Selected pathological conditions affecting endometrial receptivity

Abstract

Aim: A summary of new knowledge on embryo implantation in dependence on quality of the endometrium.

Type of study: Literature review.

Methods: Literature review from August 2022 of the relevant publications in Web of Science, Scopus and PubMed/Medline databases focused on „endometrial receptivity”, „polycystic ovary syndrome”, „endometriosis”, „SARS – CoV 19”.

Address: Department of Obstetrics and Gynecology, University Hospital Brno and Masaryk University

Results: The receptive state of the endometrium is a result of physiological remodelling and immune system activity modulated by the microbiome. This balance can be disturbed by myomas, polyps, sactosalpings, adenomyosis, endometriosis, polycystic ovary syndrome, infections. The effect of SARS – CoV 19 infection is being discussed. For a successful implantation, timing of transfer is crucial. The ultrasound examination is used conventionally. In specific cases, hysteroscopy and endometrium biopsy are recommended. Histological and immunohistochemical evaluation is performed together with examination of microbiome or transcriptome. To support the implantation, gestagens are used, or metformin in the patients with polycystic ovary syndrome. In cases of repeated implantation failure, the intrauterine infusion of mononuclear cells or platelet rich plasma is used, subcutaneous application of growth factor G-CSF, intravenous application of atosiban or intrauterine application of hCG.

Conclusion: Recent research in the field of transcriptomics, proteomics and reproductive immunology uncovers the process of implantation more deeply and opens a new stage of the assisted reproduction.