Online courses

Reproductive endocrinology

We welcome you to a selection of talks from "Endometrial Biology and Pathologies: Transdisciplinary Science Meets Clinical Practice." We are honored to present to you recognized experts from multiple disciplines who present their latest findings and discuss the challenges of translating scientific knowledge into potential applications in reproductive medicine. The program addresses cutting edge research on the biology of the endometrium. Thank you for participating in this self-study course.

Dr. Giudice's presentation: the human endometrium undergoes striking ultrasonographic, morphologic, histologic, and gene expression and protein modifications throughout the normal menstrual cycle. Genome-wide gene expression profiling has been used to assess changes in molecular and cellular functions and biochemical processes and pathways at distinct times of the cycle that have added to our understanding of this complex tissue as a target of steroid hormone action. In addition, molecular profiling of abnormal endometrium has given insight into processes occurring in and classification of endometrial cancers and other disorders of the endometrium, including endometriosis and endometrial hyperplasias.

Cytokines and Chemokines: Roles In Endometrial Function

Dr. Salamonsen's presentation: The highly dynamic and constant remodelling of the endometrium includes changes in cellular composition and differentiation, driven by the ovarian hormones and by locally acting factors. Additional changes occur following blastocyst apposition to the endometrium and with trophoblast invasion: endometrial factors then act locally also on the trophoblast to facilitate its invasion, and contribute to placentation. Cytokines and chemokines play critical roles in these processes. Dynamic changes in endometrial chemokines are important for cycle-phase specific, selective recruitment of leukocytes into the endometrium with chemokine production by glands being predominant during the phase of uterine receptivity and changing as the pre-menstrual changes occur. Importantly, chemokine receptors are expressed not only on subpopulations of endometrial leukocytes (indicating a role for chemokines in their recruitment and trafficking) but also on blastocysts and on extravillous trophoblast in first trimester decidua. Thus in the endometrium and during

Genetics Of Endometriosis In Humans and Non-human Primates

Dr. Kennedy's presentation: In a complex genetic trait, more than one genetic variant is usually involved, the relative risk in first degree relatives is elevated, and genes interact with each other and environmental factors to produce the disease phenotype. This talk reviews the evidence for a genetic basis to endometriosis. Multiple genes/chromosomal regions have been implicated in endometriosis. Affected sibling-pair analyses are presented.

Immune Mechanisms Promote Establishment & Survival Of Endometriotic Lesions

Dr. Taylors's presentation: Endometriosis affects about 150 million women world-wide and accounts for more than one billion dollars in direct medical and surgical health expenses annually. A variety of theories has been promulgated to explain the etiology of this condition, yet the precise pathogenic mechanisms responsible for pelvic pain and infertility associated with endometriosis remain unknown. Multiple examples of cellular dysregulation in endometriotic tissues have been discovered. Several aberrant immune responses, including leukocyte recruitment and activation, represent credible explanations for the molecular, cellular and symptom profiles observed in women with endometriosis. This talk provides a summary of these derangements, and possible ways to assess and correct them.

Emerging Treatments For Endometriosis

Dr. Bulun's presentation: Two emerging groups of compounds are candidates to become important therapeutic agents for endometriosis: (i) aromatase inhibitors and (ii) selective progesterone receptor modulators (SPRMs). These compounds have been used in phase II trials for endometriosis. This talk provides a review of the molecular basis for the use of aromatase inhibitors and SPRMs in endometriosis.

Abnormal Uterine Bleeding: Pathology and Treatment

Dr. Critchley's presentation: Menstruation is a manifestation of cyclical ovarian function. In the absence of pregnancy, at the time of luteal regression, the superficial two thirds of the endometrium is shed in response to the decline in circulating estrogen and progesterone concentrations. In developed countries today women may expect to menstruate over 400 times during their reproductive life span. Menstrual disorders impose a significant impact on quality of life for healthy women and management typically involves potent drugs or invasive surgery. Menstrual dysfunction is the consequence of disturbances in regulation, expression and signalling of local mediators within the endometrium. Several local factors may be outside normal limits of regulation within the endometrial environment in women complaining of abnormal uterine bleeding. It is essential to understand mechanisms involved in uterine bleeding if modulation of this physiological process is to be achieved and thereby improved medical treatment strategies developed and surgical intervention avoided for benign menstrual complaint.

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