Electron Microscopy of the Endometrium

Not only high-quality embryos play an important role for successful pregnancy, but also implantation time and endometrium quality. Implantation is a very complex multi-stage process, whose success depends on various factors. Here it’s important to single out such characteristic as endometrial receptivity — an ability to improve the embryo implantation process.

This ability is observed in the uterus in a very short and strictly defined period of the cycle’s luteal phase. This period is called an implantation window — endometrial receptivity to embryo is maximum. During the implantation window the structure of the endometrium witnesses restructuring, characterized by the appearance of endometrial epithelial protrusions — pinopodies.

According to researches, the optimal protrusion development for the implantation occurs from the 20th to 24th days of the cycle and can be identified by the increased expression of peptides — uterine receptivity biomarkers. It’s also found that, the frequency of successful pregnancies is higher for the implantation of embryos between the 22nd and 24th days of the cycle (8-10th day after ovulation) as compared with the later implantation. Moreover, the later the time of implantation is, the higher the risks of early termination of pregnancy are.

To accurately determine the implantation window, the endometrium study is carried out between the 20th and 21st days of the natural menstrual cycle by biopsy and further electron-microscopic examination. It is revealed that the duration of pinopody existence doesn’t exceed 2 days, and the time of their formation depends on the hormonal treatment scheme, and on the individual patient’s response to the treatment in the IVF cycle. In most cases, they are formed on the 20-21st day of natural cycle or 19-20th-day of the controlled ovarian stimulation. However, the process of forming pinopodies can be violated and, accordingly, the implantation window is shifted in time – development time shift.
The implantation failure may also occur in connection with the formation of an insufficient number of pinopodies. This effect may be due to hormonal imbalance, acute or chronic infections, previous surgery. According to the results of electron-microscopic examination it’s possible to prescribe the corresponding therapy and correct the IVF / ICSI schemes.
Electron microscopy of the endometrium is performed in the clinic, «Father, Mother and Baby». You can learn more detailed information making an appointment with a gynecologist — reproductologist. (To book an appointment contact please our consultant sveta-z@hotmail.com)

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