{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T15:52:50Z","timestamp":1772466770784,"version":"3.50.1"},"reference-count":83,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CIMB"],"abstract":"<jats:p>Infertility affects a substantial proportion of women of reproductive age and is frequently associated with impaired endometrial receptivity. Successful implantation depends on tightly regulated hormonal, immune, apoptotic, and stress-response pathways within the endometrium. This pilot study aimed to evaluate the expression and distribution of granulocyte colony-stimulating factor (G-CSF), bone morphogenetic proteins 2\/4 (BMP-2\/4), heat shock protein 70 (HSP-70), apoptosis, progesterone, estrogen, and pentraxin-3 (PTX-3) in the endometrium of infertile women across different menstrual cycle days. A descriptive cross-sectional analysis was performed on endometrial tissue samples obtained from six infertile women aged 21\u201349 years at various menstrual cycle days. Routine histology, immunohistochemistry, TUNEL assay, and chromogenic in situ hybridization were used to assess tissue morphology, protein expression, apoptotic activity, and PTX-3 gene expression. Quantitative evaluation was applied to immunohistochemical markers and apoptosis, while PTX-3 expression was assessed semi-quantitatively. G-CSF expression showed low-to-moderate levels with a relative mid-cycle increase. BMP-2\/4 demonstrated the highest overall positivity across most cycle days, with marked inter-sample variability. HSP-70 exhibited pronounced cycle-dependent variability. Apoptotic activity increased toward mid-to-late cycle days. Progesterone and estrogen positivity was heterogeneous and limited to selected cycle days. PTX-3 gene expression was highest during mid-cycle days and decreased toward later phases. No clear association with patient age was observed. Conclusions: The findings indicate distinct and cycle-dependent patterns of immune, morphogenetic, apoptotic, hormonal, and inflammatory markers in the endometrium of infertile women. These results highlight the dynamic nature of endometrial regulation and suggest that altered temporal coordination of these pathways may contribute to impaired endometrial receptivity.<\/jats:p>","DOI":"10.3390\/cimb48030264","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T14:06:56Z","timestamp":1772460416000},"page":"264","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cycle-Dependent Expression of Immune, Morphogenetic, Apoptotic, and Steroid-Related Markers in the Endometrium of Infertile Women: A Pilot Study"],"prefix":"10.3390","volume":"48","author":[{"given":"Elizabete","family":"Brikune","sequence":"first","affiliation":[{"name":"RSU Institute of Anatomy and Anthropology, Eksporta Street 1A, LV-1010 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9804-4666","authenticated-orcid":false,"given":"M\u0101ra","family":"Pilmane","sequence":"additional","affiliation":[{"name":"RSU Institute of Anatomy and Anthropology, Eksporta Street 1A, LV-1010 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Brikune","sequence":"additional","affiliation":[{"name":"AVA Clinic, Sabiedr\u012bba ar Ierobe\u017eotu Atbild\u012bbu (Limited Liability Company), Bazn\u012bcas Street 20\/22, LV-1010 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"ref_1","first-page":"308","article-title":"Evaluation and treatment of infertility","volume":"91","author":"Lindsay","year":"2015","journal-title":"Am. Fam. Physician"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Dias Da Silva, I., Wuidar, V., Zielonka, M., and Pequeux, C. (2024). Unraveling the dynamics of estrogen and progesterone signaling in the endometrium: An overview. Cells, 13.","DOI":"10.3390\/cells13151236"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.semcdb.2022.03.039","article-title":"Human placental development and function","volume":"131","year":"2022","journal-title":"Semin. Cell Dev. Biol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1056\/NEJMra1810764","article-title":"Endometriosis","volume":"382","author":"Zondervan","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"112903","DOI":"10.1016\/j.biopha.2022.112903","article-title":"Granulocyte colony-stimulating factor in reproductive-related disease: Function, regulation and therapeutic effect","volume":"150","author":"Ding","year":"2022","journal-title":"Biomed. Pharmacother."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1034\/j.1600-0897.2003.00024.x","article-title":"Granulocyte colony-stimulating factor suppresses interleukin-12 and\/or interleukin-2-induced interferon-\u03b3 production and cytotoxicity of decidual mononuclear cells","volume":"50","author":"Sugita","year":"2003","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_7","first-page":"81","article-title":"Production of granulocyte colony-stimulating factor in decidual tissue and its significance in pregnancy","volume":"36","author":"Duan","year":"1990","journal-title":"Osaka City Med. