The Endometrial Factor

At the dawn of precision medicine, there is a new opportunity for novel approaches to understand, diagnose and treat endometrial disorders that affect fertility, reproductive outcomes, and women’s health more broadly. Herein, the editors have assembled critically evaluated state-of-the-art chapters presenting basic and clinical knowledge about the human endometrium that impacts or will impact clinical practice. All clinicians and researchers in Reproductive Medicine will find this book useful as a reference and a valuable tool for continued advancement in the understanding and management of the "endometrial factor".

The structural, biochemical and clinical events related to menstruation, implantation, parturition, endometriosis, abnormal uterine bleeding and endometrial cancer are discussed in this comprehensive volume on the biological functions of the endometrium. New topics, such as the biochemical and molecular mechanisms regulating maternal embryonic interaction, are explored, and gynecologic endoscopy and therapeutic tools are discussed. The proceedings of the first conference is also available from the Academy, as volume 622 of The Annals of The New York Academy of Science.

Infertility is a widespread condition with significant consequences on both individual and societal levels. It has a prevalence of 9-18% of the general population, a rate that is seen in similar levels in different countries and continents. While significant progress has already been made in understanding the etiologies, pathogenesis, and management of a variety of conditions that can affect both male and female infertility at various levels, infertility remains a challenging problem for physicians and society. Even in advanced centers, the success rate of infertility treatments lingers at about 60%, and we believe that with more research we can tackle the most difficult situations. Although our understanding of embryo development and selection has greatly improved, knowledge of uterine and endometrial function and dysfunction is still insufficient. We welcome basic and translational research contributions that focus on the advancement of the field of uterine and endometrial physiology and pathology, aiming to address current challenges and unsolved issues. We welcome basic and translational studies on diagnosis and potential therapeutic management of a variety of issues affecting female reproduction at the level of the uterus, such as but not limited to: • endometriosis and adenomyosis, • immunology of endometrium, • endometritis, • implantation failure, • unexplained infertility, • studies on endometrial function/dysfunction, endometrial receptivity, uterine microbiota; • studies that focus on possible implementation and advancement of personalized medicine in management of uterine disorders of reproduction.

The field of medical genetics and genomics has been constantly revolutionized by new breakthroughs, which bring more knowledge into the etiology and help improve the health care of individuals with either rare or common diseases. Nevertheless, as technologies evolve, novel challenges emerge, both technically and ethically, so they must be prudentially addressed. Among the myriad applications of genomics in medicine, this book depicts a glimpse of the advances achieved that have been leading us to the personalized/precision medicine era.

This book focuses on uterine endometrial function and receptivity from multiple perspectives. The chapters cover a variety of topics including the role of estrogen and progesterone, animal models, parameters for assessing endometrial receptivity, the mechanism of angiogenesis, epigenetic regulation, and stem/progenitor cells. Despite nearly 35 years of experience with in vitro fertilization, the rate of successful implantations remains low. Abnormal endometrial receptivity has been proposed as one of the factors contributing to reduced reproductive potential in women, but our understanding of it is limited. Endometrial receptivity results from an orchestrated interplay between the embryo and the maternal endometrium, and the receptive status, known as the window of implantation, is reached only briefly in the mid-luteal phase. This book provides a comprehensive overview of the latest advances in endometrial function and paves the way for innovative treatments and drug development for infertility. This work will appeal to a wide readership, from researchers on endometrial function and assisted reproductive technology (ART) to clinicians and technicians in the field of gynecology.

This book is a summary of the present state of the art in the physiology of implantation and embryonic implantation. These processes are considered today as limiting factors responsible for both infertility and low gestation rates in patients undergoing assisted reproductive techniques. On the other hand, they might represent future targets for contraception. Basic aspects of cell biology of endometrial functions and molecular aspects of endometrial receptivity and implantation are discussed in the first part of this book. The clinical and experimental approaches to endometrial contraception are considered. In addition, some basic questions are indicated where further research is needed towards the better understanding and the development of new contraceptive strategies.

The Endometrium is devoted to a comprehensive multi-disciplinary account of the uterine endometrium. This book is the first to define the regulatory biological interrelationships between epithelial and stromal cell phenotypes, endothelial cells, extracellular matrix and immunobiological elements. It highlights their relevance to clinical conditions