{"id":32589,"date":"2024-05-14T12:00:00","date_gmt":"2024-05-14T10:00:00","guid":{"rendered":"https:\/\/clinicafertia.com\/blog\/ricettivita-endometriale-importanza-nel-successo-riproduttivo"},"modified":"2026-09-23T10:58:00","modified_gmt":"2026-09-23T08:58:00","slug":"ricettivita-endometriale-importanza-nel-successo-riproduttivo","status":"publish","type":"post","link":"https:\/\/clinicafertia.com\/it\/blog\/ricettivita-endometriale-importanza-nel-successo-riproduttivo","title":{"rendered":"Ricettivit\u00e0 endometriale. Importanza nel successo riproduttivo"},"content":{"rendered":"\n

Durante a\u00f1os, los esfuerzos en la mejora de los resultados en t\u00e9cnicas de reproducci\u00f3n asistida se han focalizado en mejorar los protocolos de estimulaci\u00f3n de cara a obtener el mayor n\u00famero de ovocitos, que estos sean de la mejor calidad, y embriones con la mayor capacidad de implantaci\u00f3n, con una dotaci\u00f3n gen\u00e9tica normal (euploide). Sin embargo, se precisa un embri\u00f3n de buena calidad, pero no hemos de olvidar que el endometrio es un factor muy importante en la implantaci\u00f3n.<\/p>\n\n

Tras la ovulaci\u00f3n, el endometrio experimenta cambios estructurales y bioqu\u00edmicos hasta alcanzar el estado de endometrio receptivo, que es lo que conocemos como ventana de implantaci\u00f3n<\/strong><\/a>. Este proceso est\u00e1 gobernado por una hormona, la progesterona<\/strong><\/a>, que va aumentando despu\u00e9s de la ovulaci\u00f3n e induce la transformaci\u00f3n del endometrio<\/strong> para que sea receptivo.<\/p>\n\n

\u00bfQu\u00e9 es la receptividad endometrial?<\/h3>\n\n

La receptividad endometrial<\/strong> es la capacidad del endometrio, el revestimiento interno del \u00fatero, para recibir y permitir la implantaci\u00f3n de un embri\u00f3n. Este proceso es fundamental para el \u00e9xito del embarazo<\/strong>, ya que solo un embri\u00f3n sano podr\u00e1 implantarse correctamente en un endometrio receptivo.<\/p>\n\n

\u00bfC\u00f3mo saber si mi endometrio es receptivo?<\/h3>\n\n

Existen diversas t\u00e9cnicas para evaluar la receptividad endometrial<\/strong>, entre las que se incluyen:<\/p>\n\n

Ecograf\u00eda<\/h4>\n\n

Durante la primera fase del ciclo previo a la ovulaci\u00f3n, el endometrio se va engrosando gracias al est\u00edmulo de los estr\u00f3genos y adquiere un aspecto t\u00edpico trilaminar con un espesor ideal entre 7-12 mm. Tras la ovulaci\u00f3n, se transforma en secretor gracias a la progesterona y ya est\u00e1 preparado para recibir al embri\u00f3n. Se considera que el grosor ideal en el momento de la transferencia es de 7-12 mm; si es menor de 6 mm, las tasas de gestaci\u00f3n son m\u00e1s bajas (1). Estas mediciones se realizan con una ecograf\u00eda transvaginal 2D. En ocasiones, para una mejor valoraci\u00f3n del volumen y morfolog\u00eda de la cavidad, se realiza una ecograf\u00eda 3D<\/strong><\/a>, que nos permite valorar tanto el volumen de la cavidad como la presencia de patolog\u00eda (p\u00f3lipos, miomas, septos\u2026) de un modo m\u00e1s exhaustivo.<\/p>\n\n

Biopsia endometrial<\/h4>\n\n

Nos permite visualizar el canal cervical y la cavidad endometrial, evaluar las caracter\u00edsticas del endometrio, descartar patolog\u00eda como la presencia de endometritis cr\u00f3nica<\/strong><\/a> (2), que es causa de aborto y de fallo de implantaci\u00f3n<\/strong>, analizar y tratar la patolog\u00eda de la cavidad detectada mediante ecograf\u00eda, as\u00ed como valorar una adecuada correspondencia del aspecto del endometrio con la fase del ciclo.<\/p>\n\n

Anal\u00edtica<\/h4>\n\n

Hoy sabemos que la medici\u00f3n de los niveles de progesterona<\/strong> en el d\u00eda previo a la transferencia (3) va a permitir suplementar con dicha hormona a aquellas mujeres con niveles inadecuados, favoreciendo unas mejores tasas de gestaci\u00f3n<\/strong><\/a>. Recientemente, el grupo de Humaidan (4) ha se\u00f1alado adem\u00e1s que niveles adecuados de estradiol en el d\u00eda previo a la transferencia tambi\u00e9n se relacionan con mejores tasas de \u00e9xito.<\/p>\n\n

Estudio de la microbiota<\/h3>\n\n

Hasta hace unos a\u00f1os, se pensaba que el \u00fatero era una cavidad est\u00e9ril; hoy sabemos que no es as\u00ed. Conocemos como microbiota<\/strong><\/a> al conjunto de microorganismos que habitan en nuestro organismo. A nivel del tracto genital est\u00e1 dominado por lactobacilos. Estos lactobacilos producen factores inflamatorios, sustancias antimicrobianas y \u00e1cido l\u00e1ctico que permiten mantener una flora adecuada que facilite la implantaci\u00f3n. Una microbiota alterada, con menor contenido en lactobacilos, se asocia a mayor incidencia de aborto y tasas m\u00e1s bajas de implantaci\u00f3n (5). La presencia de pat\u00f3genos, en particular Gardnerella y estreptococo, da lugar a la producci\u00f3n de factores inflamatorios que interfieren con la implantaci\u00f3n embrionaria.<\/p>\n\n

