Shoutai pill promotes endometrial decidualization and prevents recurrent spontaneous abortion through dual regulation of apoptosis and ECM remodeling by the LDHA-lactate axis

Aerobic glycolysis and AME homeostasis at the MFI function as crucial metabolic hubs for maintaining pregnancy. Dysfunction of this system triggers pathological changes, including excessive apoptosis of decidual cells, impaired ECM remodeling, and disrupted decidualization through the ERK1/2/HIF-1α signaling pathway. The core therapeutic mechanism of STW involves effective remodeling of this metabolic-signaling regulatory network, thereby improving early pregnancy outcomes, and promoting embryo implantation.