Effects of Ovulation-Inducing Drugs on Endometrial Morphology and Expression of Receptivity-Related Factors

Abstract

Endometrial receptivity is a critical determinant for successful embryo implantation. The widespread use of ovulation-inducing
drugs in assisted reproductive technology exerts profound effects on the morphological structure and molecular microenvironment of the endometrium. This paper systematically reviews the impacts of commonly used ovulation-inducing drugs (clomiphene citrate, letrozole, GnRHa,
etc.) on morphological indicators of the endometrium such as thickness, gland development and stromal structure, and focuses on the regulatory mechanisms of these drugs on the expression of receptivity-related factors including integrin ?3, leukemia inhibitory factor and HOXA10.
Studies have demonstrated that different ovulation-inducing drugs exert differential effects on endometrial receptivity by altering sex hormone
levels and receptor expression status. Clomiphene citrate can impair endometrial thickness and gland development due to its anti-estrogenic
effect, while the inhibitory effect of letrozole is relatively mild. Although the GnRHa regimen can effectively control premature LH surges, its
inhibitory effect on endogenous estrogen may compromise the physiological maturation of the endometrium. A thorough understanding of the
molecular regulatory mechanisms of ovulation-inducing drugs on the endometrium is of great significance for optimizing ovulation-inducing
regimens and improving clinical pregnancy rates.