Page 28 - PRECONGRESS COURSE 04

1. Window of Implantation
• WHO has recognised infertility as a worldwide concern
• ‘‘window of implantation’’= the time when the endometrium is most able to support trophoblast-endometrial interactions
• around days 20–24 of an idealized 28-day cycle (6-10 days after ovulation
• Noyes (1975) endometrial dating
Ruiz-Alonso et al., 2013; Cheong et al. 2013; Measuring and enhancing endometrial
Mahajan 2015; Casper et al. 2016; receptivity to improve pregnancy outcomes 5 Su et al. 2015; Robertshaw, et al. 2016
1. Window of Implantation
Classic histology
• Noyes 1975 endometrial dating based on histological parameters:
– glands becoming more irregular with a papillary or saw tooth appearance
– movement of vacuoles to a supranuclear position of epithelial cells with the possibility of the contents being visible within the uterine lumen
– the uterine stroma becoming looser and more edematous
– decidualisation of the uterine stroma
Noyes el al. 1975
Measuring and enhancing endometrial receptivity to improve pregnancy outcomes
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