2018
DOI: 10.1210/en.2017-03082
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Embryo Implantation: War in Times of Love

Abstract: Contrary to widespread belief, the implantation of an embryo for the initiation of pregnancy is like a battle, in that the embryo uses a variety of coercive tactics to force its acceptance by the endometrium. We propose that embryo implantation involves a three-step process: (1) identification of a receptive endometrium; (2) superimposition of a blastocyst-derived signature onto the receptive endometrium before implantation; and finally (3) breaching by the embryo and trophoblast invasion, culminating in decid… Show more

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Cited by 158 publications
(122 citation statements)
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“…For successful implantation, however, gene expression in the endometrium in addition is regulated by the implanting blastocyst by precisely synchronized embryo-maternal interactions [60,61,62]. Both compartments of the endometrium are involved in this process: on the one hand, the epithelium has to allow adhesion of the embryo and invasion through the epithelium, on the other hand the stromal cells must be transformed to decidua cells which regulate trophoblast invasion and provide the placental blood supply necessary for embryo nutrition.…”
Section: Cell–cell Junctions During Implantation and Decidualizationmentioning
confidence: 99%
“…For successful implantation, however, gene expression in the endometrium in addition is regulated by the implanting blastocyst by precisely synchronized embryo-maternal interactions [60,61,62]. Both compartments of the endometrium are involved in this process: on the one hand, the epithelium has to allow adhesion of the embryo and invasion through the epithelium, on the other hand the stromal cells must be transformed to decidua cells which regulate trophoblast invasion and provide the placental blood supply necessary for embryo nutrition.…”
Section: Cell–cell Junctions During Implantation and Decidualizationmentioning
confidence: 99%
“…A high expression of L-selectin and its ligand, MECA-79, during the embryo implantation period has been proposed to help increase the stickiness of the endometrial epithelium toward the implanting blastocyst [25]. The sticky surface will anchor the blastocyst firmly to the endometrial wall for the invasion phase to start [26]. As the expression of MECA-79 in the uterus was markedly reduced following the administration of a high dose of testosterone, the adhesion process could well have been compromised, which ultimately would interfere with successful embryo implantation.…”
Section: Discussionmentioning
confidence: 99%
“…The first few weeks of gestation place relatively little demand upon the mother and therefore involve little maternal investment, and so embryo quality control should occur early, with the fetal–maternal interface (i.e., the interaction between fetal ligands and maternal receptors) representing the front line in the battle between invading trophoblast and defending maternal tissues. Indeed, discussion of early fetal–maternal interactions is full of references to embryonic “invasion” of the endometrium, and the literature is full of war‐like references to “fighting lines,” “no man's land,” and the embryo as a “deceitful and treacherous enemy.” A more appropriate comparison for the very earliest stages of implantation at or soon after the initiation of embryo–maternal contact may be an interview, where the embryo seeks to make a favorable impression . The evolution of deeper implantation in placental mammals facilitated more thorough vetting of offspring, and these deeper forms of implantation may have evolved to reduce the “ease” by which a mother may reject an embryos through sloughing of superficial layers of endometrium .…”
Section: Introductionmentioning
confidence: 99%