4.5 Review

The Disorders of Endometrial Receptivity in PCOS and Its Mechanisms

Journal

REPRODUCTIVE SCIENCES
Volume 29, Issue 9, Pages 2465-2476

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s43032-021-00629-9

Keywords

Polycystic ovary syndrome (PCOS); Endometrial receptivity; Insulin resistance; Infertility

Funding

  1. Natural Science Foundation from Science and Technology Commission of Shanghai Municipality [17ZR1403100]

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Polycystic ovary syndrome (PCOS) is a complex endocrine disease involving metabolic, reproductive, and psychological dysfunctions. Impaired endometrial receptivity and ovulation disorders/anovulation are key factors in PCOS-related infertility, and focusing on endometrial function may offer more realistic solutions. Further research is needed to clarify the clinical relevance of biomarkers associated with decreased endometrial receptivity in PCOS.
Polycystic ovary syndrome (PCOS) is a mysterious and complicated endocrine disease with the combination of metabolic, reproductive, psychological dysfunctions. Impaired endometrial receptivity and ovulation disorders/anovulation are both important causes of PCOS-related infertility. However, change in endometrium has never received the same attention as ovulatory dysfunction. Besides, putting emphasis on endometrial function may be more realistic for PCOS-related infertility, given the wide use of assisted reproductive technology. The present review focuses on the disorders of endometrial receptivity of patients with PCOS, summarizes the changes of the indicators of endometrial receptivity including leukemia inhibitory factor, homeobox genes A, pinopodes, alpha v beta 3-integrin, and intercellular junctions and also analyzes the possible mechanisms of decreased endometrial receptivity and its relationship with the main endocrine and metabolic disorders of PCOS such as hyperandrogenism, inflammation, insulin resistance, and obesity. Despite several biomarkers have been found to be associated with decreased endometrial receptivity in PCOS, the clinical relevance of these findings still awaits future clarification.

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