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bioRxiv · 10.64898/2026.09.14.751518

ERBB2 establishes the timing of progesterone priming required for uterine receptivity

Li, B.·Zhang, C.·Dewar, A.·Liu, X.·Deng, W.·Qi, H.·Dey, S. K.·Sun, X.
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Abstract

Progesterone is essential for establishing uterine receptivity and sustaining early pregnancy. However, how the uterus acquires the competence to respond to progesterone at the appropriate time remains poorly understood. Here we show that ERBB2 governs the timing of progesterone responsiveness required for uterine receptivity. In endometrial samples from women with recurrent spontaneous abortion (RSA), ERBB2 is downregulated specifically in the stromal compartment, accompanied by a parallel reduction in stromal progesterone receptor (PGR). Uterine deletion of Erbb2 in mice blunts the rise of stromal PGR at the onset of the receptive window, deferring implantation and impairing decidualization despite normal circulating progesterone and estrogen. Epithelial deletion has no such effect, placing the requirement in the stroma. High-dose progesterone fails to rescue the phenotype; advancing progesterone priming by 24 hours restores stromal PGR, HAND2, Bmp2, and on-time implantation. Collectively, the present study provides evidence that ERBB2 directs the temporal window of stromal progesterone priming by setting the threshold for PGR induction, thereby synchronizing the maternal-fetal interface and safeguarding pregnancy.

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Li, B., Zhang, C., Dewar, A., Liu, X., Deng, W., Qi, H., Dey, S. K., Sun, X.. 2026-09-16. ERBB2 establishes the timing of progesterone priming required for uterine receptivity. https://doi.org/10.64898/2026.09.14.751518

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