Improving the chance of successful implantation - Part I - Embryo attachment to the endometrium and adequate trophoblast invasion

Abstract

The first in a series on improving embryo implantation is presented with emphasis on embryo attachment and trophoblast invasion. Purpose: To present knowledge of events needed for embryo attachment to the endometrium and subsequent trophoblast invasion and uterine remodeling leading to successful pregnancy. Materials and Methods: Based on normal events, some practical suggestions are proposed as to possible means of improving pregnancy rates by enhancing possible embryo attachment and trophoblast invasion. Results: Potential benefits of achieving adequate serum estradiol levels at peak follicular maturation, and the benefits of progesterone in the luteal phase are discussed. Also the potential benefits of purposeful endometrial injury is considered. Conclusions: Knowledge of the events leading to embryo attachment and trophoblast invasion could lead to novel research ideas helping to improve pregnancy rates in addition to proper hormone supplementation and endometrial biopsy.