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A role for menstruation in preconditioning the uterus for successful pregnancy
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Brosens, Jan J., Parker, Malcolm G., McIndoe, Angus, Pijnenborg, Robert and Brosens, Ivo A.. (2009) A role for menstruation in preconditioning the uterus for successful pregnancy. American Journal of Obstetrics and Gynecology, Vol.200 (No.6). 615.e1-615.e6. ISSN 0002-9378
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Official URL: http://dx.doi.org/10.1016/j.ajog.2008.11.037
Abstract
Menstruation is widely viewed as serving no purpose other than to reinitiate the endometrial cycle in the absence of pregnancy. Yet, it is striking that cyclic endometrial decidualization followed by menstrual shedding is confined to the few species, including human beings, where placenta formation entails deep trophoblast invasion of maternal tissues and its vasculature. Both menstruation and pregnancy are inflammatory conditions that cause a degree of physiological ischemia-reperfusion tissue injury, albeit much more so in pregnancy. Thus, the emergence of cyclic menstruation may not have been an evolutionary coincidence but serves to protect uterine tissues from the profound hyperinflammation and oxidative stress associated with deep placentation, a process known as preconditioning. The concept of menstrual preconditioning provides a novel paradigm for understanding how reproductive disorders impact on pregnancy outcome. For example, endometriosis could be viewed as a disorder of exaggerated menstrual preconditioning that confers protection against placentation-related disorders, such as preeclampsia.
| Item Type: | Journal Article |
|---|---|
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Warwick Medical School > Reproductive Health Faculty of Medicine > Warwick Medical School |
| Journal or Publication Title: | American Journal of Obstetrics and Gynecology |
| Publisher: | Mosby-Elsevier |
| ISSN: | 0002-9378 |
| Date: | June 2009 |
| Volume: | Vol.200 |
| Number: | No.6 |
| Page Range: | 615.e1-615.e6 |
| Identification Number: | 10.1016/j.ajog.2008.11.037 |
| Status: | Peer Reviewed |
| Publication Status: | Published |
| Access rights to Published version: | Restricted or Subscription Access |
| URI: | http://wrap.warwick.ac.uk/id/eprint/45113 |
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