Dado que la mayor\u00eda de estas bacterias, por su baja concentraci\u00f3n, no son cultivables en condiciones est\u00e1ndar, recurrimos a t\u00e9cnicas de detecci\u00f3n g\u00e9nica para su estudio.<\/p>\n\n

Estudio de la poblaci\u00f3n de c\u00e9lulas inmunes a nivel endometrial<\/h3>\n\n

Las c\u00e9lulas inmunes a nivel del endometrio desempe\u00f1an un papel crucial en la implantaci\u00f3n y consecuci\u00f3n del embarazo. A nivel endometrial, ha de desarrollarse un equilibrio adecuado que permita que el embri\u00f3n, gen\u00e9ticamente distinto de la madre, no sea rechazado y pueda implantar.<\/p>\n\n

Los mecanismos precisos que permiten esta tolerancia inmunol\u00f3gica son complejos y se mantienen en estudio hoy en d\u00eda. Se han identificado una serie de c\u00e9lulas inmunes que incluyen: c\u00e9lulas Natural Killer uterinas (uNK), macr\u00f3fagos, c\u00e9lulas T, c\u00e9lulas dendr\u00edticas y c\u00e9lulas B, presentes en la interfase materno-fetal con funciones y concentraciones variables a lo largo de las diversas etapas de la gestaci\u00f3n. Disponemos de t\u00e9cnicas que nos permiten el estudio de esta poblaci\u00f3n de c\u00e9lulas inmunes.<\/p>\n\n

Estudio del perfil g\u00e9nico endometrial, test de receptividad<\/h3>\n\n

Consiste en analizar una serie de genes relacionados con la receptividad endometrial, determinando si el endometrio es o no receptivo<\/strong> en el momento de la toma de la muestra. Ello va a permitir coordinar la transferencia embrionaria en el momento de mayor receptividad del endometrio<\/strong>. La toma de tejido se realiza en la consulta, ya sea en un ciclo natural o con tratamiento hormonal.<\/p>\n\n

Mediante esta prueba se pueden detectar desplazamientos de la ventana de implantaci\u00f3n<\/strong>, presentes en el 20-25% de las mujeres con fallo de implantaci\u00f3n, realizando una transferencia personalizada y aumentando la probabilidad de embarazo. En estos casos, tanto el grosor endometrial como la calidad de los embriones a transferir<\/strong><\/a> son adecuados, pero la implantaci\u00f3n no se produce porque la transferencia embrionaria no se ha realizado en el momento m\u00e1s \u00f3ptimo.<\/p>\n\n

El estudio personalizado e integral del endometrio, asegurando las mejores condiciones de receptividad, es fundamental para el \u00e9xito del tratamiento. En Cl\u00ednica Fertia nos ocupamos de desarrollar los mejores protocolos para conseguir el embri\u00f3n con mayor capacidad de implantaci\u00f3n, pero no nos olvidamos del factor uterino, crucial para hacer tu sue\u00f1o realidad y lograr que seas mam\u00e1.<\/p>\n\n

Contacta con nosotros<\/a> para tu primera cita de fertilidad gratuita.<\/p>\n\n

Bibliograf\u00eda<\/h3>\n\n
    \n
  1. Garcia Velasco JA, Acevedo B, Alvarez C, Alvarez M, Bellver J, Fontes J. Strategies to manage refractory endometrium. State of the art in 2016. Reprod Biomed Online. 2016;32:474-489.<\/li>\n\n\n\n
  2. Johnston-MacAnanny EB, Hartnett J, Engmann LL, Nulsen JC, Sanders MM, Benadiva CA. Chronic endometritis is a frequent finding in women with recurrent implantation failure after in vitro fertilization. Fertil Steril. 2010;93:437-441.<\/li>\n\n\n\n
  3. Labarta E, Mariani G, Holtmann N, Celada P, Remohi J, Bosch E. Low serum progesterone on the day of embryo transfer is associated with a diminished ongoing pregnancy rate in oocyte donation cycles after artificial endometrial preparation: a prospective study. Hum Reprod. 2017;32:2437-2442.<\/li>\n\n\n\n
  4. Alsbjerg B, Jensen MB, Elbaek HO, Laursen R. Midluteal serum estradiol levels are associated with live birth rates in hormone replacement therapy frozen embryo transfer cycles: a cohort study. Fertil Steril. 2024.<\/li>\n\n\n\n
  5. Moreno I, Simon C. Relevance of assessing the uterine microbiota in infertility. Fertil Steril. 2017;108:32-39.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Durante a\u00f1os, los esfuerzos en la mejora de los resultados en t\u00e9cnicas de reproducci\u00f3n asistida se han focalizado en mejorar los protocolos de estimulaci\u00f3n de cara a obtener el mayor n\u00famero de ovocitos, que estos sean de la mejor calidad, y embriones con la mayor capacidad de implantaci\u00f3n, con una dotaci\u00f3n gen\u00e9tica normal (euploide). Sin […]<\/p>\n","protected":false},"author":5,"featured_media":29477,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-32589","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cat-fertilidad"],"yoast_head":"\nRicettivit\u00e0 Endometriale: Tutto Quello che Devi Sapere<\/title>\n<meta name=\"description\" content=\"Scopri come sapere se il tuo endometrio \u00e8 ricettivo e quali tecniche permettono di valutarlo \u2014 un fattore chiave per il successo riproduttivo.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/clinicafertia.com\/it\/blog\/ricettivita-endometriale-importanza-nel-successo-riproduttivo\" \/>\n<meta property=\"og:locale\" content=\"it_IT\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ricettivit\u00e0 endometriale. 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