We showed previously in mice that restraint stress reduces the number of embryo implantation sites in the endometrium. Here we hypothesized that the uterine microenvironment is altered by restraint stress and consequently is sub-optimal for embryo implantation. On embryonic day 1 (E1), 60 of 154 pregnant CD1 mice underwent restraint stress (4h), repeated daily to E3, E5 or E7 (n = 10 mice per group). Restraint stress decreased food intake and suppressed body weight gain on E3, E5 and E7. Restraint stress decreased the actual and relative weight (percent body weight) of uterus and ovary on E5 (by 14.9%, P = 0.03; 16.1%, P = 0.004) and E7 (by 16.8%, P = 0.03; 20.0%, P = 0.01). Morphologically, restraint stress decreased relative endometrial area (by 8.94-18.8%, P = 0.003-0.021) and uterine gland area (by 30.6%, P < 0.01 on E3 and 44.5%, P < 0.01 on E5). Immunohistochemistry showed that restraint stress decreased microvessel density (by 12.9-70.5%, P < 0.01) and vascular endothelial growth factor expression (by 14.6-45.9%, P = 0.007-0.02). Restraint stress decreased by 32.4-39.8% (P = 0.002-0.01) the mean optical density ratio for proliferating cell nuclear antigen/terminal deoxynucleotidyl transferase dUTP nick end labeling. Methyl thiazolyl tetrazolium assay showed a dosedependent decrease in proliferative activity of endometrial stromal cells (from 52 of 154 pregnant E5 control mice) incubated with H 2 O 2 (100-1000 μM) in vitro. These findings supported the hypothesis that restraint stress negatively influences endometrial adaptive remodeling via an oxidative stress pathway, which resulted in fewer implantation sites. Stress Downloaded from informahealthcare.com by Nanyang Technological University on 08/26/15 For personal use only. Stress Downloaded from informahealthcare.com by Nanyang Technological University on 08/26/15 For personal use only. Stress Downloaded from informahealthcare.com by Nanyang Technological University on 08/26/15 For personal use only. Stress Downloaded from informahealthcare.com by Nanyang Technological University on 08/26/15 For personal use only. Stress Downloaded from informahealthcare.com by Nanyang Technological University on 08/26/15 For personal use only.