Metabolic and Nutritional Impact on Endometrial Gene Expression and Reproductive Disorder

  • Lianghui DiaoEmail author
  • Songchen Cai
  • Jinli Ding
  • Yong Zeng


During pregnancy, a woman’s body undergoes a series of adaptations to nourish the fetus for proper growth in the uterus and prepare the body for childbirth. The physiological and anatomical adaptations take place in various organ systems, such as reproductive, immune, and gastrointestinal systems, and start in the early stage of the first trimester, and some changes even initiate before conception. These changes peak at the third trimester or term, and the restoration to the basal level may take a few weeks after delivery. The significant changes in the body due to pregnancy lead to distinct demands for oxygen, nutrients, and metabolites, which, in turn, reshape the microenvironments in the uterus to facilitate implantation and pregnancy maintenance. The decidual stromal cells and the immune cells are the major players in the maternal-fetal interface. While most of the studies have focused on the metabolism of stromal cells during decidualization, the role of immunometabolism underlying maternal-fetal tolerance remains mostly unknown, and the insights in the context of pregnancy nowadays are mainly inspired by researches from other fields. Direct evidence to support the relationship between cellular function and metabolism came from the observation of metabolic gene expressions in reproductive disorders, metabolic syndromes, and animal models. It should be noticed that limited knowledge of the metabolic reprogramming has impeded the clinical development of a metabolism-related intervention during pregnancy. Here, we summarize the evidence and insights currently known and the open issues that remain to be solved regarding the metabolic and nutritional impact on endometrial gene expression and reproductive disorder.


Metabolic reprogramming Nutritional intervention Endometrial gene expression Decidualization Immunometabolism Reproductive disorder 



The writing of this chapter and reference to the authors’ work were made possible through funding by the National Natural Science Foundation of China (No. 81701529), Special Funds for Science and Technology Development of Guangdong Province (2017A020214006), and Sanming Project of Medicine in Shenzhen (SZSM201502035).


LH.D. conceived and developed the structure. SC.C. provided the first version of the manuscript, which was amended by JL.D. on the context related to clinical trials, and by LH.D. on the issues related to the interpretation of the published evidence regarding the metabolic pathways, endometrial gene expression, and reproductive disorder. All authors are involved in revised the manuscript and gave their final approval of the version.


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Lianghui Diao
    • 1
    Email author
  • Songchen Cai
    • 1
  • Jinli Ding
    • 2
  • Yong Zeng
    • 1
  1. 1.Shenzhen Key Laboratory for Reproductive Immunology of Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and GeneticsShenzhen Zhongshan Urology HospitalShenzhenChina
  2. 2.Reproductive Medical Center, Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic DevelopmentRenmin Hospital of Wuhan UniversityWuhanChina

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