Human cytomegalovirus (HCMV) is a ubiquitous infectious pathogen that, when transmitted to the fetus in utero, can result in numerous sequelae, including late-onset sensorineural damage. The villous trophoblast, the cellular barrier between maternal blood and fetal tissue in the human placenta, is infected by HCMV in vivo. Primary trophoblasts cultured on impermeable surfaces can be infected by HCMV, but release of progeny virus is delayed and minimal. It is not known whether these epithelial cells when fully polarized can release HCMV and, if so, if release is from the basal membrane surface toward the fetus. We therefore ask whether, and in which direction, progeny virus release occurs from HCMV-infected trophoblasts cultured on semipermeable (3.0-m-pore-size) membranes that allow functional polarization. We show that infectious HCMV readily diffuses across cell-free 3.0-m-pore-size membranes and that apical infection of confluent and multilayered trophoblasts cultured on these membranes reaches cells at the membrane surface. Using two different infection and culture protocols, we found that up to 20% of progeny virus is released but that <1% of released virus is detected in the basal culture chamber. These results suggest that very little, if any, HCMV is released from an infected villous trophoblast into the villous stroma where the virus could ultimately infect the fetus.Human cytomegalovirus (HCMV) is endemic, infecting 40 to 80% of urban populations in developed countries (10). The incidence of congenital HCMV infection is between 0.2 and 2.2% of all live-born infants. Such infections are one of the most common causes of mental retardation and nonhereditary sensorineural deafness in children (46,48). Only 40% of pregnant women with primary HCMV infections give birth to infected infants (47) suggesting an effective fetal barrier, either physical or immunological. How HCMV is transmitted to the fetus during pregnancy is unknown; however, congenital infections are associated with chronic villitis (38, 41) and infection of the placenta (1, 4, 16, 32, 36-39, 41, 44, 45), which may also act as a viral reservoir (19). Passage through the placenta (2, 3) could occur in two directions: through the cytotrophoblast (CT) columns in anchoring villi or across the villous syncytiotrophoblast (ST) in the intervillous space.Infection originating in the uterine wall could lead to infection of extravillous CT involved in either interstitial or endovascular invasion. Infection could then progress in a cell-to-cell manner through the CT columns of anchoring villi to the chorionic stroma and eventually infect the fetus (15). Although this route is possible during a reactivated uterine infection, endovascular CT comes into direct contact with maternal blood and therefore could also be exposed to a primary infection.The ST lines all chorionic villi within the intervillous space, thereby interfacing maternal blood and fetal tissues. The ST is thus positioned to either physically prevent or to actively participate in the dissemina...