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What is the contribution of embryo-endometrial asynchrony to implantation failure?

Journal of Assisted Reproduction and Genetics volume 33, pages 1419–1430 (2016)Cite this article

Abstract

Purpose

The synchronized development of a viable embryo and a receptive endometrium is critical for successful implantation to take place. The aim of this paper is to review current thinking about the importance of embryo-endometrial synchrony in in vitro fertilization (IVF).

Methods

Detailed review of the literature on embryo-endometrial synchrony.

Results

By convention, the time when the blastocyst first attaches and starts to invade into the endometrium has been defined as the ‘window of implantation’. The term window of implantation can be misleading when it is used to imply that there is a single critical window in time that determines whether implantation will be successful or not. Embryo maturation and endometrial development are two independent continuous processes. Implantation occurs when the two tissues fuse and pregnancy is established. A key concept in understanding this event is developmental ‘synchrony’, defined as when the early embryo and the uterus are both developing at the same rate such that they will be ready to commence and successfully continue implantation at the same time. Many different events, including controlled ovarian hyperstimulation as routinely used in IVF, can potentially disrupt embryo-endometrial synchrony. There is some evidence in humans that implantation rates are significantly reduced when embryo-endometrial development asynchrony is greater than 3 days (±1.5 days).

Conclusions

Embryo-endometrial synchrony is critical for successful implantation. There is an unmet need for improved precision in the evaluation of endometrial development to permit better synchronization of the embryo and the endometrium prior to implantation.

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Affiliations

  1. Department of Obstetrics and Gynaecology, University of Melbourne, The Royal Women’s Hospital, 20 Flemington Road, Parkville, 3052, VIC, Australia

    Wan-Tinn Teh & Peter Rogers

  2. Reproductive Services, The Royal Women’s Hospital, Parkville, VIC, Australia

    Wan-Tinn Teh & John McBain

Authors
  1. Wan-Tinn Teh
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  2. John McBain
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  3. Peter Rogers
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Corresponding author

Correspondence to Wan-Tinn Teh.

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Conflicts of interest

The authors declare that they have no conflict of interest.

Funding

Wan-Tinn Teh received National Health and Medical Research Council Medical Postgraduate Scholarship (No. 1055814) for her PhD study.

Additional information

Capsule Embryo-endometrial synchrony is critical for successful implantation. There is an unmet need for improved precision in the evaluation of endometrial development to permit better synchronization of the embryo and the endometrium prior to implantation.

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Teh, WT., McBain, J. & Rogers, P. What is the contribution of embryo-endometrial asynchrony to implantation failure?. J Assist Reprod Genet 33, 1419–1430 (2016). https://doi.org/10.1007/s10815-016-0773-6

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  • DOI: https://doi.org/10.1007/s10815-016-0773-6

Keywords

  • Endometrium
  • Embryo
  • Uterine receptivity
  • Implantation
  • Synchrony