The objective of this study was to assess the LIF (leukemia inhibitory factor) concentration in uterine flushing and serum (ELISA) of women with proven fertility, infertile women and women with recurrent miscarriage. In addition, progesterone level was determined in serum. A decreased production of LIF in the uterine microenvironment was found in states of impaired fertility. With a cut-off point of 8.23 pg/ml for LIF level in uterine flushings we have achieved 86.7% sensitivity and 100% specificity in detection of women with idiopathic infertility compared to fertile controls. No correlation between LIF in serum and uterine flushing was demonstrated, rendering LIF measurements in serum useless for diagnosis of impaired infertility. We conclude that LIF measurement in uterine flushing could be a useful diagnostic tool to predict unsuccessful implantation.