Seed or the Soil.

Implantation remains the black box in Assisted Reproduction program. It is surprising that we are still debating the relative role of the Seed ( Embryo ) versus and/or the soil ( Endometrium ) in implantation. All available evidences indicate that the Embryo plays a crucial role in implantation, in the absence of any demonstrable endometrial pathology.

We published a paper in 2016 (1) suggesting that, “the endometrial thickness is not the deciding factor for the successful implantation of human embryo.”  Besides we also found that. ‘Thin endometrium,’ was a rare occurrence in ART cycles and we had none less  than 7mm in thickness. We also concluded Endometrial thickness should not be a reason to defer Embryo Transfer.

All attempts at further defining an endometrial factor with Doppler studies and endometrial receptor array have not given any satisfactory answers. These are Red Herrings and don’t seem to help in improving implantation, pregnancy or take home baby rates.

1) Does the endometrial thickness really matter in Assisted Reproductive
Technology Cycles - A Retrospective analysis. Gayathri Devi SS , N. Pandiyan, Radha Pandiyan.  Chettinad Health City Medical Journal 2016; 5(1): 13 - 19.

https://www.chcmj.ac.in/pdf/vol5_no1/Does_the_endometrial.pdf