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Evaluation of endometrial receptivity and implantation failure

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CURRENT OPINION IN OBSTETRICS & GYNECOLOGY
卷 34, 期 3, 页码 107-113

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/GC0.0000000000000783

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endometrial receptivity; implantation; molecular profiling

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This review succinctly examines the mechanisms of implantation and luteal phase endometrial differentiation, the causes of impaired endometrial function and receptivity, and the current methods for evaluating and treating impaired endometrial receptivity. Although there is an understanding of some mechanisms of impaired endometrial receptivity, treatment options remain limited.
Purpose of review To succinctly review the basic mechanisms of implantation and luteal phase endometrial differentiation, the etiologies of impaired endometrial function and receptivity, and the current methods that exist to evaluate and treat impaired endometrial receptivity. Recent findings Human embryo implantation requires bidirectional communication between blastocyst and a receptive endometrium. Etiologies of impaired endometrial receptivity are varied. Some of these include delayed endometrial maturation, structural abnormalities, inflammation, and progesterone resistance. Current methods to evaluate endometrial receptivity include ultrasonography, hysteroscopy, and endometrial biopsy. Treatments are limited, but include operative hysteroscopy, treatment of endometriosis, and personalized timing of embryo transfer. Summary Although some mechanisms of impaired endometrial receptivity are well understood, treatment options remain limited. Future efforts should be directed towards developing interventions targeted towards the known mediators of impaired endometrial receptivity.

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