Accelerated endometrial maturation in the luteal phase of cycles utilizing controlled ovarian hyperstimulation: impact of gonadotropin-releasing hormone agonists versus antagonists.
OBJECTIVE
To evaluate the endometrium obtained during the luteal phase of controlled ovarian hyperstimulation (COH) cycles utilizing gonadotropin-releasing hormone (GnRH) antagonists, and to compare these findings with those obtained in cycles utilizing a GnRH agonist and with artificial cycles among recipients.


METHODS
Prospective evaluation of oocyte donors.


METHODS
University-based in vitro fertilization (IVF) center.


METHODS
Fifteen oocyte donors undergoing standard COH were enrolled in 1 of 3 COH groups, and 40 recipients of oocyte donation were used as a control group.


METHODS
Controlled ovarian hyperstimulation and endometrial biopsy.


METHODS
Histological dating of endometrial biopsies, serum estradiol (E(2)) and progesterone levels.


RESULTS
On the day of oocyte retrieval, endometrial maturation was advanced by an average of 5.8 +/- 0.4 days in the antagonist group and 5.9 +/- 0.7 days in the agonist group. This advancement persisted on day 7 postoocyte retrieval. Serum progesterone levels were elevated before human chorionic gonadotropin (hCG) administration, but remained similar in both groups.


CONCLUSIONS
Controlled ovarian hyperstimulation is associated with elevated progesterone levels in the late follicular phase and accelerated endometrial maturation in the subsequent luteal phase. No significant differences exist between preretrieval serial serum progesterone levels and luteal phase endometrial histology between cycles utilizing GnRH agonists or antagonists.
Saadat
Peyman
P
Keck School of Medicine of the University of Southern California, Los Angeles, and Good Samaritan Hospital, Los Angeles, California 90033, USA. peymansaadat@hotmail.com
Boostanfar
Robert
R
Slater
Cristin C
CC
Tourgeman
David E
DE
Stanczyk
Frank Z
FZ
Paulson
Richard J
RJ
D000328:Adult; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D004717:Endometrium / Q000503:physiopathology*; D004958:Estradiol / Q000097:blood; D005260:Female; D005498:Follicular Phase / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000037:antagonists & inhibitors*; D006801:Humans; D007246:Infertility / Q000628:therapy*; D008183:Luteal Phase; D018587:Oocyte Donation; D010062:Ovulation Induction; D011374:Progesterone / Q000097:blood; D011446:Prospective Studies; D013997:Time Factors; D020858:Tissue and Organ Harvesting
D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol