{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:00:58Z","timestamp":1789988458193,"version":"4.0.1"},"reference-count":142,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Endometrial receptivity failure and recurrent implantation failure (RIF) are clinically heterogeneous outcomes shaped by embryo competence, uterine anatomy, endocrine support, immune adaptation, and the timing of embryo-endometrial synchrony. This Review focuses on how immune-cellular niches, cell-specific and spatiotemporal mechanisms, disease-modified receptivity states, and evidence-to-translation boundaries should be interpreted in assisted reproduction. Single-cell, spatial, and multi-omics studies increasingly resolve abnormalities in stromal, sepithelial, vascular, perivascular, and immune compartments, including altered decidualization, epithelial competence, inflammatory tone, metabolic signaling, and microbiota-immune communication. However, most of these signals remain mechanistic, preclinical, associative, or candidate-biomarker evidence rather than proof of clinical utility. Therefore, biological plausibility should not be conflated with routine care: transcriptome-based receptivity timing tests, empirical immune profiling or treatment, microbiota-directed interventions, endometrial scratching, and regenerative add-ons require cautious interpretation unless they improve clinically meaningful outcomes. Future progress depends on standardized RIF phenotyping, cycle-phase and sampling control, euploid embryo transfer where relevant, external validation of cell-specific markers, prospective trials, live-birth endpoints, safety follow-up, and transparent separation of discovery evidence from clinically actionable strategies.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1942809","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:06:19Z","timestamp":1789985179000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Endometrial receptivity failure in assisted reproduction: immune-cellular niches, mechanistic evidence, and translational boundaries"],"prefix":"10.3389","volume":"17","author":[{"given":"Yuhang","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Reproductive Medicine, 116 Hospital, China RongTong Medical Healthcare Group Co. 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