ABSTRACT
In women and menstruating nonhuman primates, regeneration of the endometrium is essential for the resumption of reproductive fertility. The capacity for renewal of this adult reproductive tract tissue is truly remarkable and attests to its pivotal role in normal reproduction. Because the endometrial “wound” can regenerate in the absence of ovarian hormonal support, it is likely that normal wound healing mechanisms also play a role in regeneration. Numerous autocrine/paracrine growth factors and cytokines are also expected to initiate and support the remodeling and reconstruction of the endometrium. Many of these factors are present in inflammatory cells that infiltrate the endometrial wound, i.e. platelets and macrophages. The massive uterine involution that occurs following parturition constitutes another normal physiological process of mammals that requires endometrial restoration. In addition to the extensive endometrial remodeling required following menses and postpartum uterine involution, there is evidence for subtle epithelial turnover (apoptosis or shedding) during the female cycle independent of menses. Although this chapter will focus primarily on endometrial regeneration during menses, uterine involution and repair as well as restorative processes of the endometrium unrelated to menses will also be discussed.
