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Using primary human cell cultures, we first demonstrated that obesity is associated with significantly lower in vitro decidualization of endometrial stromal cells (ESCs). We then showed that a trophoblastic cell line's invasive ability was greater in the presence of conditioned media from cultures of ESCs from obese women. The results of functional assays indicated that supplementation of the culture medium with EVs from nonobese women can rescue (at least in part) the defect in in vitro decidualization described in ESCs from obese women. Furthermore, exposure to endometrial EVs from obese women (vs. nonobese women) was associated with significantly greater invasive activity by HTR\u20108\/SVneo cells. Using mass\u2010spectrometry\u2010based quantitative proteomics, we found that EVs isolated from uterine supernatants of biopsies from obese women (vs. nonobese women) presented a molecular signature focused on cell remodelling and angiogenesis. The proteomics analysis revealed two differentially expressed proteins (fibronectin and angiotensin\u2010converting enzyme) that might be involved specifically in the rescue of the decidualization capacity in ESCs from obese women; both of these proteins are abundantly present in endometrial EVs from nonobese women, and both are involved in the decidualization process. In conclusion, our results provided new insights into the endometrial EVs\u2019 pivotal role in the poor uterine receptivity observed in obese women.<\/jats:p>","DOI":"10.1002\/jex2.103","type":"journal-article","created":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T11:38:48Z","timestamp":1689680328000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The effect of obesity on uterine receptivity is mediated by endometrial extracellular vesicles that control human endometrial stromal cell decidualization and trophoblast invasion"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1520-8181","authenticated-orcid":false,"given":"Laurent","family":"Galio","sequence":"first","affiliation":[{"name":"Universit\u00e9 Paris\u2010Saclay, UVSQ, INRAE, BREED Jouy\u2010en\u2010Josas France"},{"name":"Ecole Nationale V\u00e9t\u00e9rinaire d'Alfort, BREED Maisons\u2010Alfort 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