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- Title
Current perspectives on endometrial receptivity: A comprehensive overview of etiology and treatment.
- Authors
Hiraoka, Takehiro; Osuga, Yutaka; Hirota, Yasushi
- 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.
- Subjects
ENDOMETRIUM physiology; ENDOMETRIOSIS; ENDOMETRIAL diseases; UTERINE diseases; TREATMENT failure; EMBRYO transfer; INFERTILITY; GONADOTROPIN; HUMAN reproductive technology; ENDOMETRIUM; COMPLICATIONS of prosthesis
- Publication
Journal of Obstetrics & Gynaecology Research, 2023, Vol 49, Issue 10, p2397
- ISSN
1341-8076
- Publication type
Article
- DOI
10.1111/jog.15759