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Determination of Endometrial Status and the Implantation Window

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Abstract

Human embryo implantation normally takes place between days 20 and 24, or between days LH +7 and LH +11 of a normal conception cycle. The process begins with apposition of the hatched blastocyst to the luminal surface epithelium of the endometrium and is followed by adhesion, invasion and anchorage of the trophoblast into the endometrial stroma where it comes into contact with maternal blood vessels. Irrespective of whether fertilization takes place in vivo or in vitro, endometrial receptivity results from an orchestrated interplay between the embryo and the maternal endometrium in which hormones, hormone receptors, Oligosaccharides, lectins, integrins, growth factors, cytokines, proteases and their inhibitors, Prostaglandins, peptides, and factors that modulate immune cell reactivity against the embryo play a role. At the same time, the endometrium provides constraints on uncontrolled invasion of the trophoblast. A receptive endometrium is an end result of responses to endocrine and paracrine messages that derive from the stimulated ovary, exogenous hormones, endometrium, and the embryo. For instance, poor oocyte quality may be associated with inadequate follicle maturation and hormone secretion that affect embryo quality, endometrium and implantation.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, 00029 HUS, Finland

    Markku Seppälä

  2. Division of Reproductive Endocrinology and Infertility, University of North Carolina, Chapel Hill, NC, USA

    Bruce Lessey

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  1. Markku Seppälä
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  1. Department of Molecular, Cellular, and Developmental Biology, University of Colorado, Boulder, Colorado, USA

    Jonathan Van Blerkom

  2. Colorado Reproductive Endocrinology, Rose Medical Center, Denver, Colorado, USA

    Jonathan Van Blerkom

  3. Cardiff Assisted Reproduction Unit, University Hospital of Wales, Heath Park Cardiff, Wales, UK

    Linda Gregory

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Seppälä, M., Lessey, B. (2004). Determination of Endometrial Status and the Implantation Window. In: Van Blerkom, J., Gregory, L. (eds) Essential IVF. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-8955-0_21

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