The aim of this chapter is to bring the reader up to date with current thinking about the role of uterine receptivity in in vitro fertilization (IVF). The contents have been substantially revised and updated since the last edition, including information on the wealth of new data currently emerging on global gene expression profiling of human endometrium. Although some progress in understanding of human uterine receptivity has been made over the past 10 years, most workers in the field would support the view that there have not been any paradigm shifts in our understanding of this complex topic. . | __19 Uterine Receptivity Peter A. W. Rogers Centre for Women s Health Research Department of Obstetrics and Gynecology Monash University Monash Medical Centre Clayton Victoria Australia INTRODUCTION The aim of this chapter is to bring the reader up to date with current thinking about the role of uterine receptivity in in vitro fertilization IVF . The contents have been substantially revised and updated since the last edition including information on the wealth of new data currently emerging on global gene expression profiling of human endometrium. Although some progress in understanding of human uterine receptivity has been made over the past 10 years most workers in the field would support the view that there have not been any paradigm shifts in our understanding of this complex topic. The contribution that reduced uterine receptivity makes to human infertility remains unclear. Unfortunately a number of issues prevent significant progress in understanding the role of uterine receptivity in human reproduction including first and foremost the ethical and practical constraints that limit mechanistic studies involving embryo implantation in the human. Without successful embryo implantation and pregnancy as an outcome measure definitive studies investigating uterine receptivity remain problematic. Despite this the ready availability of human endometrium from non-conception cycles under a wide range of normal and manipulated situations provides huge scope for investigating endometrial events that may characterize a receptive state. 403 404 Rogers The use of IVF as a routine clinical treatment for infertility provides an important avenue for focusing basic and clinical research on the human reproductive processes from gametogenesis to fertilization and implantation. In particular many of the research-oriented IVF programs are now focusing attention on the role of the non-receptive uterus in reducing embryo implantation .
