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Chapter 3 - Embryo–Maternal Interactions

Published online by Cambridge University Press:  26 April 2023

By
Lois A. Salamonsen ,
Tracey A. Edgell ,
Guiying Nie  and
Jemma Evans
Edited by
Catherine Racowsky ,
Jacques Cohen  and
Nicholas Macklon
Catherine Racowsky
Affiliation:
Hôpital Foch, France
Jacques Cohen
Affiliation:
IVF 2.0, New York
Nicholas Macklon
Affiliation:
London Women's Clinic
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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.

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Chapter
Information
Manual of Embryo Selection in Human Assisted Reproduction , pp. 20 - 30
Publisher: Cambridge University Press
Print publication year: 2023

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References

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