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Uterine Function: From Normal to Polycystic Ovarian Syndrome Alterations.
Curr Med Chem. 2018; 25(15):1792-1804.CM

Abstract

BACKGROUND

The endometrium is one of the most important female reproductive organs. Polycystic ovarian syndrome (PCOS) is a reproductive and endocrine pathology that affect women of reproductive age. PCOS negatively affects the endometrium, leading to implantation failure and proliferative aberrations.

METHODS

We conducted a search at the http://www.ncbi.nlm.nhi.gov/pubmed/electronic database using the following key words: endometrial steroid receptors, endometrium, uterine function, endometrium and PCOS, implantation window, implantation and PCOS, implantation markers, inflammation, oxidative stress. We selected the articles based on their titles and abstracts, then we analyzed the full text and classified the articles depending on the information provided according to the sections of the present review.

RESULTS

The endocrine and metabolic abnormalities displayed in women with PCOS promote complex effects on the endometrium, leading to a low rate of implantation and even infertility. Women with PCOS show alterations in the Hypothalamic-Pituitary- Ovarian axis, which results in constant circulating levels of estrogen, similar to those at the early follicular phase, and a deficiency in the withdrawal of estrogen and progesterone. Besides this deficiency in the withdrawal of estrogen and progesterone, the insulin/ glucose pathway, adhesion molecules, cytokines and the inflammatory cascade, together with the establishment of a pro-oxidative status, lead to an imbalance in the uterine function, which in turn leads to implantation failure or even endometrial cancer.

CONCLUSION

Women with PCOS display a dysregulation of the Hypothalamic-Pituitary- Ovarian axis, which alters the steroid pathway. In addition, the deficiency in the withdrawal of estrogen and progesterone in the endometrium results in abnormal endometrial cellular proliferation. The imbalance in adipose tissue observed in PCOS patients reinforces the increase in circulating hormones. The present review describes the role of hormones, metabolites, cytokines, adhesion molecules and the insulin/glucose pathway related to the uterine endometrium in women with PCOS and their role in implantation failure and development of endometrial cancer.

Authors+Show Affiliations

Laboratory of Ovarian Physio-pathology, Center of Pharmacological and Botanical Studies, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.Laboratory of Ovarian Physio-pathology, Center of Pharmacological and Botanical Studies, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29210631

Citation

Ferreira, Silvana R., and Alicia B. Motta. "Uterine Function: From Normal to Polycystic Ovarian Syndrome Alterations." Current Medicinal Chemistry, vol. 25, no. 15, 2018, pp. 1792-1804.
Ferreira SR, Motta AB. Uterine Function: From Normal to Polycystic Ovarian Syndrome Alterations. Curr Med Chem. 2018;25(15):1792-1804.
Ferreira, S. R., & Motta, A. B. (2018). Uterine Function: From Normal to Polycystic Ovarian Syndrome Alterations. Current Medicinal Chemistry, 25(15), 1792-1804. https://doi.org/10.2174/0929867325666171205144119
Ferreira SR, Motta AB. Uterine Function: From Normal to Polycystic Ovarian Syndrome Alterations. Curr Med Chem. 2018;25(15):1792-1804. PubMed PMID: 29210631.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Uterine Function: From Normal to Polycystic Ovarian Syndrome Alterations. AU - Ferreira,Silvana R, AU - Motta,Alicia B, PY - 2017/04/17/received PY - 2017/11/03/revised PY - 2017/11/29/accepted PY - 2017/12/7/pubmed PY - 2019/2/8/medline PY - 2017/12/7/entrez KW - Polycystic Ovary Syndrome KW - adhesion molecules KW - adipokines KW - androgen KW - estradiol KW - glucose KW - insulin KW - progesterone KW - uterine endometrium. SP - 1792 EP - 1804 JF - Current medicinal chemistry JO - Curr. Med. Chem. VL - 25 IS - 15 N2 - BACKGROUND: The endometrium is one of the most important female reproductive organs. Polycystic ovarian syndrome (PCOS) is a reproductive and endocrine pathology that affect women of reproductive age. PCOS negatively affects the endometrium, leading to implantation failure and proliferative aberrations. METHODS: We conducted a search at the http://www.ncbi.nlm.nhi.gov/pubmed/electronic database using the following key words: endometrial steroid receptors, endometrium, uterine function, endometrium and PCOS, implantation window, implantation and PCOS, implantation markers, inflammation, oxidative stress. We selected the articles based on their titles and abstracts, then we analyzed the full text and classified the articles depending on the information provided according to the sections of the present review. RESULTS: The endocrine and metabolic abnormalities displayed in women with PCOS promote complex effects on the endometrium, leading to a low rate of implantation and even infertility. Women with PCOS show alterations in the Hypothalamic-Pituitary- Ovarian axis, which results in constant circulating levels of estrogen, similar to those at the early follicular phase, and a deficiency in the withdrawal of estrogen and progesterone. Besides this deficiency in the withdrawal of estrogen and progesterone, the insulin/ glucose pathway, adhesion molecules, cytokines and the inflammatory cascade, together with the establishment of a pro-oxidative status, lead to an imbalance in the uterine function, which in turn leads to implantation failure or even endometrial cancer. CONCLUSION: Women with PCOS display a dysregulation of the Hypothalamic-Pituitary- Ovarian axis, which alters the steroid pathway. In addition, the deficiency in the withdrawal of estrogen and progesterone in the endometrium results in abnormal endometrial cellular proliferation. The imbalance in adipose tissue observed in PCOS patients reinforces the increase in circulating hormones. The present review describes the role of hormones, metabolites, cytokines, adhesion molecules and the insulin/glucose pathway related to the uterine endometrium in women with PCOS and their role in implantation failure and development of endometrial cancer. SN - 1875-533X UR - https://www.unboundmedicine.com/medline/citation/29210631/Uterine_Function:_From_Normal_to_Polycystic_Ovarian_Syndrome_Alterations_ L2 - http://www.eurekaselect.com/158100/article DB - PRIME DP - Unbound Medicine ER -