For successful embryo implantation a synchronous and receptive endometrium must be developed within the uterus. Failure to achieve endometrial receptivity means pregnancy cannot occur regardless of embryo quality. The secretions from the endometrium into the uterine cavity reflect the hospitable or otherwise nature of the endometrium and form the microenvironment of implantation.
Our work is protein focussed utilising cytokine/chemokine analysis, proteomic and glycoproteomic analysis to identify changes to the uterine fluid associated with receptivity and infertility. Our approach has been to both understand and predict receptivity failure; studying both the vital implantation window but also the regenerative proliferative phase; examining for clues as to where and when receptivity failure originated. Our belief is that identifying these dysregulated factors will open up a new era in the development of novel therapeutic options for treating women impacted by poor endometrial receptivity.
Our uterine fluid studies have been complimented with development of a serum based multivariate assay to predict receptivity with the goal of predicting likelihood of successful implantation following embryo transfer. An initial retrospective trial of 283 women, testing serum collected at hCG+2, was successful in predicting >80% of transfer outcomes. A multicentre validation trial is now in progress for completion 2020.