TY - JOUR
T1 - Determinants of Embryo Implantation
T2 - Roles of the Endometrium and Embryo in Implantation Success
AU - Awonuga, Awoniyi O.
AU - Camp, Olivia G.
AU - Abu-Soud, Husam M.
AU - Rappolee, Daniel A.
AU - Puscheck, Elizabeth E.
AU - Diamond, Michael P.
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Society for Reproductive Investigation.
PY - 2023/8
Y1 - 2023/8
N2 - Both uterine endometrium and embryo contribute to implantation success. However, their relative role in the implantation success is still a matter for debate, as are the roles of endometrial receptivity analysis (ERA), endometrial scratch (ES), endometrial microbiome, and intrauterine or intravenous measures that are currently advocated to improve the implantation success. There is insufficient evidence to suggest that the endometrium is more important than the embryo in determining the implantation success and the utility of these measures, especially when euploid embryos are transferred is limited. Although embryo implantation on epithelium other than the endometrium is a very rare event, evidence suggests that embryo implantation and growth is not limited to the endometrium alone. Embryos can implant and develop to result in livebirths on epithelium that lacks the typical endometrial development present at implantation. Currently, the role of embryo euploidy in implantation success is underappreciated. At a minimum, it is the author’s opinion that until robust, definitive studies are conducted that demonstrate benefit, reproductive endocrinologists and infertility specialist should be prudent in the way they counsel patients about the utility of ERA, ES, and other measures in improving implantation success.
AB - Both uterine endometrium and embryo contribute to implantation success. However, their relative role in the implantation success is still a matter for debate, as are the roles of endometrial receptivity analysis (ERA), endometrial scratch (ES), endometrial microbiome, and intrauterine or intravenous measures that are currently advocated to improve the implantation success. There is insufficient evidence to suggest that the endometrium is more important than the embryo in determining the implantation success and the utility of these measures, especially when euploid embryos are transferred is limited. Although embryo implantation on epithelium other than the endometrium is a very rare event, evidence suggests that embryo implantation and growth is not limited to the endometrium alone. Embryos can implant and develop to result in livebirths on epithelium that lacks the typical endometrial development present at implantation. Currently, the role of embryo euploidy in implantation success is underappreciated. At a minimum, it is the author’s opinion that until robust, definitive studies are conducted that demonstrate benefit, reproductive endocrinologists and infertility specialist should be prudent in the way they counsel patients about the utility of ERA, ES, and other measures in improving implantation success.
KW - Advanced extrauterine pregnancy
KW - Ectopic pregnancy
KW - Embryo
KW - Endometrium
KW - Livebirth
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U2 - 10.1007/s43032-023-01224-w
DO - 10.1007/s43032-023-01224-w
M3 - Review article
C2 - 36988904
AN - SCOPUS:85152073798
SN - 1933-7191
VL - 30
SP - 2339
EP - 2348
JO - Reproductive Sciences
JF - Reproductive Sciences
IS - 8
ER -