IVF has evolved into a suite of mainstream medical interventions to overcome infertility, yet implantation failure poses a critical limiting factor even when the embryos are carefully selected. This is of particular concern given that the use of IVF is increasing every year as women choose to have children at a later age. Implantation requires a synchronously developed healthy embryo and a receptive endometrium. Endometrial receptivity is vital for implantation. Currently there is no test available to determine the status of endometrial receptivity at the time of embryo transfer. Development of diagnostics for endometrial receptivity is critical to improve IVF outcomes.
Our recent studies have identified a promising biomarker for receptivity. During the establishment of receptivity, a large part of a cell surface glycoprotein is released into the uterine cavity and its levels in the uterine fluid directly correlate with the status of receptivity, making this glycoprotein a promising biomarker for endometrial receptivity. Our next step is to establish a high throughput assay for this glycoprotein.
Our previous studies have relied on uterine lavage as the source of uterine fluid for receptivity tests. However, a number of intrinsic drawbacks are associated with uterine lavage collection and impose a critical gap in translating research discoveries into practice. Alternative methods of endometrial fluid sampling warrant investigation. Anatomically, the uterine cavity is directly connected to the cervical cavity; uterine secretions thus would be present in the endocervical fluids. Retrieving endocervical fluid is much easier and totally non-invasive. We are thus exploring the utility of endocervical fluids in the diagnosis of endometrial receptivity.