Vaginal versus oral E(2) administration: effects on endometrial thickness, uterine perfusion, and contractility.
OBJECTIVE
To compare the effects of vaginal or oral E(2) administration on endometrial thickness, uterine perfusion, and contractility.


METHODS
Prospective, randomized, crossover study.


METHODS
Assisted Reproduction Unit, Clamart, France.


METHODS
Thirty-nine infertile women undergoing 78 E(2)/P cycles.


METHODS
Women received micronized 17beta-E(2), 2 mg/day orally (cycle days 1 to 28) and P, 300 mg/day vaginally (cycle days 15 to 28). After a menstrual cycle washout interval, women received a similar treatment except that 17beta-E(2) was administered vaginally.


METHODS
Endometrial thickness, mean uterine artery pulsatility index, endometrial blood flow, and uterine contraction frequency assessed in ultrasound scans on cycle days 14 and 18.


RESULTS
On day 14, the endometrium was thicker (8.7 +/- 0.6 vs. 7.1 +/- 0.3 mm, P< .0001), pulsatility index values were lower (2.4 +/- 0.1 vs. 3.0 +/- 0.2, P< .0002), and endometrial blood flow tended to be increased in the vaginal E(2) cycles as compared to the oral E(2) cycles. On day 18, similar differences remained. However, P-induced decrease in contraction frequency was slighter in vaginal E(2) cycles (33% vs. 18%, P< .0003).


CONCLUSIONS
Vaginal E(2) administration improves endometrial proliferation and uterine perfusion, presumably because of combined local and systemic effects, but may interfere with P-induced uterine relaxation.
Fanchin
R
R
Department of Obstetrics and Gynecology and Reproductive Endocrinology, Hôpital Antoine Béclère, Clamart, France. renato.fanchin@abc.ap-hop-paris
Righini
C
C
Schönauer
L M
LM
Olivennes
F
F
Cunha Filho
J S
JS
Frydman
R
R
D000282:Administration, Intravaginal; D000284:Administration, Oral; D000328:Adult; D004717:Endometrium / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000187:drug effects; D004958:Estradiol / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D006801:Humans; D011374:Progesterone / Q000097:blood; D012039:Regional Blood Flow / Q000187:drug effects; D014463:Ultrasonography; D014590:Uterine Contraction / Q000187:drug effects; D014599:Uterus / Q000098:blood supply*
D011374:Progesterone; D004958:Estradiol