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1126\/science.150.3698.893","article-title":"Bone: Formation by autoinduction","volume":"150","author":"Urist","year":"1965","journal-title":"Science"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1210\/jc.2010-1450","article-title":"Leiomyoma simultaneously impair endometrial BMP-2-mediated decidualization and anticoagulant expression through secretion of TGF-\u03b23","volume":"96","author":"Sinclair","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1210\/en.2007-0849","article-title":"Opposite regulation of transforming growth factor-\u03b22 and -\u03b23 expression in the human endometrium","volume":"149","author":"Cornet","year":"2008","journal-title":"Endocrinology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.cytogfr.2005.01.009","article-title":"BMP receptor signaling: Transcriptional targets, regulation of signals, and signaling cross-talk","volume":"16","author":"Miyazono","year":"2005","journal-title":"Cytokine Growth Factor Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"7023","DOI":"10.1111\/jcmm.15372","article-title":"BMP2 regulates Serpinb6b expression via cAMP\/PKA\/Wnt4 pathway during uterine decidualization","volume":"24","author":"Yu","year":"2020","journal-title":"J. Cell. Mol. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1101\/gad.10.13.1580","article-title":"Bone morphogenetic proteins: Multifunctional regulators of vertebrate development","volume":"10","author":"Hogan","year":"1996","journal-title":"Genes Dev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/S0092-8674(03)00847-X","article-title":"BMP induction of Id proteins suppresses differentiation and sustains embryonic stem cell self-renewal in collaboration with STAT3","volume":"115","author":"Ying","year":"2003","journal-title":"Cell"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"114015","DOI":"10.1016\/j.intimp.2025.114015","article-title":"Deletion of BMP4 impairs trophoblast function and decidual macrophage polarization via autophagy leading to recurrent spontaneous abortion","volume":"147","author":"Tang","year":"2025","journal-title":"Int. Immunopharmacol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"bqae049","DOI":"10.1210\/endocr\/bqae049","article-title":"BMP4 in human endometrial stromal cells can affect decidualization by regulating FOXO1 expression","volume":"165","author":"Huang","year":"2024","journal-title":"Endocrinology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1093\/humupd\/dmad031","article-title":"Roles of bone morphogenetic proteins in endometrial remodeling during the human menstrual cycle and pregnancy","volume":"30","author":"Wei","year":"2024","journal-title":"Hum. Reprod. Update"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1688","DOI":"10.1016\/j.fertnstert.2014.02.040","article-title":"The WNT\/\u03b2-catenin signaling pathway and expression of survival-promoting genes in luteinized granulosa cells: Endometriosis as a paradigm for a dysregulated apoptosis pathway","volume":"101","author":"Sanchez","year":"2014","journal-title":"Fertil. Steril."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1002\/(SICI)1098-0997(1999)7:1\/2<5::AID-IDOG2>3.0.CO;2-Y","article-title":"Heat shock proteins in human endometrium throughout the menstrual cycle","volume":"7","author":"Tabibzadeh","year":"1999","journal-title":"Infect. Dis. Obstet. Gynecol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"103829","DOI":"10.1016\/j.jri.2023.103829","article-title":"HSP70 regulates lipid metabolism of decidual macrophages to maintain normal pregnancy","volume":"156","author":"Yang","year":"2023","journal-title":"J. Reprod. Immunol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/aji.12525","article-title":"Potential role of heat-shock protein 70 and interleukin-15 in the pathogenesis of threatened spontaneous abortions","volume":"76","author":"Gulic","year":"2016","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s12192-008-0067-8","article-title":"Increased serum heat-shock protein 70 levels reflect systemic inflammation, oxidative stress and hepatocellular injury in preeclampsia","volume":"14","author":"Molvarec","year":"2009","journal-title":"Cell Stress Chaperones"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/978-1-61779-860-3_5","article-title":"Detection of apoptosis by TUNEL assay","volume":"887","author":"Kyrylkova","year":"2012","journal-title":"Methods Mol. Biol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Mirzayans, R., and Murray, D. (2020). Do TUNEL and other apoptosis assays detect cell death in preclinical studies?. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21239090"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Moore, C.L., Savenka, A.V., and Basnakian, A.G. (2021). TUNEL assay: A powerful tool for kidney injury evaluation. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22010412"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1080\/01926230701320337","article-title":"Apoptosis: A review of programmed cell death","volume":"35","author":"Elmore","year":"2007","journal-title":"Toxicol. Pathol."