Endometrial responses in artificial cycles: a prospective study comparing four different oestrogen dosages.
OBJECTIVE
To examine the endometrial response to four different regimens of oestrogen.


METHODS
A prospective, randomized cross-over study.


METHODS
Jessop Hospital for Women, Sheffield.


METHODS
Twenty one women with premature ovarian failure divided into three equal groups.


METHODS
Four different regimens of hormone replacement therapy: variable, fixed 1 mg, fixed 2 mg and fixed 4 mg oestrogen dosages. Each woman received the variable dosage regimen in one cycle and crossed over to receive one of the three fixed dose regimens (1 mg, Group 1; 2 mg, Group 2; 4 mg Group 3) in another cycle.


METHODS
Ultrasonographic measurement of endometrial thickness and outpatient endometrial biopsy on day 19 of the artificial cycle; analysis of endometrial specimens by three separate methods: traditional histological criteria, morphometry and immunohistochemistry.


RESULTS
The endometrial response was similar in those treated with the variable and the fixed 2 mg or 4 mg dosage regimens. The response was suboptimal in those treated with the fixed 1 mg dosage regimen.


CONCLUSIONS
Normal endometrial development requires adequate priming of the endometrium by oestrogen, which may be administered in a sequential, variable dosage fashion, or simply by a fixed daily dosage regimen. However, the minimum daily dose required is likely to be 2 mg of oestradiol valerate. No adverse effect on the endometrium was observed at a daily dose of 4 mg oestradiol valerate, which produced plasma levels of oestradiol above the reference ranges of the natural cycle.
Li
T C
TC
Department of Obstetrics and Gynaecology, University of Sheffield, UK.
Cooke
I D
ID
Warren
M A
MA
Goolamallee
M
M
Graham
R A
RA
Aplin
J D
JD
D000328:Adult; D004717:Endometrium / Q000187:drug effects* / Q000473:pathology; D004958:Estradiol / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000097:blood; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016649:Primary Ovarian Insufficiency / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D011374:Progesterone / Q000008:administration & dosage; D011446:Prospective Studies; D013997:Time Factors
D004966:Estrogens, Conjugated (USP); D011374:Progesterone; D004958:Estradiol