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macaques have the similar peripheral steroid hormone metabolism, structure of the
endometrium, endometrial response to exogenous estrogens and sex steroid hormone receptor
expression as humans (West and Brenner, 1983; Brenner et al., 1990). They have 28 to 30
day long menstrual cycles, single-egg ovulation and single off-spring delivery, distinct
menarche and menopause, at 3 and 20 years of age respectively (Cline et al., 2008). Their
similarity to humans makes the non-human primates a suitable model for endometrial studies.
Figure 13. The cynomolgus macaque.
1.3
ENDOMETRIAL DYSFUNCTION
Human endometrium undergoes specific changes during each menstrual cycle. All those
changes are hormone dependent and metabolically demanding (Schulte et al., 2015). Thus,
any hormone or metabolic disturbance may affect the endometrium adversely leading to
abnormalities and poor reproductive outcome. PCOS and thyroid gland dysfunction are
associated with hormonal and metabolic abnormalities that may affect the endometrium
adversely, leading to alterations in its functions and receptivity.
1.3.1 Polycystic ovary syndrome
PCOS is one of the most common endocrine disorders in women of reproductive age, with a
reported prevalence as high as 15% (Fauser et al., 2012). PCOS is commonly associated with
infertility and metabolic disorders. Its clinical manifestations may include menstrual
irregularities, signs of androgen excess (hirsutism), overweight and obesity. Independent of
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