Page 29 - PRECONGRESS COURSE 04

1. Window of Implantation
Classic histology
• Noyes 1975 endometrial dating based on histological parameters
• Paradigm: served as the gold standard for clinical evaluation of luteal
phase in the last 60 years
• Has been questioned in recent years and randomized studies
• Maximal chance of conceiving a clinically recognized pregnancy in one cycle is approximately 30%
• WOI lasts between 12h and 2 days, and varies from patient to patient
• 5-50% of normal cycles are ‘‘out of phase’’
over two day difference between histologic dating and day after ovulation
• 25% of women have delayed endometrial development in the luteal phase
Ruiz-Alonso et al., 2013; Cheong et al. 2013; Measuring and enhancing endometrial
Mahajan 2015; Casper et al. 2016; receptivity to improve pregnancy outcomes 7 Su et al. 2015; Robertshaw, et al. 2016
1. Window of Implantation
Classic histology - PINOPODS
Surface epithelial microvilli exhibiting cystic changes
Normal cycle: days 20-22 (18-22 stimulated); 48 h life
Facilitate blastocyst / uterine epithelium contact (they express integrins)
Measuring and enhancing endometrial receptivity to improve pregnancy outcomes
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PRECONGRESS COURSE 04 I GENEVA, SWITZERLAND – 2 JULY 2017 29