Comparison of transdermal versus oral estradiol on endometrial receptivity.
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.
Krasnow
J S
JS
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pennsylvania 15213, USA.
Lessey
B A
BA
Naus
G
G
Hall
L L
LL
Guzick
D S
DS
Berga
S L
SL
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
D011374:Progesterone; D004958:Estradiol