The human endometrium is a hormonally regulated tissue that cyclically growths and differentiates in order to become a structure adequate for implantation. Molecular studies have shown some contradicting results and thus a reappraisal of the endometrium ultrastructure is warranted. In our study, endometrium biopsies were taken during the implantation window of 10 healthy women of reproductive age and analyzed using electron microscopy. Our results showed that during implantation window, the endometrial epithelium encompassed 4 cell types: microvilli-rich cells, pinopode cells, vesiculated cells, and ciliated cells. These cells showed signs of active communication with their external environment and neighboring cells, such as endocytosis, transcytosis and exocytosis. We highlighted important differences between surface and glandular epitheliums and characterized apocrine and holocrine secretion. It is likely that the features described reflect distinct functions in endometrium physiology that should be taken into account in the evaluation of the endometrium during the implantation window.
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