{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"bioRxiv"}],"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:58:20Z","timestamp":1790816300126,"version":"4.1.0"},"posted":{"date-parts":[[2026,9,28]]},"group-title":"Developmental Biology","reference-count":71,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"award":["K99HD112539"],"award-info":[{"award-number":["K99HD112539"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["R01HD116742"],"award-info":[{"award-number":["R01HD116742"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["R01AI148695"],"award-info":[{"award-number":["R01AI148695"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["R01HD109152"],"award-info":[{"award-number":["R01HD109152"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Society for reproductive investigation","award":["SRI\/Bayer discovery innovation grant"],"award-info":[{"award-number":["SRI\/Bayer discovery innovation grant"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,9,28]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:p>Embryo implantation remains a major limitation of assisted reproductive technology, with failure occurring in approximately 30% of euploid embryo transfers. Implantation requires a synchronized dialogue between the blastocyst and receptive endometrium during the window of implantation (WOI), yet minimally invasive approaches to characterize the structural and molecular features of receptivity remain limited. We analyzed paired sonohysterogram images and uterine lavage samples collected during the proliferative and mid-secretory phases from subjects with regular ovulatory cycles and proven fertility. Endometrial folds were quantified, and lavage samples were analyzed by Luminex multiplex immunoassay. Folds were present in both phases but were significantly more abundant during the mid-secretory WOI, independent of imaging view and endometrial thickness. Folding correlated strongly with circulating estradiol level during the proliferative phase but not the mid-secretory phase, and folding patterns between phases were not correlated, suggesting distinct regulatory mechanisms. Consistent with these structural patterns, uterine lavage demonstrated phase-specific differences in expression of factors associated with endometrial receptivity and implantation, with glandular epithelium, and myeloid-lineage cells emerging as major contributors. Together, these findings identify coordinated structural and secretory processes during the WOI and support further evaluation of endometrial folding and uterine lavage as complementary, minimally invasive markers of endometrial receptivity.<\/jats:p>\n                <jats:sec>\n                  <jats:title>Significant Statement<\/jats:title>\n                  <jats:p>This study identifies coordinated structural and secretory features of the human endometrium during the window of implantation, highlighting endometrial folding and uterine lavage as complementary, minimally invasive approaches for investigating endometrial receptivity.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.09.24.754255","type":"posted-content","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:25:19Z","timestamp":1790587519000},"source":"Crossref","is-referenced-by-count":0,"title":["Dynamic Changes in Endometrial Folding and Secretory Activity Across the Menstrual Cycle"],"prefix":"10.64898","author":[{"given":"Jessica Garcia","family":"De Paredes","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Health, Rutgers Biomedical and Health Sciences, Newark, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anat","family":"Chemerinski","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Health, Rutgers Biomedical and Health Sciences, Newark, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lipika","family":"Murali","sequence":"additional","affiliation":[{"name":"Institute for Quantitative Health Science and Engineering, Michigan State University, University, East Lansing, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Lynch","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Health, Rutgers Biomedical and Health Sciences, Newark, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingshi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Health, Rutgers Biomedical and Health Sciences, Newark, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0021-4319","authenticated-orcid":false,"given":"Gregory","family":"Burns","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University, East Lansing, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5714-4994","authenticated-orcid":false,"given":"Emmanuel","family":"Paul","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University, East Lansing, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nataki C.","family":"Douglas","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Health, Rutgers Biomedical and Health Sciences, Newark, NJ, USA"},{"name":"Center for Immunity and Inflammation, Rutgers Biomedical and Health Sciences, Newark, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5051-6724","authenticated-orcid":false,"given":"Ripla","family":"Arora","sequence":"additional","affiliation":[{"name":"Institute for Quantitative Health Science and Engineering, Michigan State University, University, East Lansing, MI, USA"},{"name":"Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University, East Lansing, MI, USA"},{"name":"Department of Biomedical Engineering, Michigan State University, University, East Lansing, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026093016550918000_2026.09.24.754255v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/J.FERTNSTERT.2020.07.002"},{"key":"2026093016550918000_2026.09.24.754255v1.2","doi-asserted-by":"crossref","unstructured":"Muter J , Lynch VJ , McCoy RC , Brosens JJ . 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