Understanding a Critical Step in Human Reproduction

Harvey Kliman, M.D., Ph.D.,Research Scientist in Obstetrics and Gynecology

More than 10 percent of reproductive age couples suffer from infertility, and in 20-25 percent of such couples, there is no proven cause. In many of these cases, the couples pursue assisted reproductive technology (ART). However, even using ART, fewer than 10 percent of embryos implant successfully. Abnormalities in the process of implantation undermine the effectiveness of ART. Dr. Kliman recognized the value of a test to determine if the endometrium (uterine lining) was physically capable of supporting implantation.

Highlighted Study Findings

Previous research by Dr. Kliman identified an endometrial marker that could help predict whether implantation would occur during any given assisted cycle. He found that this marker is either absent, or expressed at the wrong time in patients whose assisted attempts fail. Since the majority of endometrial samples studied thus far had been from patients seeking treatment for infertility, there was little information on the prevalence of expression abnormalities of this marker in the general female population. In research funded by the Ethel F. Donaghue Women’s Health Investigator Program, Dr. Kliman was able to evaluate expression of this marker in normal, reproductive age women compared to women with unexplained infertility to establish the incidence of this marker abnormality. In this study, Dr. Kliman found that 85% of fertile women display normal patterns of this marker expression. Among women with infertility issues, only 20% revealed normal patterns. Nearly 30% of women with fertility problems had none of this marker. Due to the direct correlation between successful embryo implantation and levels of this marker, Dr. Kliman determined that a test involving this marker could help guide the physician and patient toward the most effective infertility treatment. Based on this work, Dr. Kliman developed a test that is now widely used. Significant emotional and financial expenditures have been saved for couples utilizing this test.