HOX genes are a family of regulatory genes that encode transcription factor
s and are essential during embryonic development. These genes are highly co
nserved between species such that all metazoans possess a common genetic sy
stem for embryonic patterning. This system is conserved in the reproductive
tract, where HOX genes are involved in the development of the mullerian sy
stem. The reproductive tract is unusual in that HOX genes continue to be ex
pressed in the adult. HOX genes are essential both for appropriate reproduc
tive tract development and for adult function. This article reviews the rol
e of HOX genes in the development of the reproductive tract and the effect
of HOX gene mutations on the development of the reproductive tract in both
mice and humans. It then reviews the role and regulation of HOX genes in th
e adult function of the reproductive tract, specifically evidence that HOX
genes are important for human endometrial development and receptivity.