Estradiol and progesterone replacement regimens for the induction of endometrial receptivity.
Initiation of pregnancy in premature ovarian failure patients by use of donated oocytes fertilized in vitro requires establishment of a normal endometrial environment. We compared administration of estradiol (E2) and progesterone (P) by polysiloxane vaginal rings versus oral micronized E2 and P vaginal suppositories in 10 such patients. Serum E2 levels were similar between groups and similar to normally-cycling controls. With vaginal administration of E2, a burst effect was noted, with marked elevation 1 hour after insertion. The pattern with oral administration was more consistent, although marked conversion to estrone occurred. The P cylinder and suppositories delivered similar levels, with diminution of P in some patients with the cylinder. Despite apparent limitations, endometrial histology was normal after each cycle; both groups achieved pregnancies. Administration of E2 and P by polysiloxane vaginal rings achieved hormonal levels similar to oral micronized E2 and P vaginal suppositories. Endometrial biopsies after the stimulated cycle were appropriately mature.
Steingold
K
K
Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk.
Stumpf
P
P
Kreiner
D
D
Liu
H C
HC
Navot
D
D
Rosenwaks
Z
Z
D000042:Absorption; D000282:Administration, Intravaginal; D000284:Administration, Oral; D000328:Adult; D001706:Biopsy; D004717:Endometrium / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D004958:Estradiol / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D011374:Progesterone / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D012016:Reference Values; D013488:Suppositories
D013488:Suppositories; D011374:Progesterone; D004958:Estradiol