Recurrent implantation failure (RIF) is characterized by the repeated failure of implantation, often linked to impaired endometrial receptivity. This study investigates how granulocyte colony-stimulating factor (G-CSF) promotes endometrial stromal cell decidualization. THESCs (human telomerase reverse transcriptase-immortalized endometrial stromal cells) were used as an in vitro cell model to induce decidualization. The effects of G-CSF on the expression of decidualization genes and apoptosis during decidualization were examined. Additionally, a chemical inhibitor of signal transducer and activator of transcription 3 (STAT3) and the small interfering RNA (siRNA) targeting Homeobox A10 (Hoxa10) were employed to explore the involvement of the STAT3/HOXA10 axis in the action of G-CSF. G-CSF promoted decidualization markers expression and suppressed apoptosis in THESCs Treatment with G-CSF enhanced STAT3 activation during decidualization induction. STAT3 inhibition diminished the effects of G-CSF on decidualization marker expression and apoptosis suppression. Furthermore, it was demonstrated that G-CSF increased Hoxa10 expression in a STAT3-dependent manner. Silencing Hoxa10 abrogated the effects of G-CSF on promoting decidualization. G-CSF enhances decidualization of endometrial stromal cells via STAT3/HOXA10 axis activation. These findings suggest that optimal G-CSF delivery strategies could improve endometrial receptivity in RIF patients.
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