O-099 Implantation 2024 - what do we know?

Abstract

Abstract Three major factors are involved in implantation, the embryo, the endometrium and the microbiome. The interactions between these major participants need to, support normal pregnancies and reject abnormal ones and have an appropriate pro/anti-inflammatory response to the genital tract microbiome. Implantation is controlled by a series biological checks and balances in the context of an endometrium that regenerates monthly. Our understanding of these checks and balances has been advanced with the use of sequencing technologies. • The high incidence of aneuploidy in early human embryos has been described in detail with low-coverage sequencing- based PGT-A. • The contribution of karyotype abnormality to miscarriages has been clarified with the use of a microarray-based comparative genomic hybridisation and the cell free DNA. • New insights into endometrial composition have been made through single cell sequencing that has revealed the existence of new subsets of cells at the maternal fetal interface. • The genital tract microbiome has been investigated using high-throughput next-generation sequencing of bacterial 16S rRNA genes. This rich tapestry of information has revealed the complexity of cellular and molecular process controlling implantation. The challenge is to identify specific mechanisms and therapeutic targets for couples suffering reproductive failure.