Endometrial-embryo cross-talk during the peri-implantation period

Introduction: Implantation failure remains a major challenge in assisted reproductive technology. Successful implantation requires coordinated endometrial-embryo cross-talk mediated by clinical, embryological, and molecular factors.Aim: To evaluate clinical parameters, IVF-related variables, and molecular markers of endometrial receptivity associated with implantation outcomes.Methods: A prospective observational study was conducted among 100 women undergoing IVF, divided into implanted (n = 45) and non-implanted (n = 55) groups. Clinical history, IVF parameters, and endometrial biomarkers (LIF, IL-6, integrin ?v?3, HB-EGF, Glycodelin A) were assessed. Statistical comparisons and correlation analyses were performed.Results: Baseline demographic and infertility-related parameters did not differ significantly between groups. Endometrial thickness (10.1±1.5 vs. 9.4±1.6 mm, p = 0.03), blastocyst transfer rate (73% vs. 53%, p = 0.04), and embryo quality (? grade B: 89% vs. 66%, p = 0.01) were significantly higher in the implanted group. Molecular markers were elevated in the implanted group, including LIF (152.4±28.6 vs. 128.7±26.9 pg/mL, p = 0.001), IL-6 (34.2±7.5 vs. 28.9±6.8 pg/mL, p = 0.006), integrin ?v?3 (2.8±0.6 vs. 2.3±0.5 AU, p = 0.005), HB-EGF (87.5±15.2 vs. 74.1±14.7 pg/mL, p = 0.003), and Glycodelin A (42.7±9.4 vs. 36.5±8.7 ng/mL, p = 0.03). Correlation analysis confirmed significant associations, with LIF showing the strongest correlation (r = 0.34, p = 0.001).Conclusion: Implantation success is determined by a combination of endometrial receptivity and embryo quality. Elevated cytokines, adhesion molecules, and growth factors create a favorable molecular milieu, while clinical parameters such as endometrial thickness and blastocyst transfer further enhance outcomes. Integrated assessment of these factors may improve prediction and optimization of IVF success.