open access

Vol 47, No 5 (2009)
Original paper
Submitted: 2011-12-19
Published online: 2010-01-14
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Physiopathology of human embryonic implantation: clinical incidences.

Philippe Merviel, Emmanuelle Lourdel, Rosalie Cabry, VÊronique Boulard, MÊlanie Brzakowski, Pauline Demailly, Françoise Brasseur, Henri Copin, Aviva Devaux
DOI: 10.2478/v10042-009-0058-3
·
Folia Histochem Cytobiol 2009;47(5):25-34.

open access

Vol 47, No 5 (2009)
ORIGINAL PAPERS
Submitted: 2011-12-19
Published online: 2010-01-14

Abstract

Embryo implantation consists of a series of events promoting the invasion of the endometrium and then the uterine arterial system by the extra-embryonic trophoblast. In order for this semi-heterologous implantation to succeed, the endometrium has to first undergo a number of structural and biochemical changes (decidualization). The decidua's various constituents subsequently play a role in the embryonic implantation. The third step is the transformation of the uterine vascular system and the growth of the placenta, which will provide the foetoplacental unit with nutrients. Several physiopathological aspects will be discussed: 1) the implantation window, regulated by maternal and embryonic hormonal secretions and thus influenced by any defects in the latter: dysharmonic luteal phase, 21-hydroxylase block, abnormal integrin expression, 2) the successive trophoblast invasions of uterine vessels which, when defective, lead to early embryo loss or late-onset vascular pathologies, as preeclampsia, 3) the pregnancy's immunological equilibrium, with a spontaneously tolerated semi-allogeneic implant, 4) the impact of pro-coagulant factors (thrombophilia) on the pregnancy's progression, 5) the environment of the uterus, ranging from hydrosalpinx to uterine contractions. In summary, the least anatomical or physiological perturbation can interfere with human embryonic implantation - a very particular phenomenon and a true biological paradox.

Abstract

Embryo implantation consists of a series of events promoting the invasion of the endometrium and then the uterine arterial system by the extra-embryonic trophoblast. In order for this semi-heterologous implantation to succeed, the endometrium has to first undergo a number of structural and biochemical changes (decidualization). The decidua's various constituents subsequently play a role in the embryonic implantation. The third step is the transformation of the uterine vascular system and the growth of the placenta, which will provide the foetoplacental unit with nutrients. Several physiopathological aspects will be discussed: 1) the implantation window, regulated by maternal and embryonic hormonal secretions and thus influenced by any defects in the latter: dysharmonic luteal phase, 21-hydroxylase block, abnormal integrin expression, 2) the successive trophoblast invasions of uterine vessels which, when defective, lead to early embryo loss or late-onset vascular pathologies, as preeclampsia, 3) the pregnancy's immunological equilibrium, with a spontaneously tolerated semi-allogeneic implant, 4) the impact of pro-coagulant factors (thrombophilia) on the pregnancy's progression, 5) the environment of the uterus, ranging from hydrosalpinx to uterine contractions. In summary, the least anatomical or physiological perturbation can interfere with human embryonic implantation - a very particular phenomenon and a true biological paradox.
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About this article
Title

Physiopathology of human embryonic implantation: clinical incidences.

Journal

Folia Histochemica et Cytobiologica

Issue

Vol 47, No 5 (2009)

Article type

Original paper

Pages

25-34

Published online

2010-01-14

DOI

10.2478/v10042-009-0058-3

Bibliographic record

Folia Histochem Cytobiol 2009;47(5):25-34.

Authors

Philippe Merviel
Emmanuelle Lourdel
Rosalie Cabry
VĂŠronique Boulard
MĂŠlanie Brzakowski
Pauline Demailly
Françoise Brasseur
Henri Copin
Aviva Devaux

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