Microengineered patient-derived endometrium-on-a-chip for the evaluation of endometrial receptivity and personalised translational medicine.

Endometrial receptivity is a critical determinant of embryo implantation and early pregnancy success; however, current methods for assessing endometrial receptivity remain poorly validated and insufficiently reliable for clinical application. Here, we establish a patient-derived vascularised endometrium-on-a-chip (EoC), successfully replicating the dynamic microenvironment and both temporal and spatial architecture of native endometrial tissue. Using our EoC, we develop a clinically relevant endometrial receptivity scoring system, ERS2, which integrates molecular profiling of established receptivity markers with quantitative analyses of angiogenesis. The ERS2 enables personalised assessment of endometrial health and implantation potential, addressing inter-patient variability often overlooked by conventional techniques. By leveraging our EoC to therapeutic monitoring, we observe progressive restoration of the endometrial microenvironment following platelet-rich-plasma treatments, highlighting the translational utility of our model. This study represents the innovative application of a patient-derived EoC and scoring system to assess receptivity, offering personalised infertility management and advancing targeted therapies in reproductive medicine.