title: Comparison of transdermal versus oral estradiol on endometrial receptivity.
abstract: OBJECTIVE
  To compare the effects of oral micronized E2 with transdermal E2 on endometrial receptivity in women undergoing oocyte donation.
  
  
  METHODS
  Prospective, randomized, crossover trial. Serum E2 and P concentrations were measured on cycle days 14 and 22 (luteal day +8). Endometrial biopsies were obtained on day 22 and read in a blinded fashion for histology and beta-3-integrin expression.
  
  
  METHODS
  University-based donor oocyte program.
  
  
  METHODS
  Twenty-seven patients presenting for donor oocytes.
  
  
  METHODS
  Endometrial histology and beta-3-integrin expression.
  
  
  RESULTS
  The endometrial glandular histology in women given oral micronized E2 was delayed by a mean of 1.6 days in comparison to that of women given transdermal E2. Seventy percent of women given oral E2 displayed a lag > or = 4 days whereas 29.6% given transdermal E2 displayed a similar lag. Serum E2 levels were 1,194 +/- 108.8 pg/mL (mean +/- SEM; conversion factor to SI unit, 3.671) in women on oral micronized E2 and 117.4 +/- 14.0 pg/mL in those on transdermal E2.
  
  
  CONCLUSIONS
  The supraphysiologic serum E2 levels associated with oral micronized E2 may have a deleterious impact on endometrial receptivity. The development of more physiologic hormone replacement protocols may enhance endometrial receptivity and lead to improved clinical pregnancy rates.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pennsylvania 15213, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Krasnow
authors.forename: B A
authors.initials: BA
authors.lastname: Lessey
authors.forename: G
authors.initials: G
authors.lastname: Naus
authors.forename: L L
authors.initials: LL
authors.lastname: Hall
authors.forename: D S
authors.initials: DS
authors.lastname: Guzick
authors.forename: S L
authors.initials: SL
authors.lastname: Berga
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D018592:Cross-Over Studies; D004717:Endometrium / Q000187:drug effects* / Q000502:physiology; D004958:Estradiol / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D006801:Humans; D011374:Progesterone / Q000008:administration & dosage / Q000097:blood; D011446:Prospective Studies
chemical_list: D011374:Progesterone; D004958:Estradiol