Factors that influence successful implantation and subsequent pregnancy can be neatly conceptualised using a gardening metaphor.

The three prerequisites for successful planting (pregnancy) are a good-quality seed (a good-quality embryo, formed from good-quality gametes), fertile soil (a receptive endometrium and uterine environment) and the right climate (a healthy host).

Absence of one of these prerequisites will impair embryo implantation and development of successful pregnancy. This applies in both natural and assisted reproduction.¹

In the current era, when assisted reproductive technology is readily accessible, one should not forget the crucial role of the ‘soil’ — the endometrium and uterus.