Endometrial morphology and hormonal profiles in in vitro fertilization patients.
Endometrial biopsy was performed in 27 infertile women participating in the IVF program. Their mean age was 31.8 years, 33% of the women being over 35 years old. The average duration of infertility was 6.9 years. The superovulation protocol consisted of hMG/hCG in 5 cases, of combined GnRH analog/gonadotropin therapy in 20 women, and 2 patients received combined contraceptive pill/gonadotropin treatment. Judging by hormonal profiles, follicular growth rate and number of oocytes retrieved, the response to stimulation was normal. The mean estradiol (E2) levels increased from 132.7 pg/ml on day -5 (SEM = 9.67) to 1272 pg/ml (SEM = 103.7) on the day of hCG administration and to 1813 pg/ml (SEM = 209.6) 1 day later. One day before the hCG application, the mean progesterone and LH levels were 1.34 ng/ml and 8.38 IU/ml, respectively. Only one patient had clinical hyperstimulation syndrome. Ova were harvested in all women, the mean number of oocytes being 7.7 (SEM = 0.83) per patient. In all 27 cases lack of fertilization or faulty ovum cleavage were observed. Thus, an endometrial biopsy (EB) was performed 72 h after oocytes retrieval. The mean estrogen and progesterone levels on the EB day were 610.9 pg/ml (SEM = 78.44) and 45.4 ng/ml (SEM = 7.53), respectively. Histologic examination of the endometrium showed normal secretory endometrium consistent with day 16-17 of spontaneous ovulatory cycle. Two women who received combined contraceptive pills/gonadotropin therapy showed inactive endometrium with subnuclear vacuoles and decidual reaction in the stroma similar to that observed in women on estrogen-progestin birth control medication.(ABSTRACT TRUNCATED AT 250 WORDS)
Barash
A
A
Department of Obstetrics and Gynecology, Kaplan Hospital, Hebrew University Hadassah Medical School, Rehovot, Israel.
Czernobilsky
B
B
Insler
V
V
Borenstein
R
R
Rosenberg
M
M
Fink
A
A
D000328:Adult; D001706:Biopsy; D010064:Embryo Implantation / Q000187:drug effects; D004624:Embryo Transfer; D004717:Endometrium / Q000166:cytology* / Q000187:drug effects / Q000502:physiology*; D004958:Estradiol / Q000097:blood*; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology; D005307:Fertilization in Vitro; D006801:Humans; D011247:Pregnancy; D011374:Progesterone / Q000097:blood*
D005300:Fertility Agents, Female; D011374:Progesterone; D004958:Estradiol