Physiological and molecular processes initiated during implantation for pregnancy success are complex but highly organized. This review primarily highlights adverse ripple effects arising from defects during the peri-implantation period that perpetuate throughout pregnancy. These defects are reflected in aberrations in embryo spacing, decidualization, placentation and intrauterine embryonic growth, manifesting in preeclampsia, miscarriages and/or preterm birth. Understanding molecular signaling networks that coordinate strategies for successful implantation and decidualization may lead to approaches to improve the outcome of natural pregnancy and pregnancy conceived from in vitro fertilization.
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We regret that space limitations precluded us from citing many relevant references. We thank K. Yoshinaga and A. Erlebacher for helpful discussions. Work embodied in this article from S.K.D.'s group was supported in part by US National Institutes of Health (NIH) grants (HD12304, HD068524 and DA06668), the March of Dimes, and the Grand Challenges Explorations Initiative through the Bill & Melinda Gates Foundation. J.C. is supported by an NIH National Research Service Award Fellowship (F30AG040858) and the University of Cincinnati Medical Scientist Training Program (T32 GM063483), and X.S. is supported by a Lalor Foundation Postdoctoral Fellowship.
The authors declare no competing financial interests.
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Cha, J., Sun, X. & Dey, S. Mechanisms of implantation: strategies for successful pregnancy. Nat Med 18, 1754–1767 (2012). https://doi.org/10.1038/nm.3012
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