Uterine secretomics: a window on the maternal-embryo interface Ying Cheong, M.D., Carolien Boomsma, Ph.D., Cobi Heijnen, Ph.D., Nick Macklon, Ph.D.  Fertility and Sterility  Volume 99, Issue 4, Pages 1093-1099 (March 2013) DOI: 10.1016/j.fertnstert.2013.01.144 Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Endometrial fluid can be simply aspirated using an embryo transfer catheter attached to a 2 ml syringe. The external catheter is inserted through the cervix with the inner catheter tip shielded within it to avoid contamination with cervical mucus. Once within the uterine cavity, the inner catheter is advanced, and suction is applied for 30 seconds before it is again withdrawn within the external catheter, which is withdrawn from the uterus. Fertility and Sterility 2013 99, 1093-1099DOI: (10.1016/j.fertnstert.2013.01.144) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 2 The area under the curve (AUC) for IL-1β and TNF-α levels as predictors of pregnancy was 0.61 (95% CI, 0.52–0.69), which is shown to be similar to the AUC for predicting pregnancy by embryo quality based on morphologic scoring (0.61; 95% CI, 0.54–0.68). (From Boomsma et al., Endometrial secretion analysis identifies a cytokine profile predictive of pregnancy in IVF, Hum Reprod 2009;24:1427–35, by permission of Oxford University Press.) Fertility and Sterility 2013 99, 1093-1099DOI: (10.1016/j.fertnstert.2013.01.144) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Developmentally impaired human embryos inhibit the secretion of selective implantation modulators by decidualizing endometrial stroma cells (ESCs). Primary ESCs were first decidualized for 5 days and then cocultured with human embryos or none (control cultures, Con). Over the 72-hour coculture period, 30 embryos arrested (Arr) whereas 11 continued to develop normally (Dev). Analysis of the culture supernatants revealed that the presence of an arresting embryo inhibited the secretion of the indicated factors. The letters above the box plots indicate statistically significant differences between groups. P<.01 for all comparisons except for IL-6 and IL-17 (P<.05) (37). Fertility and Sterility 2013 99, 1093-1099DOI: (10.1016/j.fertnstert.2013.01.144) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions