Comprehensive approaches to endometrial assessment with emphasis on the extracellular matrix: A literature review
DOI:
https://doi.org/10.37800/RM.2.2025.488Keywords:
extracellular matrix (ECM), endometrial stroma, histochemistry, reproductive failures, diagnostic methods, reproductive medicineAbstract
Relevance: Endometrial receptivity is key for successful implantation and pregnancy progression. In recent years, increasing attention has been given to the extracellular matrix (ECM) as a structural and functional component of the endometrial stroma, which plays a role in angiogenesis, cell differentiation, and cell-to-cell interactions. Disruptions in the ECM composition and organization may be associated with recurrent reproductive failures and primary infertility, but they remain insufficiently studied.
The study aimed to critically analyze the current literature on the structure and functions of the ECM in the endometrial stroma and evaluate the most recent methodologies for its investigation in the context of diagnosing implantation disorders.
Materials and Methods: A systematic review of the scientific literature from 2015 to 2025 was conducted, using databases such as PubMed, Scopus, and Web of Science, as well as domestic peer-reviewed journals. The review included publications containing data on the ECM composition and functions, as well as the application of morphological, immunohistochemical, ultrasonographic, and molecular methods for evaluating endometrial receptivity.
Results: The stroma ECM is composed of collagens, glycoproteins, proteoglycans, enzymes, and receptor proteins, which undergo active remodeling throughout the menstrual cycle. The role of the reticulin-collagen pattern has been identified as a marker of decidualization and receptivity. In patients with recurrent reproductive failure, disturbances in matrix remodeling, fibrosis, hypoplasia, and a decrease in the expression of key molecules are observed. Morphological methods, including histochemistry and immunohistochemistry, combined with ultrasound and transcriptomic analysis, enable a comprehensive assessment of endometrial status.
Conclusion: Endometrial stroma ECM is crucial in determining the stroma’s functional state. Integrating morphological, molecular, and imaging diagnostic methods enhances the accuracy of receptivity assessment and opens new opportunities for a personalized approach in reproductive medicine.
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Copyright (c) 2025 Н.М. Ошахтиева, Е.К. Камышанский, Р.Ф. Гатин, К.Ш. Махамбетова, А.К. Ыбырайымбек, В.Ф. Беженарь, И.В. Механцева
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