Editorial: Cellular micro-environment of the endometrium: reproduction, embryo implantation, and placentation - from bench to bedside and beyond to tissue engineering

It has been reported that the birth rate in the United States experienced a sharp decline of approximately 22% between 2007 and 2022. One of the contributing factors to this trend is a decrease in the general fertility rate among women. Infertility represents a global health issue, affecting approximately 15% of couples worldwide and resulting in substantial medical, emotional, and socioeconomic consequences. On a global scale, declining fertility rates combined with an increasing maternal age at first childbirth further exacerbate these challenges (Adashi et In this line, the interaction between the embryo and the endometrium can be described as a complex cellular dialogue characterized by a fine balance between immunological tolerance and immune protection -an apparent immunological paradox that serves as a gateway to successful implantation, endometrial decidualization, placental formation, and subsequent embryonic and foetal development. The embryo-endometrium cross-talk is the art of balance and pregnancy success fully depends on successful implantation. The endometrium should be in a receptive and mature state, and the competent blastocyst in a synchronized manner.