Decrypting spatiotemporal code of human endometrial receptivity

The mechanism underlying the establishment of human endometrial receptivity remains elusive, constituting a significant obstacle to advancing our knowledge of female infertility. Via integrating high-resolution spatiotemporal and single-cell transcriptomic profiling and in situ sequencing, we construct a spatiotemporal atlas of human endometrial receptivity at single-cell resolution. Our study depicts detailed spatial molecular topography governing the opening and closing of human endometrial receptivity. Notably, the results indicate that stromal-specific NR2F1, CEBPD and epithelial-specific SGK1, KLF5 and ELF3 are closely associated with the opening of implantation window. Furthermore, cholesterol metabolism is found to promote ciliogenesis. Remarkably, we identify stroma- and epithelium-specific factors and unravel a previously unappreciated role of FGFs-FGFR2 signaling pathway mediating stroma-epithelium crosstalk in epithelial differentiation during the onset of receptivity. This spatiotemporally resolved receptivity code provides insights into the female fertility, with potential implications for the intervention of female infertility.