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The endometrium becomes receptive to blastocyst implantation 6–8 days after ovulation and remains receptive for ∼4 days (cycle days 20–24) ( Bergh and Navot, 1992 ).The importance of endometrial environment is highlighted by the observation that high-quality embryos transferred into women involved as embryo recipients in a surrogacy procedure have a higher probability of implanting than if they are transferred back into the donor women ( Check , 2005 ).More is known about the fate of the embryo post-implantation.Using markers of early pregnancy, such as human chorionic gonadotrophin (h CG), it has been demonstrated that one-third of post-implantation early pregnancy losses occur during the pre-clinical stages of pregnancy in fertile women ( Wilcox , 1999a ).gene expression clusters or cytokine ‘fingerprints’) rather than single biomarkers.This strategy may be particularly relevant in the field of implantation because numerous factors are involved, many of these have multiple functions, and there is potentially a large amount of redundancy.Other factors, which are yet to be identified, must play a role.
The majority of spontaneous human conceptions fail to complete implantation and to achieve ongoing pregnancy.
Despite many advances in assisted reproductive technologies (ART), implantation rates are still low.
The process of implantation requires a reciprocal interaction between blastocyst and endometrium, culminating in a small window of opportunity during which implantation can occur.
Implantation failure is thought to occur as a consequence of impairment of embryo developmental potential and/or impairment of uterine receptivity and the embryo–uterine dialogue.
Therefore a better comprehension of implantation, and the relative importance of the factors involved, is warranted.