Mechanism of implantation of the embryo

Česká verzia

Authors: Renáta Krajčovičová; Igor Crha; Pavel Ventruba; Jana Žáková; Iva Vlašínová
Authors place of work: Gynekologicko-porodnická klinika LF MU a FN Brno
Published in the journal: Prakt Gyn 2012; 16(1): 20-26
Category: Assisted reproduction: Review article

Summary

The implantation of the embryo is complex and multistage process, which consists of complicated interactions between endometrium, myometrium, trophoblast and embryo. The result is implantation of the fertilized egg into the uterus. This mechanism is under the control of internal and external factors that are not exactly explained yet. Main steps are the adhesion of the embryo on the endometrium surface, the interaction between cells of endometrium and myometrium, overcoming mucins barriers, trophoblast invasion and its proliferations and decidualization. This work gives a comprehensive view of the possible causes of failure in the proces of the implantation, describes the diagnosis and treatment of these failures. We cannot reveal the cause of infertility in 10–20% couples, who undergo the diagnosis process. The mechanism of implantation are intensively investigated especially the unexplained infertility of the healthy couples, who don´t have any genetic, anatomical, hormonal or infectious problems and the transfer of the perfect embryo into well-preparated endometrium has repeated failure. Different recommended procedure improving implantation rate in IVF are described in the literature. Some of these methods are very simple (cleaning of the cervical canal before embryotransfer, using uterolytics drugs, the biopsy of the endometrium before ET) some are explicitly experimental (transcervical application of the seminal plasma or transcervical transfers of the genes responsible for the implantation).

Key words:
implantation of the embryo – nidation – implantation rate – infertility factors – embryotransfer – endometriosis – sactosalpinx – polycystic ovary syndrome

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