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Endometrial receptivity describes the intricate process undertaken by the uterine lining to prepare for the implantation of an embryo. The accepted definition of endometrial receptivity is "the period of endometrial maturation during which the trophectoderm of the blastocyst can attach to the endometrial epithelial cells and subsequently invade the endometrial stroma and vasculature." Successful implantation and early pregnancy maintenance rely on endometrial receptivity, such that its deficiency or absence leads to early pregnancy loss and infertility. This activity reviews the concept of endometrial receptivity, embryo implantation, and the current technology available to assess endometrial receptivity. Objectives: Explain the importance of endometrial receptivity in achieving clinical pregnancy. Describe the pathophysiology of endometrial receptivity. Identify factors that can disturb endometrial receptivity. Summarize the current methods for assessing endometrial receptivity. Access free multiple choice questions on this topic.

Endometrial receptivity describes the intricate process undertaken by the uterine lining to prepare for the implantation of an embryo. While embryo development and endometrial preparation are concurrent yet independent processes, their synchronization is critical to the success of embryo apposition, adhesion, invasion, and further ongoing pregnancy.[1] The accepted definition of endometrial receptivity is "the period of endometrial maturation during which the trophectoderm of the blastocyst can attach to the endometrial epithelial cells and subsequently invade the endometrial stroma and vasculature." [2] The limited period of optimal endometrial receptivity in which the endometrium is ready to receive an embryo, paired with an embryo's readiness to the implant, is commonly referred to as the "window of implantation" and is generally detected between days 20 and 24 of a normal 28-day menstrual cycle.[2][3] Many molecular pathways involve hormones, adhesion molecules, cytokines, and growth factors acting in concert to create a synchronous window of implantation. When synchrony is lost or receptivity is not achieved, the consequence is early pregnancy loss or infertility.[4] This review aims to define endometrial receptivity, describe the critical factors contributing to the development and function of a receptive endometrium, review the causes and consequences of a non-receptive endometrium, and discuss the available technologies for diagnosing and treating the potentially defective endometrium in infertility patients.

Patients in the care of infertility practices are cared for by an interprofessional team of medical professionals, including clinicians (MDs, DOs, NPs, and PAs), nurses, embryologists, lab technicians, and other health professionals. It is essential for all team members to be aware of the optimal time for the patient to achieve pregnancy to generate a thoughtful treatment plan with the highest likelihood of success; this requires open communication channels between team members and accurate, updated patient record keeping. This interprofessional approach will yield the best patient outcomes.