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Despite many advances in assisted reproductive technologies (ART), implantation rates are still low.The process of implantation requires a reciprocal interaction between blastocyst and endometrium, culminating in a small window of opportunity during which implantation can occur.The endometrium of the secretory phase is morphologically and functionally well-prepared for implantation and the early development of the fertilized ovum.The maturation process of the endometrium is mediated by ovarian sex steroid hormones.

The implantation process of the human embryo requires a subtle dialogue between the mother and the embryo.

Although many proteins and molecules may influence endometrial development, their co-ordinated contribution to the implantation process is still poorly understood and a translation into clinical use has not sufficiently been performed.

Clinical evaluation of the endometrium by ultrasound and other techniques, like endometrial biopsy and analysis of uterine secretions, has been intensively studied and therapeutic options to improve endometrial function have been suggested and tested.

ENDOMETRIAL HISTOLOGY varies across the normal menstrual cycle and is due to stimulation by estradiol and progesterone.

Estradiol stimulation results in proliferation of the basalis and functionalis, whereas progesterone promotes glandular development and secretion and is believed to initiate the changes necessary for implantation.