Endometrial receptivity: changes in cell-surface morphology

Semin Reprod Med. 2000;18(3):229-35. doi: 10.1055/s-2000-12561.

Abstract

Ovulation and fertilization trigger embryonic development and endometrial differentiation by corpus luteum progesterone production. These two synchronous processes couple about 1 week later, when the blastocyst begins to implant in the now receptive endometrium (implantation window). Receptivity is a state of endometrial differentiation marked by a change in epithelial morphology: the hairy-like cell microvilli fuse to a single flower-like membrane projection called the "pinopode." Scanning electron microscopy of sequential endometrial biopsies shows that pinopodes form briefly (1-2 days), and their numbers correlate with implantation. On average, the formation of pinopodes is earlier in stimulated (days 19-20) and later in artificial (days 21-22) compared with natural cycles (days 20-21). There is, however, a wide (up to 5 days) variation between women in the cycle days on which pinopodes form. These results suggest the existence of a narrow and discrete implantation window in humans. Detection of pinopodes is a potential clinical marker to assess endometrial receptivity.

Publication types

  • Review

MeSH terms

  • Cell Membrane / ultrastructure
  • Embryo Implantation*
  • Endometrium / physiology*
  • Endometrium / ultrastructure*
  • Epithelium / ultrastructure
  • Female
  • Humans
  • Menstrual Cycle
  • Microscopy, Electron, Scanning
  • Microvilli / ultrastructure
  • Ovulation Induction
  • Pregnancy
  • Time Factors