},{"key":"ref_27","first-page":"4144","article-title":"Apoptosis in the human uterine endometrium during the menstrual cycle","volume":"81","author":"Kokawa","year":"1996","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"9744","DOI":"10.1073\/pnas.1732707100","article-title":"Defective mammary gland morphogenesis in mice lacking the progesterone receptor B isoform","volume":"100","author":"Lydon","year":"2003","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"4809","DOI":"10.1210\/endo.140.10.7070","article-title":"Progesterone receptor regulates decidual prolactin expression in differentiating human endometrial stromal cells","volume":"140","author":"Brosens","year":"1999","journal-title":"Endocrinology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/aogs.12770","article-title":"Clinical use of progesterone in infertility and assisted reproduction","volume":"94","author":"Ciampaglia","year":"2015","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.mce.2011.10.035","article-title":"Mechanisms of endometrial progesterone resistance","volume":"358","author":"Lam","year":"2012","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.jsbmb.2008.03.027","article-title":"Estetrol: A unique steroid in human pregnancy","volume":"110","author":"Holinka","year":"2008","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"329","DOI":"10.11613\/BM.2014.035","article-title":"The many faces of estrogen signaling","volume":"24","author":"Ostanek","year":"2014","journal-title":"Biochem. Med."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Greygoose, E., Metharom, P., Kula, H., Seckin, T.K., Seckin, T.A., Ayhan, A., and Yu, Y. (2025). The estrogen\u2013immune interface in endometriosis. Cells, 14.","DOI":"10.3390\/cells14010058"},{"key":"ref_35","first-page":"4474","article-title":"Deficient 17\u03b2-hydroxysteroid dehydrogenase type 2 expression in endometriosis: Failure to metabolize 17\u03b2-estradiol","volume":"83","author":"Zeitoun","year":"1998","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Marquardt, R.M., Kim, T.H., Shin, J.H., and Jeong, J.W. (2019). Progesterone and estrogen signaling in the endometrium: What goes wrong in endometriosis?. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20153822"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1210\/en.2007-1302","article-title":"The long pentraxin PTX3 in human endometrium: Regulation by steroids and trophoblast products","volume":"149","author":"Popovici","year":"2008","journal-title":"Endocrinology"},{"key":"ref_38","unstructured":"Suvarna, S.K., Layton, C., and Bancroft, J.D. (2019). Bancroft\u2019s Theory and Practice of Histological Techniques, Elsevier."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"7633","DOI":"10.1073\/pnas.83.20.7633","article-title":"Isolation and characterization of the cDNA for murine granulocyte colony-stimulating factor","volume":"83","author":"Tsuchiya","year":"1986","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1038\/319415a0","article-title":"Molecular cloning and expression of cDNA for human granulocyte colony-stimulating factor","volume":"319","author":"Nagata","year":"1986","journal-title":"Nature"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1242\/dev.111.2.531","article-title":"Involvement of Bone Morphogenetic Protein-4 (BMP-4) and Vgr-1 in morphogenesis and neurogenesis in the mouse","volume":"111","author":"Jones","year":"1991","journal-title":"Development"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"5384","DOI":"10.1158\/1078-0432.CCR-05-2380","article-title":"Novel thioredoxin inhibitors paradoxically increase hypoxia-inducible factor-alpha expression but decrease functional transcriptional activity, DNA binding, and degradation","volume":"12","author":"Jones","year":"2006","journal-title":"Clin. Cancer Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"4096","DOI":"10.1128\/JVI.76.8.4096-4102.2002","article-title":"Heat shock cognate protein 70 is involved in rotavirus cell entry","volume":"76","author":"Guerrero","year":"2002","journal-title":"J. Virol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/S0039-128X(02)00039-9","article-title":"Comparison of different antibodies for detection of progesterone receptor in breast cancer","volume":"67","author":"Press","year":"2002","journal-title":"Steroids"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1095\/biolreprod66.4.1161","article-title":"Differential expression of estrogen receptors alpha and beta in the reproductive tracts of adult male dogs and cats","volume":"66","author":"Nie","year":"2002","journal-title":"Biol. Reprod."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1002\/path.1077","article-title":"Evaluation of seven oestrogen receptor beta antibodies for immunohistochemistry, western blotting, and flow cytometry in human breast tissue","volume":"197","author":"Skliris","year":"2002","journal-title":"J. Pathol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e110531","DOI":"10.5812\/aapm.110531","article-title":"Pulsed radiofrequency increases nestin and matrix metalloproteinase-2 expression in porcine lumbar dorsal root ganglion","volume":"12","author":"Arons","year":"2022","journal-title":"Anesth. Pain Med."