{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:23:40Z","timestamp":1790011420316,"version":"4.0.1"},"reference-count":50,"publisher":"The Endocrine Society","issue":"6","funder":[{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012264","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["Z01ES103333"],"award-info":[{"award-number":["Z01ES103333"]}],"id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Low vitamin D levels have been associated with female infertility, but the underlying mechanisms are not understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine vitamin D treatment, in vitro and in vivo, on human endometrial stromal cell (eSC) decidualization, including mediating pathways and to assess the feasibility of vitamin D measurement in menstrual effluent (ME).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>ME, ME-derived endometrial stromal cells, and peripheral plasma were collected from participants in the Research Outsmarts Endometriosis (ROSE) study (2017-2024) and the Investigation of Vitamin D and Menstrual Cycles trial (inVitD) (2022-2024; NCT05050916).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>ROSE study: North America; inVitD study: Detroit, Michigan, and Durham, North Carolina.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Healthy females aged 19 to 40 years. The inVitD trial participants provided ME pre- and post-cholecalciferol supplementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Oral cholecalciferol supplementation (50 000\u2005IU\/week or 4200\u2005IU\/week \u00d7 3 months) was provided to vitamin D deficient inVitD trial participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure<\/jats:title>\n                    <jats:p>First, we examined the effect of active vitamin D (calcitriol) on ME-eSC decidualization in vitro. Second, we compared ME-eSC decidualization pre- and post-oral cholecalciferol supplementation. Mechanistic studies investigated target signaling proteins and mRNA expression. Third, we compared levels of vitamin D biomarkers in peripheral plasma vs ME.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Calcitriol increased eSC decidualization measured by insulin-like growth factor-binding protein 1 (P &amp;lt; .0001) and prolactin levels (P &amp;lt; .0001). Calcitriol and decidualization alone induced VDR mRNA expression. Calcitriol reduced protein kinase B (AKT) and proline-rich AKT substrate of 40\u2005kDa phosphorylation during decidualization. Decidualization capacity increased following in vivo cholecalciferol supplementation (P = .07). Peripheral plasma 1,25-dihydroxyvitamin D levels were correlated with ME levels (r = 0.66, P = .01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Vitamin D enhances eSC decidualization, likely through reduced AKT signaling and downstream events, highlighting its potential role in fertility. Vitamin D biomarkers were measurable in ME.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf708","type":"journal-article","created":{"date-parts":[[2026,1,4]],"date-time":"2026-01-04T12:27:48Z","timestamp":1767529668000},"page":"e1532-e1543","source":"Crossref","is-referenced-by-count":5,"title":["Leveraging Menstrual Effluent to Investigate Vitamin D and Human Decidualization: A Potential Link with Fertility"],"prefix":"10.1210","volume":"111","author":[{"given":"Christine N","family":"Metz","sequence":"first","affiliation":[{"name":"Northwell, Institute of Molecular Medicine, The Feinstein Institutes for Medical Research , Manhasset, NY 11030 ,","place":["USA"]},{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell , Hempstead, NY 11549 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prodyot K","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Northwell, Institute of Molecular 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