Infertile Women with Severe Ovarian Endometriosis during the ‘Implantation Window’ of Menstrual Cycle

Overexpression of ErbB-1 (EGFR) Protein in Eutopic Endome-Trium of Infertile Women with Severe Ovarian Endometriosis during the ‘Implantation Window’ of Menstrual Cycle

Assessment of Differential Expression of Progesterone Receptors A & B in Endometriosis Undergoing IVF Treatment: A Personalized Approach for Better IVF Success

Role of Hormones and the Potential Impact of Multiple Stresses on Infertility

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