Definition - What does Decidualization mean?

Decidualization is the process in which dramatic changes occur in the endometrial stromal cells that results in the formation of the decidua— a modified inner lining of the uterus that is essential to establish and maintain a successful pregnancy.

An impairment of endometrial decidualization is considered to be a cause of infertility and is also a rate-limiting step in assisted reproductive treatment (ART).

FertilitySmarts explains Decidualization

Decidualization typically begins on day 23 of the menstrual cycle and is driven by high levels of progesterone and increased production of cyclic adenosine monophosphate (cAMP), an important second messenger for many biological processes. Decidualization is an extensive process that affects all regions of the uterus and changes it into a receptive state for the embryo to embed in the uterine environment.

Decidualization is essential to the formation of placenta between the mother and the embryo. This same process induces the production of various cellular and molecular factors that lead to changing and remodeling of the maternal spiral arteries. This remodeling is required for these arteries to perform their nutrient supply role to the placenta and fetus.

Abnormalities in decidualization have been found to be involved in endometriosis, infertility, and recurrent miscarriages. Moreover, chronic deciduitis - a long-lasting infection of the decidua - may result in pre-term labor.

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