Franasiak Jason M, Ruiz-Alonso Maria, Scott Richard T, Simón Carlos
Division of Reproductive Endocrinology, Department of Obstetrics Gynecology, and Reproductive Science, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey; Reproductive Medicine Associates of New Jersey, Basking Ridge, New Jersey.
Igenomix, Paterna, Valencia, Spain.
Fertil Steril. 2016 Apr;105(4):861-6. doi: 10.1016/j.fertnstert.2016.02.030.
Embryonic implantation requires synchrony between the endometrium and the embryo. When analyzed in isolation, competent embryos may be unsuccessful when placed on a nonreceptive endometrium or vice versa, contributing to the "black box" of implantation failure. It is when the two are assessed together that dyssynchrony becomes evident, due to premature progesterone stimulus on the endometrium, physiologic displacement of the window of implantation or late blastulation of the embryo, or all combined. From the embryonic component, detailed assessment of the timing of blastulation is essential. The molecular diagnosis of endometrial receptivity based on its transcriptomic signature could be superior to other techniques used in the past for defining the endometrial window of implantation.
胚胎着床需要子宫内膜与胚胎之间的同步性。单独分析时，将有活力的胚胎置于非容受性的子宫内膜上可能会失败，反之亦然，这导致了着床失败的“黑匣子”现象。当将两者一起评估时，由于子宫内膜受到过早的孕酮刺激、着床窗的生理移位或胚胎的晚期囊胚形成，或这些因素综合作用，不同步就变得明显了。从胚胎方面来看，详细评估囊胚形成的时间至关重要。基于转录组特征的子宫内膜容受性分子诊断可能优于过去用于定义子宫内膜着床窗的其他技术。
