In-Vitro Decidualization With Different Progesterone Concentration: Development of a Hormone-Responsive 3D Endometrial Tissue Using Rat Endometrial Tissues.

Abstract

Infertility in women is associated with various uterine and ovarian disorders. Treatment strategies for infertility can range from medications to embryo implantation through assisted reproductive technology (ART). ART has enabled considerable progress; however, there is currently no treatment to replacethe endometrium itself. Decidualization requires a complex interaction between endometrial tissue and estrogen and progesterone.We aimed to createa three-dimensional endometrial-like tissue model usingin-vitro cell sheet engineering with rat endometrium, and culturecells at different progesterone concentrations to mimic local concentrations.Histological and morphological changes revealed that development of the endometrial-like tissuewas not proportional to progesterone concentrations in terms of thickness, number of endometrial glands, or area fraction of intimal glands. These results suggest that decidualization may not be commensurate with the local endometrial progesterone concentration.Notably, the number of endometrial glands increased in the high concentration group and compaction occurred, indicating thatthe endometrial conditions in the high concentration group may be most conducive to increase pregnancy rates. Thesefindings suggest that there may be an "optimal progesterone concentration" for decidualization, application of which may lead to new strategies for improving pregnancy rates in women with infertility.