Current perspectives on endometrial receptivity: A comprehensive overview of etiology and treatment

Abstract

Recurrent implantation failure (RIF) remains a challenging problem in assisted reproductive technology (ART). Further insights into uterine abnormalities that can disturb embryo implantation should be obtained. This review provides an overview of the effects of organic and non‐organic uterine disorders on endometrial receptivity. The results suggest that various uterine pathologies can lead to defective embryo implantation via multiple mechanisms. In particular, uterine adenomyosis dysregulates molecular and cellular interactions that are vital for successful embryo implantation with a background of chronic inflammation, which may be alleviated by pretreatment with a gonadotropin‐releasing hormone agonist. Uterine myomas can cause endometrial deformation and adverse alterations in uterine contractility. Nonetheless, the effectiveness of myomectomy remains debated, and endometrial polyp removal may be considered, particularly in patients with RIF. Chronic endometritis abrogates the appropriate uterine immunological environment critical for embryo implantation. Abnormal endometrial microbiota have been suggested to influence endometrial receptivity; however, supporting evidence is currently scarce. Platelet‐rich plasma therapy may be a potential treatment for thin endometria; nevertheless, further validation is required. Endometrial receptivity analysis can detect dysregulation of the window of implantation, and new non‐invasive methods for predicting endometrial receptivity have recently been proposed. However, numerous issues still need to be fully clarified. Further clinical and basic studies are necessary to investigate the pathophysiology of defective endometrial receptivity and identify optimal treatments for patients undergoing ART, especially those with RIF.

Assessment of the Role of Endometrial Receptivity Analysis in Enhancing Assisted Reproductive Technology Outcomes for Advanced-Age Patients

“…The live birth rate in the study group was almost double that of control group 1, indicating a substantial improvement in outcomes through personalized approaches [14].…”

“…The pregnancy rate, implantation rate, and live birth rate were significantly higher in the study group compared to control group 1, highlighting the efficacy of ERA in optimizing reproductive outcomes. The live birth rate in the study group was almost double that of control group 1, indicating a substantial improvement in outcomes through personalized approaches [ 14 ].…”

Expanding Role of Epigenetics in Human Health and Disease

“…Next, the blastocyst attaches to the receptive endometrium, which is known as adhesion, and finally, the attached blastocyst invades the endometrial stroma by crossing through the endometrial epithelial basement membrane, a process known as invasion. 128…”

Exploring Immunome and Microbiome Interplay in Reproductive Health: Current Knowledge, Challenges, and Novel Diagnostic Tools

“… 47 50 51 52 Studies have suggested that Lactobacillus -dominated endometrial microbiota may improve reproductive outcomes; however, conflicting reports have been published. 49 53 54 55 56 57 58 Imbalances in endometrial microbiota are linked to various reproductive issues, including repeated implantation failure (RIF), pregnancy loss, endometriosis, endometritis, endometrial polyps, hyperplasia, and endometrial cancer (EC). 49 59 60 61 62 63 For instance, Fusobacterium infection of the endometrium causes inflammation, leading to conditions such as endometriosis.…”