Endometrial function is often overlooked in the study of fertility in reproductive ecology, but it is crucial to implantation and the support of a successful pregnancy. Human female reproductive physiology can handle substantial energy demands that include the production of fecund cycles, ovulation, fertilization, placentation, a 9-month gestation, and often several years of lactation. The particular morphology of the human endometrium as well as our relative copiousness of menstruation and large neonatal size suggests that endometrial function has more resources allocated to it than many other primates. The human endometrium has a particularly invasive kind of hemochorial placentation and trophoblast that maximizes surface area and maternal-fetal contact, yet these processes are actually less efficient than the placentation of some of our primate relatives. The human endometrium and its associated processes appear to prioritize maximizing the transmission of oxygen and glucose to the fetus over efficiency and protection of maternal resources. Ovarian function controls many aspects of endometrial function and thus variation in the endometrium is often a reflection of ecological factors that impact the ovaries. However, preliminary evidence and literature from populations of different reproductive states, ages and pathologies also suggests that ecological stress plays a role in endometrial variation, different from or even independent of ovarian function. Immune stress and psychosocial stress appear to play some role in the endometrium's ability to carry a fetus through the mechanism of inflammation. Thus, within reproductive ecology we should move towards a model of women's fecundity and fertility that includes many components of ecological stress and their effects not only on the ovaries, but on processes related to endometrial function. Greater attention on the endometrium may aid in unraveling several issues in hominoid and specifically human evolutionary biology: a low implantation rate, high rates of early pregnancy loss, prenatal investment in singletons but postnatal support of several dependent offspring at once, and higher rate of reproductive and pregnancy-related pathology compared to other primates, ranging from endometriosis to preeclampsia. The study of the endometrium may also complicate some of these issues, as it raises the question of why humans have a maximally invasive placentation method and yet slow fetal growth rates. In this review, I will describe endometrial physiology, methods of measurement, variation, and some of the ecological variables that likely produce variation and pregnancy losses to demonstrate the necessity of further study. I propose several basic avenues of study that leave room for testable hypotheses in the field of reproductive ecology. And finally, I describe the potential of this work not just in reproductive ecology, but in the resolution of broader women's health issues.
Novel topics compiled in this one-of-a-kind volume provide tantalizing hints for clinical application through future translational research. Only recently have we come to ask what role the male might play in pregnancy loss and embryo implantation failure, beyond contributing an abnormal set of paternal chromosomes at fertilization. This volume explores the recent evidence that these conditions might also be related to the transmission of previously unrecognized chromosomal micro-deletions and duplications, or via the epigenetic dysregulation of early embryonic gene function by spermatozoal microRNAs or alterations in sperm DNA methylation patterning, or by DNA damage secondary to either reactive oxygen species or environmental toxicants. In addition, the composition of seminal plasma has been found to be highly complex, containing many factors that play important roles in altering the uterine environment and the female immune system permissive of embryo implantation and trophectoderm outgrowth leading to successful pregnancy. Coverage includes an examination of both spermatozoa and seminal fluid component factors.
Embryo transfer is the last step in the IVF treatment cycle, yet the one with the highest failure rate. This book provides a practical review of all aspects of endometrial receptivity, including histological, hormonal, biochemical and immunological, to enable specialists to make evidence-based decisions that influence success rates..
Embryology at a Glance is a highly illustrated and innovative introduction to key embryological concepts, with concise, memorable descriptions of major embryological developments. This new edition covers the basic principles of human development, from mitosis and meiosis, before exploring the primary formation of each body system, including the development of the musculoskeletal, circulatory, digestive, reproductive, and nervous systems during the foetal and neonatal periods. Key features include: New chapters on cell signalling genes, stem cells, and antenatal screening for common congenital and genetic defects Full colour photographs and illustrations Links to clinical practice highlighted throughout Timelines of each developmental stage MCQs and EMQs for revision and review A companion website at www.ataglanceseries.com/embryology featuring 15 brand new animations, and podcasts to help clearly explain the processes that occur during development. An additional instructor resource contains an image bank of all the figures from the book to aid teaching this fascinating area Embryology at a Glance provides the perfect alternative to the overwhelming detail seen in conventional embryology texts. It provides just the right level of detail on embryology and congenital abnormalities for all medical students and health professionals to develop a thorough understanding of human development and its implications for clinical practice.
This brand new title provides a highly illustrated introduction to key embryological concepts, with concise, memorable descriptions of major embryological developments. Embryology at a Glance introduces the basic principles of human development, from mitosis and meiosis, and walks you through the primary formation of each body system, with coverage of the continued development of the respiratory and vascular systems during the foetal and neonatal periods. Fully geared towards the medical school curriculum, the coverage of major steps in human development allows a better understanding of adult anatomy, development-associated conditions, congenital abnormalities and their treatments. Embryology at a Glance: Features full colour photographs and illustrations, including 3-dimensional illustrations where appropriate, and full labels Offers ‘one-stop’ coverage of the skeletal, muscular, circulatory, respiratory, nervous, reproductive, urinary, endocrine and digestive systems Highlights clinical correlations throughout Includes timelines so you won’t lose sight of the temporal aspect of embryology Includes Multiple Choice Questions (MCQs) and Extended Matching questions (EMQs) for revision and review A companion website with links to the Dr Webster’s embryological and anatomical podcasts is available at: www.wiley.com/go/embryology The clear, descriptive diagrams characteristic of the at a Glance series will help all medical students and health professionals develop an understanding of human development and its implications for clinical practice.
The immune cells that reside at the interface between the placenta and uterus are thought to play many important roles in pregnancy. Recent work has revealed that the composition and function of these cells are locally controlled by the specialized uterine stroma (the decidua) that surrounds the implanted conceptus. Here, I discuss how key immune cell types (natural killer cells, macrophages, dendritic cells, and T cells) are either enriched or excluded from the decidua, how their function is regulated within the decidua, and how they variously contribute to pregnancy success or failure. The discussion emphasizes the relationship between human and mouse studies. Deeper understanding of the immunology of the maternal-fetal interface promises to yield significant insight into the pathogenesis of many human pregnancy complications, including preeclampsia, intrauterine growth restriction, spontaneous abortion, preterm birth, and congenital infection.