Role of HOXA10 and HOXA11 Genes in Endometrial Development and Infertility in the Polycystic Ovary Syndrome

Introduction: Polycystic ovary syndrome (PCOS) is a reproductive endocrine disorder. Homeotic genes like HOX genes, a group of conserved transcription factors, are essential for the development of the reproductive tract and the functioning of the endometrium. The HOXA genes play essential roles in embryo organogenesis and the functioning of the adult uterine. Regarding reproductive health, HOXA genes such as HOXA10 and HOXA11 are crucial for endometrial receptivity and implantation. The HOXA10 gene is a vital element in embryo implantation, endometrial receptivity, uterine biogenesis, and immune regulation in the adult uterus. It promotes cell growth during decidualization and the maturation of endometrial cells, making the endometrium for implantation. HOXA10 and HOXA11 are dynamically regulated by estrogen and progesterone, showing peak expression during the secretory phase of the menstrual cycle when implantation occurs. Research has shown that infertility in women with PCOS can be associated with the dysregulation of the HOXA10 and HOXA11 genes, resulting in implantation failure due to disrupted endometrial receptivity. Conclusion: Collectively, the HOXA10 and HOXA11 genes are crucial for the endometrium for implantation and thus maintaining fertility. In women afflicted with PCOS, the dysregulation of these genes might significantly contribute to infertility by causing decreased endometrial receptivity and impaired implantation processes. A thorough comprehension of the molecular pathways and hormonal regulation of these genes could pave the way for the development of novel therapeutic strategies focused on improving fertility outcomes for patients with PCOS.