ABSTRACT
Implantation, a critical step for establishing pregnancy, requires molecular and cellular
events resulting in uterine growth and differentiation, blastocyst adhesion, invasion,
and placental formation. Successful implantation requires a receptive endometrium,
a normal and functional embryo at the blastocyst stage, and a synchronized dialogue
between maternal and embryonic tissues. In addition to the well-characterized role
of sex steroids, the complexity of embryo implantation and placentation is exemplified
by the number of cytokines and growth factors with demonstrated roles in these processes.
Disturbances in the normal expression and action of these cytokines result in an absolute
or partial failure of implantation and abnormal placental formation in mice and human.
Members of the gp130 cytokine family, interleukin-11 (IL-11) and leukemia inhibitory
factor, the transforming growth factor beta superfamily, the colony-stimulating factors,
and the IL-1 and IL-15 systems are crucial molecules for a successful implantation.
Chemokines are also important, both in recruiting specific cohorts of leukocytes to
the implantation site and in trophoblast trafficking and differentiation. This review
provides discussion of the embryonic and uterine factors that are involved in the
process of implantation in autocrine, paracrine, and/or juxtacrine manners at the
hormonal, cellular, and molecular levels.
KEYWORDS
Blastocyst - endometrium - implantation - pregnancy - uterine biology
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Hugh S TaylorM.D.
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School
of Medicine
333 Cedar Street, New Haven, CT 06520-8063
eMail: hugh.taylor@yale.edu
