<p>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.</p>