ABSTRACT
This chapter reviews the molecular and mechanical effects that fibroids can have on endometrial receptivity and embryo implantation. The window of implantation is a finite period of time in which the endometrium is receptive to the embryo. Depending on location and size, fibroids can physically block tubal ostia or cervix, distort the uterine cavity, initiate uterine contractility, alter the vasculature of the overlying endometrium, increase inflammation, and dysregulate endometrial receptivity genes. All of these factors can contribute to failed embryo implantation and subfertility/infertility. We review key mechanism by which fibroids can impact endometrial receptivity and implantation and discuss targets of future research and therapy.
