Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-13T02:16:05.886Z Has data issue: false hasContentIssue false

Chapter 3 - Embryo–Maternal Interactions

Published online by Cambridge University Press:  26 April 2023

Catherine Racowsky
Affiliation:
Hôpital Foch, France
Jacques Cohen
Affiliation:
IVF 2.0, New York
Nicholas Macklon
Affiliation:
London Women's Clinic
Get access

Summary

Establishment of pregnancy requires successful implantation of a healthy embryo into the woman’s endometrium. Synchrony of development between the embryo and the maternal endometrium is well known as essential in establishment of pregnancy. Ovarian stimulation, that dramatically changes natural hormonal levels, is highly detrimental to development of a ‘receptive endometrium’, which lasts for ~4 days in the mid-secretory phase of a normal cycle. Thus, it is hardly surprising that so few ‘good quality’ embryos implant successfully into the endometrium to establish pregnancy. Until the endometrium is recognised as an equal partner to the embryo and prepared appropriately, we will not see a substantial rise in IVF success. None of the many ‘adjuva nt therapies’ are proven as successful; some do more harm than good. A good test for endometrial receptivity is urgently needed, along with consideration of how clinical protocols can be amended to decrease their harmful effects on the endometrium.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Wilcox, AJ, Baird, DD, Weinberg, CR. Time of implantation of the conceptus and loss of pregnancy. N Engl J Med. 1999;340(23):1796–9.CrossRefGoogle ScholarPubMed
Evans, J, Salamonsen, LA, Winship, A, Menkhorst, E, Nie, G, Gargett, CE, Dimitriadis, E. Fertile ground: human endometrial programming and lessons in health and disease. Nat Rev Endocrinol. 2016;12(11):654–67.Google Scholar
Whitby, S, Salamonsen, LA, Evans, J. The endometrial polarity paradox: differential regulation of polarity within secretory-phase human endometrium. Endocrinology. 2018;159(1):506–18.Google Scholar
Aplin, JD, Ruane, PT. Embryo-epithelium interactions during implantation at a glance. J Cell Sci. 2017;130(1):1522.Google Scholar
Heng, S, Cervero, A, Simon, C, Stephens, AN, Li, Y, Zhang, J, et al. Proprotein convertase 5/6 is critical for embryo implantation in women: regulating receptivity by cleaving EBP50, modulating ezrin binding, and membrane-cytoskeletal interactions. Endocrinology. 2011;152(12):5041–52.CrossRefGoogle ScholarPubMed
Heng, S, Paule, SG, Li, Y, Rombauts, LJ, Vollenhoven, B, Salamonsen, LA, Nie, G. Posttranslational removal of α-dystroglycan N terminus by PC5/6 cleavage is important for uterine preparation for embryo implantation in women. FASEB J. 2015;29(9):4011–22.Google Scholar
Salamonsen, LA., Evans, J, Nguyen, HPT, Edgellet, TA. The microenvironment of human implantation: determinant of reproductive success. Am J Reprod Immunol. 2016;75(3):218–25.CrossRefGoogle ScholarPubMed
Burton, GJ, Watson, AL, Hempstock, J, Skepper, JN, Jauniaux, E. Uterine glands provide histiotrophic nutrition for the human fetus during the first trimester of pregnancy. J Clin Endocrinol Metab. 2002;87(6):2954–9.CrossRefGoogle ScholarPubMed
Teklenburg, G, Salker, M, Molokhia, M, Lavery, S, Trew, G, Aojanepong, T, et al. Natural selection of human embryos: decidualizing endometrial stromal cells serve as sensors of embryo quality upon implantation. PLoS ONE, 2010;5(4):e10258.Google Scholar
Antoniotti, GS, Coughlan, M, Salamonsen, LA, Evans, J. Obesity associated advanced glycation end products within the human uterine cavity adversely impact endometrial function and embryo implantation competence. Hum Reprod. 2018;33(4):654–65.Google Scholar
Drakopoulos, P, Racca, A, Errázuriz, J, De Vos, M, Tournaye, H, Blockeel, C, et al. The role of progesterone elevation in IVF. Reprod Biol. 2019;19(1):15.Google Scholar
Evans, J, Hannan, NJ, Edgell, TA, Vollenhoven, BJ, Lutjen, PJ, Osianlis, T, et al. Fresh versus frozen embryo transfer: backing clinical decisions with scientific and clinical evidence. Hum Reprod Update. 2014;20(6):808–21.CrossRefGoogle ScholarPubMed
Craciunas, L, Tsampras, N, Raine-Fenning, N, Coomarasamy, A. Intrauterine administration of human chorionic gonadotropin (hCG) for subfertile women undergoing assisted reproduction. Cochrane Database Syst Rev. 2016;5:Cd011537.Google Scholar
Groenewoud, ER, Cohlen, BJ, Macklon, NS. Programming the endometrium for deferred transfer of cryopreserved embryos: hormone replacement versus modified natural cycles. Fertil Steril. 2018;109(5):768–74.Google Scholar
Altmäe, S, Esteban, FJ, Stavreus-Evers, A, Simón, C, Giudice, L, Lessey, BA, et al. Guidelines for the design, analysis and interpretation of ‘omics’ data: focus on human endometrium. Hum Reprod Update. 2014;20(1):1228.Google Scholar
Craciunas, L, Gallos, I, Chu, J, Bourne, T, Quenby, S, Brosens, JJ, Coomarasamy, A. Conventional and modern markers of endometrial receptivity: a systematic review and meta-analysis. Hum Reprod Update. 2019;25(2):202–23.CrossRefGoogle ScholarPubMed
Boomsma, CM, Macklon, NS. What can the clinician do to improve implantation? Reprod Biomed Online. 2006;13(6):845–55.CrossRefGoogle ScholarPubMed
Datta, AK, Campbell, S, Deval, B, Nargund, G. Add-ons in IVF programme – hype or hope? Facts Views Vis Obgyn. 2015;7(4):241–50.Google ScholarPubMed
Shirlow, R, Healey, M, Volovsky, M, MacLachlan, V, Vollenhoven, B. The effects of adjuvant therapies on embryo transfer success. J Reprod Infertil. 2017;18(4):368–78.Google ScholarPubMed
Kovacs, G, Salamonsen, L, editors. How to prepare the endometrium to maximize implantation rates and IVF success. Cambridge, UK: Cambridge University Press; 2019.Google Scholar
Lensen, S, Osavlyuk, D, Armstrong, S, Stadelmann, C, Hennes, A, Napier, E, et al. A randomized trial of endometrial scratching before in vitro fertilization. N Engl J Med. 2019;380(4):325–34.CrossRefGoogle ScholarPubMed
Salamonsen, LA, Dimitriadis, E. Infertility and the endometrium. Clin Exp Obstet Gynecol. 2022;14(9):195–206.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×