Obesity and Peri-Implantation Endometrium

This thesis explored the impact of obesity on the peri-implantation endometrium and reproductive outcomes. It found that obese women were more likely to experience miscarriages involving empty gestational sacs or anembryonic pregnancies, possibly due to impaired endometrial selection of normal pregnancies. The study showed no difference in immune cell density in the endometrium between obese and normal weight women, indicating that endometrial dysfunction in obese women is not immune-mediated. However, the clonogenic capacity of endometrial mesenchymal stem cells was negatively correlated with BMI, suggesting reduced regenerative capacity in obese women. Additionally, an obesogenic environment impaired stromal cell decidualisation, as evidenced by inhibited PRL expression in the presence of adipose tissue supernatant from obese women. These findings highlighted the metabolic influences on endometrial stromal function in obese women.