Turkiye Klinikleri Journal of Medical Sciences

.: REVIEW
İmplantasyon Sürecinde Embriyo, Endometriyum Farklanması ve Moleküler Yolaklar
Embryo, Endometrium Differentiation and Molecular Pathways During Implantation
Filiz YILMAZa, Işıl TEKMENa
aHistoloji ve Embriyoloji AD, Dokuz Eylül Üniversitesi Tıp Fakültesi, İzmir, TÜRKİYE
Turkiye Klinikleri J Med Sci. 2019;39(2):212-20
doi: 10.5336/medsci.2018-63651
Article Language: TR
Full Text
ÖZET
 İmplantasyon süreci, menstrual siklusun 20-24. günleri arasında blastokist ile endometriyumun karşılıklı etkileşimini içerir. Bu süreçte blastokist endometriyum yüzeyine yaklaşır, sıkıca bağlanır ve endometriyuma invaze olur. Başarılı implantasyon için; üç önemli bileşen varlığı gereklidir. Birincisi; moleküler olarak programlanmış hücre büyümesi ve differansiyasyona sahip kaliteli embriyo, ikincisi; implantasyona izin veren değişkenlik potansiyeline sahip endometriyum (endometrial reseptivite) ve üçüncüsü; cross-talk diye adlandırılan embriyo ile endometriyum arasındaki bilgi alışverişidir. Bu etkileşime, hormonlar, sitokinler, prostaglandinler ve adezyon molekülleri dâhil olmak üzere birçok faktör aracılık eder. Bu faktörlerden bir veya birkaçının eksikliği implantasyonun gerçekleşmemesine dolayısıyla infertiliteye sebep olur. Bu nedenle implantasyon sürecinde yer alan moleküler yolakları iyi bilmek, yardımcı üreme tedavilerine başvuran hastalar için etyolojinin araştırılmasına ve tedavi sürecine katkı sağlamaktadır. Bu derlemede; güncel bir yaklaşım olarak
implantasyonun üç önemli komponenti olan embriyo, endometriyumun farklanması ve cross-talk olaylarındaki moleküler yolaklar ayrıntılandırılmıştır.

Anahtar Kelimeler: Blastokist; implantasyon; VEGF; MUC-1; HB-EGF; MMP-9; endometriyum
ABSTRACT
 The implantation process involves mutual interaction between the blastocyst and the endometrium, which should result in a short window period. In this process, the blastocyst approaches to the surface of the endometrium, tightly connects and invades the endometrium. For successful implantation; three important components are required. First; a good quality of embryo who is programmed and has got cell growth and differentiation, the second; endometrium (endometrial receptivity) has potential for variability that allows implantation and the third; it is the exchange of information between the endometrium and the embryo, called cross-talk. Several factors, including hormones, cytokines, prostaglandins and adhesion molecules, are involved in this interaction. The lack of one or more of these factors leads to the implantation failure and thus to infertility. Therefore, knowing the molecular pathways involved in the implantation process will contribute to the research of the etiology and the treatment process for those applying for assisted reproductive techniques. In this review; the molecular pathways in the differentiation of embryo and endometrium and cross-talk in the implantation process will be elaborated.

Keywords: Blastocyst; implantation; VEGF; MUC-1; HB-EGF; MMP-9; endometrium
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