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Jain, N., and Pilmane, M. (2021). Evaluating the expression of candidate homeobox genes and their role in local-site inflammation in mucosal tissue obtained from children with non-syndromic cleft lip and palate. J. Pers. Med., 11.","DOI":"10.3390\/jpm11111135"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.prp.2018.10.029","article-title":"The evaluation of inflammatory, anti-inflammatory and regulatory factors contributing to the pathogenesis of COPD in airways","volume":"215","author":"Vitenberga","year":"2019","journal-title":"Pathol. Res. Pract."},{"key":"ref_50","unstructured":"Barton, B., and Peat, J. (2014). Medical Statistics: A Guide to SPSS, Data Analysis and Critical Appraisal, Wiley."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jri.2015.01.010","article-title":"Treatment with granulocyte colony-stimulating factor in patients with repetitive implantation failures and\/or recurrent spontaneous abortions","volume":"108","year":"2015","journal-title":"J. Reprod. Immunol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2703","DOI":"10.1093\/humrep\/dep240","article-title":"Use of granulocyte colony-stimulating factor for the treatment of unexplained recurrent miscarriage: A randomised controlled trial","volume":"24","author":"Scarpellini","year":"2009","journal-title":"Hum. Reprod."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"254","DOI":"10.4103\/jhrs.JHRS_20_18","article-title":"Effect of intrauterine perfusion of granulocyte colony-stimulating factor on endometrial parameters and in vitro fertilization outcome in women undergoing IVF\/ICSI cycles: A randomized controlled trial","volume":"11","author":"Jain","year":"2018","journal-title":"J. Hum. Reprod. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/0165-2478(93)90165-X","article-title":"Suppression of natural killer cell activity by granulocytes in patients with aplastic anemia: Role of granulocyte colony-stimulating factor","volume":"39","author":"Taga","year":"1993","journal-title":"Immunol. Lett."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1007\/s43032-024-01527-6","article-title":"The effect of granulocyte colony-stimulating factor on endometrial receptivity of implantation failure mouse","volume":"32","author":"Yang","year":"2025","journal-title":"Reprod. Sci."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/j.fertnstert.2013.12.016","article-title":"A randomized clinical trial of endometrial perfusion with granulocyte colony-stimulating factor in IVF cycles: Impact on endometrial thickness and clinical pregnancy rates","volume":"101","author":"Barad","year":"2014","journal-title":"Fertil. Steril."},{"key":"ref_57","first-page":"278","article-title":"The role played by granulocyte colony-stimulating factor (G-CSF) in women submitted to in vitro fertilization associated with thin endometrium: Systematic review","volume":"24","author":"Rocha","year":"2020","journal-title":"JBRA Assist. Reprod."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1007\/s00404-018-4892-4","article-title":"Therapeutic role of granulocyte colony-stimulating factor (G-CSF) for infertile women undergoing IVF-ET treatment: A meta-analysis","volume":"298","author":"Zhang","year":"2018","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1530\/rep.1.01076","article-title":"TGF-beta superfamily expression and actions in the endometrium and placenta","volume":"132","author":"Jones","year":"2006","journal-title":"Reprod."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.cytogfr.2005.04.003","article-title":"BMPs: From bone morphogenetic proteins to body morphogenetic proteins","volume":"16","author":"Reddi","year":"2005","journal-title":"Cytokine Growth Factor Rev."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Massimiani, M., Lacconi, V., La Civita, F., Ticconi, C., Rago, R., and Campagnolo, L. (2019). Molecular signaling regulating endometrium\u2013blastocyst crosstalk. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21010023"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1002\/rmb2.12088","article-title":"Decidualization of the human endometrium","volume":"17","author":"Okada","year":"2018","journal-title":"Reprod. Med. Biol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/S0163-7258(98)00028-X","article-title":"Heat shock protein 70 kDa: Molecular biology, biochemistry, and physiology","volume":"80","author":"Kiang","year":"1998","journal-title":"Pharmacol. Ther."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1007\/s00018-004-4464-6","article-title":"Hsp70 chaperones: Cellular functions and molecular mechanism","volume":"62","author":"Mayer","year":"2005","journal-title":"Cell. Mol. Life Sci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1093\/HUMREP\/11.3.633","article-title":"Heat shock proteins in human endometrium throughout the menstrual cycle","volume":"11","author":"Tabibzadeh","year":"1996","journal-title":"Hum. Reprod."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Wu, J.X., Lin, S., and Kong, S.B. (2021). Psychological stress and functional endometrial disorders: Update of mechanism insights. