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• W103624824 abstract "textabstractWhen one considers the recognized 'causes' of infertility, problems with gametequality and availability rank highly, as does the means of their transport,whether it be through the fallopian tubes in the female or vas deferens in themale. Conception is seen as the primary goal, and fertility therapies arecurrently focused on helping couples achieve this. In around 25% of couples withfertility problems, medical investigation reveals no such clear cause. It is nowunderstood however, that while a couple may succeed in conception,implantation failure may be the underlying reason for their difficulties inachieving a pregnancy (Macklon et al., 2002). Implantations depend on thesuccesful interaction between the embryo and the endometrium of the uterus.Since the earliest days of in vitro fertilization (IVF) the focus of attention hasbeen the embryo. In order to obtain multiple embryos to allow selection fortransfer to the uterus, complex ovarian stimulation regimens have been devisedwhich result in many oocytes being harvested for fertilization. In most women,these stimulation regimens succefully achieve this aim. Yet despite the ability toproduce large numbers of embryos for selection for transfer, pregnancy ratesfrom IVF remain around 25% per started cycle (ESHRE 2008). Once the embryois transferred into the uterus, it must interact with the endometrium, and in themajority of treatment cycles, this is the moment in which failure occurs.The role played by the endometrium as a determinant factor of fertilitytreatment, and in particular IVF outcomes remains unclear. Moreover, theimpact of ovarian stimulation on endometrial quality is only now beginning to beelucidated. In this introductory chapter, the hormonal control of endometrialdevelopment is reviewed, and current approaches for assessing the receptivity ofthe endometrium to the embryo are critically assessed (Chapter 1.1.1). Theconcept of the 'implantation window' is introduced (Chapter 1.1.2) and themolecular regulation of endometrial maturation and implantation is reviewed(Chapter 1.2), with emphasis on the most important of the described markers ofreceptivity (Chapter 1.3). The challenges of studying the impact of ovarianstimulation on endometrium are described (Chapter 1.4) as a prelude tointroducing a novel means of addressing these by studying endometrial secretionfluid (Chapter 1.5). These considerations lead to the defining of the objectives ofthe research described in this thesis (Chapter 1.6)." @default.
• W103624824 created "2016-06-24" @default.
• W103624824 creator A5039580668 @default.
• W103624824 date "2009-05-12" @default.
• W103624824 modified "2023-09-24" @default.
• W103624824 title "Ovarian Stimulation and the Endometrium: New Approaches and Insights" @default.
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