Vasculogenesis and angiogenesis in the endometrium during menstrual cycle and implantation

Blood vessels develop via two subsequent processes, vasculogenesis and angiogenesis, both being of crucial importance during menstrual cycle and implantation. These processes are also involved in the development of the fetal and placental vasculatures. During vasculogenesis, formation of the earliest primitive capillaries is achieved by in situ differentiation of hemangiogenic stem cells that are derived from pluripotent mesenchymal cells. The subsequent process, angiogenesis, is characterized by development of new vessels from already existing vessels, and is a well coordinated process initiated by stimulation of various growth factors. Vasculogenesis and angiogenesis are important and complex processes involving extensive interplay between cells and growth factors. The development, maturation and maintenance of the vascular network are necessary for successful hemochorial placentation as well as normal embryonic development and growth. In this review, we outline the basic mechanisms of vasculogenesis and angiogenesis in the endometrium during the menstrual cycle and different stages of implantation, and consider how this data can be applied to human pregnancy. Recent studies have shown that during the initiation steps of implantation, angiogenic factors trigger vasculogenesis and angiogenesis. Different inducers and stimulators affect angiogenesis and vasculogenesis by directly or indirectly stimulating proliferation, differentiation and migration of endothelial or respective precursor cells. As a conclusion, understanding the mechanisms of angiogenesis and the roles of angiogenic factors during the menstrual cycle and implantation may provide new insights and possible approaches for embryo implantation and healthy pregnancy.