Decidualization
Decidualization is the change the uterine lining makes after ovulation. Its support cells turn into decidual cells. Those cells can receive an embryo and feed it. Progesterone from the corpus luteum drives the change.1
In women this happens in the second half of every cycle, whether or not an embryo arrives. A lining that prepares poorly undermines implantation. It also raises risk later in pregnancy.2 Work cited in that review ties recurrent pregnancy loss to a weak cyclic change.
A normal progesterone level does not promise a lining that responds to it. In endometriosis the lining responds poorly to progesterone. Receptor levels tend to run lower, and progesterone-driven genes are altered.3
Cited in this entry
- DeMayo FJ, Lydon JP. 90 YEARS OF PROGESTERONE: New insights into progesterone receptor signaling in the endometrium required for embryo implantation. Journal of molecular endocrinology. 2020. https://pubmed.ncbi.nlm.nih.gov/31809260/
- Ng SW, Norwitz GA, Pavlicev M, Tilburgs T, Simón C, Norwitz ER. Endometrial Decidualization: The Primary Driver of Pregnancy Health. International Journal of Molecular Sciences. 2020. https://pubmed.ncbi.nlm.nih.gov/32521725/
- Zhang P, Wang G. Progesterone Resistance in Endometriosis: Current Evidence and Putative Mechanisms. International journal of molecular sciences. 2023. https://pubmed.ncbi.nlm.nih.gov/37108154/
This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.
