{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:17:53Z","timestamp":1793189873731,"version":"4.5.0"},"reference-count":176,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T00:00:00Z","timestamp":1689811200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002301","name":"Estonian Research Council","doi-asserted-by":"publisher","award":["PRG1076"],"award-info":[{"award-number":["PRG1076"]}],"id":[{"id":"10.13039\/501100002301","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002301","name":"Estonian Research Council","doi-asserted-by":"publisher","award":["MOBJD1056"],"award-info":[{"award-number":["MOBJD1056"]}],"id":[{"id":"10.13039\/501100002301","id-type":"DOI","asserted-by":"publisher"}]},{"name":"ERIN","award":["EU952516"],"award-info":[{"award-number":["EU952516"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Modern lifestyle has led to an increase in the age at conception. Advanced age is one of the critical risk factors for female-related infertility. It is well known that maternal age positively correlates with the deterioration of oocyte quality and chromosomal abnormalities in oocytes and embryos. The effect of age on endometrial function may be an equally important factor influencing implantation rate, pregnancy rate, and overall female fertility. However, there are only a few published studies on this topic, suggesting that this area has been under-explored. Improving our knowledge of endometrial aging from the biological (cellular, molecular, histological) and clinical perspectives would broaden our understanding of the risks of age-related female infertility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE AND RATIONALE<\/jats:title>\n                    <jats:p>The objective of this narrative review is to critically evaluate the existing literature on endometrial aging with a focus on synthesizing the evidence for the impact of endometrial aging on conception and pregnancy success. This would provide insights into existing gaps in the clinical application of research findings and promote the development of treatment options in this field.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SEARCH METHODS<\/jats:title>\n                    <jats:p>The review was prepared using PubMed (Medline) until February 2023 with the keywords such as \u2018endometrial aging\u2019, \u2018receptivity\u2019, \u2018decidualization\u2019, \u2018hormone\u2019, \u2018senescence\u2019, \u2018cellular\u2019, \u2018molecular\u2019, \u2018methylation\u2019, \u2018biological age\u2019, \u2018epigenetic\u2019, \u2018oocyte recipient\u2019, \u2018oocyte donation\u2019, \u2018embryo transfer\u2019, and \u2018pregnancy rate\u2019. Articles in a language other than English were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OUTCOMES<\/jats:title>\n                    <jats:p>In the aging endometrium, alterations occur at the molecular, cellular, and histological levels suggesting that aging has a negative effect on endometrial biology and may impair endometrial receptivity. Additionally, advanced age influences cellular senescence, which plays an important role during the initial phase of implantation and is a major obstacle in the development of suitable senolytic agents for endometrial aging. Aging is also accountable for chronic conditions associated with inflammaging, which eventually can lead to increased pro-inflammation and tissue fibrosis. Furthermore, advanced age influences epigenetic regulation in the endometrium, thus altering the relation between its epigenetic and chronological age. The studies in oocyte donation cycles to determine the effect of age on endometrial receptivity with respect to the rates of implantation, clinical pregnancy, miscarriage, and live birth have revealed contradictory inferences indicating the need for future research on the mechanisms and corresponding causal effects of women\u2019s age on endometrial receptivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WIDER IMPLICATIONS<\/jats:title>\n                    <jats:p>Increasing age can be accountable for female infertility and IVF failures. Based on the complied observations and synthesized conclusions in this review, advanced age has been shown to have a negative impact on endometrial functioning. This information can provide recommendations for future research focusing on molecular mechanisms of age-related cellular senescence, cellular composition, and transcriptomic changes in relation to endometrial aging. Additionally, further prospective research is needed to explore newly emerging therapeutic options, such as the senolytic agents that can target endometrial aging without affecting decidualization. Moreover, clinical trial protocols, focusing on oocyte donation cycles, would be beneficial in understanding the direct clinical implications of endometrial aging on pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/humupd\/dmad019","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T17:56:35Z","timestamp":1688493395000},"page":"773-793","source":"Crossref","is-referenced-by-count":182,"title":["Endometrial receptivity in women of advanced age: an underrated factor in infertility"],"prefix":"10.1093","volume":"29","author":[{"given":"Amruta D S","family":"Pathare","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu , Tartu, Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Loid","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu , Tartu, Estonia"},{"name":"Competence Centre on Health Technologies , Tartu, Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0221-2093","authenticated-orcid":false,"given":"Merli","family":"Saare","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu , Tartu, Estonia"},{"name":"Competence Centre on Health Technologies , Tartu, Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian Brusell","family":"Gidl\u00f6f","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute and Karolinska University Hospital , Stockholm, Sweden"},{"name":"Department of Gynecology and Reproductive Medicine, Karolinska University Hospital , Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3909-0050","authenticated-orcid":false,"given":"Masoud","family":"Zamani Esteki","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute and Karolinska University Hospital , Stockholm, Sweden"},{"name":"Department of Clinical Genetics, Maastricht University Medical Centre+ , Maastricht, The Netherlands"},{"name":"Department of Genetics and Cell Biology, GROW School for Oncology and Reproduction, Maastricht University , Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesh","family":"Acharya","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute and Karolinska University Hospital , Stockholm, Sweden"},{"name":"Department of Clinical Medicine, Women\u2019s Health and Perinatology Research Group, UiT The Arctic University of Norway , Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maire","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu , Tartu, Estonia"},{"name":"Competence Centre on Health Technologies , Tartu, Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1251-8160","authenticated-orcid":false,"given":"Andres","family":"Salumets","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu , Tartu, Estonia"},{"name":"Competence Centre on Health Technologies , Tartu, Estonia"},{"name":"Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute and Karolinska University Hospital , Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,7,19]]},"reference":[{"key":"2023110708000672200_dmad019-B1","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1093\/oxfordjournals.humrep.a137209","article-title":"A report on 100 cycles of oocyte donation; 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