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.690255"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0303-7207(00)00261-6","article-title":"Apoptosis and apoptosis-related proteins in human endometrium","volume":"165","author":"Vaskivuo","year":"2000","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1093\/humupd\/dmv038","article-title":"Menstrual physiology: Implications for endometrial pathology and beyond","volume":"21","author":"Maybin","year":"2015","journal-title":"Hum. Reprod. Update"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/j.mam.2012.12.011","article-title":"Physiological and molecular determinants of embryo implantation","volume":"34","author":"Zhang","year":"2013","journal-title":"Mol. Asp. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1210\/er.2014-1045","article-title":"Cyclic decidualization of the human endometrium in reproductive health and failure","volume":"35","author":"Gellersen","year":"2014","journal-title":"Endocr. Rev."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/S0301-2115(00)00554-6","article-title":"Androgen, estrogen and progesterone receptor expression in the human uterus during the menstrual cycle","volume":"98","author":"Mertens","year":"2001","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1055\/s-0029-1242991","article-title":"Estrogen receptor-\u03b2, estrogen receptor-\u03b1, and progesterone resistance in endometriosis","volume":"28","author":"Bulun","year":"2010","journal-title":"Semin. Reprod. Med."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1111\/aogs.13156","article-title":"Progesterone resistance in endometriosis: Origins, consequences and interventions","volume":"96","author":"Patel","year":"2017","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Ali, M., Ciebiera, M., Vafaei, S., Alkhrait, S., Chen, H.Y., Chiang, Y.F., Huang, K.C., Feduniw, S., Hsia, S.M., and Al-Hendy, A. (2023). Progesterone signaling and uterine fibroid pathogenesis: Molecular mechanisms and potential therapeutics. Cells, 12.","DOI":"10.3390\/cells12081117"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1055\/s-2007-991042","article-title":"Decidualization of the human endometrium: Mechanisms, functions, and clinical perspectives","volume":"25","author":"Gellersen","year":"2007","journal-title":"Semin. Reprod. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"S9","DOI":"10.1186\/1477-7827-4-S1-S9","article-title":"Estrogen receptor-\u03b1 and defects in uterine receptivity in women","volume":"4","author":"Lessey","year":"2006","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_77","first-page":"411","article-title":"Endometrial steroid receptor dysregulation and its association with vitamin D, AMH, and inflammation in recurrent implantation failure: A case-control study","volume":"19","author":"Rostami","year":"2025","journal-title":"Int. J. Fertil. Steril."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1146\/annurev.immunol.23.021704.115756","article-title":"Pentraxins at the crossroads between innate immunity, inflammation, matrix deposition, and female fertility","volume":"23","author":"Garlanda","year":"2005","journal-title":"Annu. Rev. Immunol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10875-007-9126-7","article-title":"Pentraxins in innate immunity: From C-reactive protein to the long pentraxin PTX3","volume":"28","author":"Mantovani","year":"2008","journal-title":"J. Clin. Immunol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1242\/dev.01056","article-title":"PTX3 plays a key role in the organization of the cumulus oophorus extracellular matrix and in vivo fertilization","volume":"131","author":"Salustri","year":"2004","journal-title":"Development"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1210\/mend.16.6.0859","article-title":"Knockout of pentraxin 3, a downstream target of growth differentiation factor-9, causes female subfertility","volume":"16","author":"Varani","year":"2002","journal-title":"Mol. Endocrinol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"30161","DOI":"10.1074\/jbc.M703738200","article-title":"PTX3 interacts with inter-\u03b1-trypsin inhibitor: Implications for hyaluronan organization and cumulus oophorus expansion","volume":"282","author":"Scarchilli","year":"2007","journal-title":"J. Biol. Chem."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.1210\/jcem.84.6.5886","article-title":"Hypoxia and cAMP stimulate vascular endothelial growth factor (VEGF) in human endometrial stromal cells: Potential relevance to menstruation and endometrial regeneration","volume":"84","author":"Popovici","year":"1999","journal-title":"J. Clin. Endocrinol. Metab."}],"container-title":["Current Issues in Molecular Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1467-3045\/48\/3\/264\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T14:53:29Z","timestamp":1772463209000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1467-3045\/48\/3\/264"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,2]]},"references-count":83,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["cimb48030264"],"URL":"https:\/\/doi.org\/10.3390\/cimb48030264","relation":{},"ISSN":["1467-3045"],"issn-type":[{"value":"1467-3045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,2]]}}}