4. Implantation

8/16/2019 4. Implantation

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Implantation

Dr. Andhi Jusup, M.Kes

Lab Fisiologi UNS Surakarta

20!


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"he i#plantation o$ the pla%enta inthe uterus #a& be %onsidered as an

allogra$t, and this raises the 'uestion as

to (h& there is #aternal toleran%e to this

nonsel$ tissue.


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Blastocyst implantation involved series of even:

1. Synchronized development of the conceptus and

a receptive uterus.

2. Attachment of the conceptus to the uterus.

3. Transformation of the endometrium to decidua.

4. Formation of the definitive placenta.


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In human, it has een estimated that et!een 3"#and $"# of conceptuses are lost efore or at the

time of implantation, !ithout !omen ein% a!are

of havin% een pre%nant.

About half are

probably a

consequence of geneticdefect in the conceptus

The etiology of the

remaining losses isunknown

Kennedy, 1997: Physiology of implantation


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The endometrium is not essential to implantation, since the lastocyst can e

implanted succesfully into many tissues.

Embryonic implantation in human is a progressive

and a complex process

The embryo plays an important role in

the receptive phase of implantation

(“indo!"#

The blastocyst produce prostaglandins, platelet-activating factor and plasminogen

activator ( $he component of both the neoplastic and imflamatory process

in%ol%ed in blastocyst implantation#"

The blastocyst is the driving force in implantation (efficient,in%asi%e, aggresi%e, dynamic force of succesfull pregnancy"


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The human embryo begins to

produce hCG before implantation(before h&' maternal detectable"

Corpus luteum

Higher levels of

estrogen and progestogen


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!regnant "omen

hCG is synthesi#ed in the syncytiotrophoblast

of implanting blastocyst

hCG is rising $% &H receptor on the luteal cells

&uteotrophic action (Progestogenic acti%ity"

$he main function of h&' appears to be maintenance of the

&orpus uteum (&" of early pregnancy


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!'GE(TE')E

& !rogesterone plays an important role in preparing and

maintaining the endometrium for the acceptance and

support of the conceptus during and after

implantation*

& !rogesterone may have direct supportive effect on the

trophobalst*

The antiprogestine +' ./0 is effective in preventing implantation

and also in inducing abortion, particularly if it is used before 1 "ee2s

from the last menstrual period*


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!lacental progesterone production "as detected as

early as 13 days of gestational age

+ 4/ days after embryo transfer0*

THE '&E 5 !'GE(TE')E +!0 6)7

E(T'678& +E0 5' (CCE((5& !'EG6)C9

To prepare the endometrium

for embryo implantation

To stabili#e endometrium during

early pregnancy

(Stuart Lavery, 2003)


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!attern of plasma hormones during pregnancy

estriol $$ oestrone andoestradiol

!rogesterone

estrone

!rolactine

/3 ng;ml

hCG


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!rogesterone is largerly produced by the corpus luteum

+C&0 and the C& remain active for the hole pregnancy, but

after -1 "ee2s its role is limited in producing progesterone*

$he human conceptus thus shos a remar)able

endocrine emancipation

The placenta emerges as the ma

4. Implantation

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