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Objective: To study the specific mechanisms through which progesterone and selective progesterone receptor modulators impact the growth, synthesis, and accumulation of the extracellular matrix in uterine leiomyomas., Design: Laboratory study., Setting: Academic Research Institutions., Patients (s): This study involved reproductive-age women diagnosed with infertility associated uterine leiomyomas who underwent myomectomy either after selective progesterone receptor modulator ulipristal acetate (UA) treatment or without any pharmacological pretreatment. Control samples included healthy myometrium tissue (n = 100). Specimens were obtained from the Department of Reproduction and Gynecological Endocrinology and Biobank, Medical University of Bialystok, Poland., Interventions: Daily (5 mg/d) UA treated for 2 months (n = 100) and untreated (n = 150) patients with uterine leiomyomas or normal healthy myometrium (n = 100) tissue samples immediately after surgery were collected for transcriptional analysis and assessments., Main Outcome Measures: Progesterone-induced activation of the signaling pathways related to uterine leiomyomas extracellular matrix synthesis, deposition, and growth, as well as the expression profile of progesterone receptors in uterine leiomyomas, were assessed., Results: The results indicated that progesterone activated the transforming growth factor-β and SMAD3 signaling pathways and promoted proliferation, growth, and extracellular matrix remodeling in uterine leiomyomas by up-regulating SMAD3, transforming growth factor-β (TGF-β) receptor type 1 and II, Ras homolog A, vascular endothelial growth factor, or increasing the fibrosis-related gene collagen, type I, ɑ-1, and procollagen, type I, ɑ-1 production. In contrast, UA had inhibitory effects on these processes. The study also showed that both nuclear and membrane progesterone receptors play distinct roles in uterine leiomyoma pathobiology., Conclusions: We showed that both nuclear and membrane progesterone receptors were relevant in the treatment of uterine leiomyomas, especially when combined with selective progesterone receptor modulators. Novel therapeutic approaches combining selective progesterone receptor modulators with or without direct and indirect extracellular matrix targeting through selected specifically TGF-β and SMAD3 (SMAD3, TGF-β receptor types 1 and II, Ras homolog A, vascular endothelial growth factor, collagen, type I, ɑ-1) signaling pathways could therefore be a treatment option for uterine leiomyomas., Competing Interests: Declaration of Interests G.M. has nothing to disclose. D.P.T. has nothing to disclose. P.B. has nothing to disclose. O.L. has nothing to disclose. M.Sz. has nothing to disclose. M.S. has nothing to disclose. A.P.P. has nothing to disclose. M.K. has nothing to disclose. T.B. has nothing to disclose. M.Z.K. has nothing to disclose. A.P. has nothing to disclose. J.T. has nothing to disclose. X.L. has nothing to disclose. I.H. has nothing to disclose. S.W. has nothing to disclose. N.A.R. has nothing to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Despite the willingness, humans belong to the species with the limited procreation possibilities. Infertility affects about 15% of population is the very important subject for the reproductive medicine. An assisted reproductive technology (ART) offers the significant chance for the infertile couples, but it does not give the guarantee for the pregnancy and for the birth of a healthy child. The implantation of embryo, despite numerous trials and attempts, remain the last barrier in the assisted reproduction technologies; thus, the endometrial receptivity becomes the subject of permanent interest. In this review we have tried to present various methods of improvement of an endometrial receptivity with the conclusion that we still wait for the valuable prognostic factor in the treatment of infertility by ART which could predict the chance for the birth of a healthy child.

Recently, a dramatic increase in the average life expectancy has been noted, regarded as the one of the greatest achievements of the last decades, but in consequence osteoporosis affects millions of people all over the world. Currently osteoporosis is defined as a skeletal disorder characterized by compromised bone strength which leads to an increased risk of fractures. The most commonly used tool to evaluate the 10-year risk of fractures is the fracture risk assessment tool validated in many independent cohorts. Osteoporosis itself has no symptoms, but fractures are common symptoms of osteoporosis which can result in disability and mortality. Hence, osteoporosis is called a silent epidemic as well as a silent killer. The best way to assess patients with osteoporosis is by using the most widely employed techniques - dual-energy X-ray absorptiometry or quantitative computed tomography. There are a lot of precisely documented risk factors of osteoporosis - e.g. cigarette smoking, alcohol use, getting little or no exercise, being small-framed or thin, a diet low in foods containing calcium and vitamin D - and their limitation or elimination is the best way for prophylactics of this dangerous disease. Some other risk factors such as age and sex of patients should not be omitted in the decision making process. In the literature there are numerous therapeutic proposals and different guidelines. In this review we present the recent advances in the prophylactics and treatment of osteoporosis., Competing Interests: The authors report no conflict of interest., (Copyright © 2022 Termedia.)