The Impact of Uterine Disorders on Embryo Implantation and Early Survival: From Molecular Insights to Clinical Evidence

Antonio D Apos Amato, D Apos Amato A, Andrea Etrusco, Riemma G, Gaetano Riemma, Chiantera V, Vito Chiantera, Antonio Simone Laganà, Vittorio Agrifoglio, Agrifoglio V, Mariano Catello Di Donna, Di Donna MC, Basilio Pecorino, Pecorino B, Andrea Tinelli, Giuseppe Scibilia, Tinelli A, Antonio Malvası, Malvasi A, Antonio Malvasi, Bernard Fioretti, Fioretti B, Gliozheni E, Elko Gliozheni, Antonio D’Amato, Cicinelli E, Ettore Cicinelli, Antonio D'Amato, D'Amato A
Gynecologic and obstetric investigation · 2025 · vol. 90(5) , pp. 383–397 · doi:10.1159/000543836 · PMID:39884257 · W4407028357
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-06 ⓘ

This review analyzes how uterine pathologies like polyps, fibroids, and adenomyosis impact embryo implantation and survival, proposing that tailored treatments may improve reproductive outcomes.

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Abstract

BACKGROUND: Embryo implantation and early survival in a synchronized, receptive endometrium are critical for establishing a successful pregnancy, but uterine pathologies can present challenges to reproductive success by significantly impacting this complex process. OBJECTIVES: The purpose of this review was to analyze the impact of uterine pathologies on embryo implantation, early embryo survival, and finally on the development of infertility, with references to reproductive outcomes and the main evidence related to therapeutic strategies. METHODS: The relevant publications were identified after queries of the following sources: PubMed, Google Scholar, Web of Science, and publishers' databases, complemented by a cross-check of the reference lists. We used a combination of the search terms "uterine pathology," "infertility," "embryo implantation," and "embryo survival" with terms relevant to the topic of each paragraph, such as "endometrial polyps (EPs)," "leiomyoma," "uterine malformations," "adenomyosis," and "intrauterine adhesions (IUAs)." OUTCOME: All articles describing the influence of each uterine pathology on embryo implantation/early survival were included, with a focus on the role of EPs, leiomyomas, uterine malformations, adenomyosis, and IUAs. CONCLUSIONS AND OUTLOOK: The exact influence of uterine diseases on the uterine-embryo crosstalk is unknown. Nevertheless, numerous molecular mechanisms have been proposed to explain some of the underlying processes. Tailored treatments for each specific disease may improve the endometrial milieu and, thus, reproductive outcomes. Future studies should aim to further understand the underlying molecular phenomena driving the development of these pathologies, how they may disrupt early embryo life stages, and the exact benefit of medical and surgical treatments on embryo survival.

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Condition tags

adenomyosisinfertility

MeSH descriptors

Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (100)

Source provenance

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License: CC0 · commercial use OK