Optimization of endometrial preparation results in a normal endometrial function test (EFT) and good reproductive outcome in donor ovum recipients.
OBJECTIVE
Numerous studies have investigated potential markers of endometrial receptivity as predictors of successful implantation. Cyclin E and p27 have recently been studied using the endometrial function test (EFT). Our objective is to determine the correlation between the expression of cyclin E and p27 and the adequacy of uterine preparation of recipients using donor oocytes.


METHODS
Twenty recipients undergoing preparatory cycles with leuprolide acetate, estrogen, and progesterone. Endometrial biopsies were obtained 10-12 days after progesterone supplementation following the course of estrogen. The tissue was prepared for histological analysis and immunohistochemical staining for cyclin E assessment. The outcome of their subsequent ovum donation cycle was blinded to the reviewer of the EFT.


RESULTS
All recipients showed normal luteal transformation. Nineteen (95%) of the recipients had a normal EFT. This is significantly higher than what we demonstrated, previously, in unexplained infertility patients, where only 40% of such patients had a normal EFT. Thirteen recipients with a normal EFT had a clinical pregnancy, while 6 did not become pregnant in their subsequent transfer cycles. The sole patient with an abnormal EFT did not conceive on 2 subsequent cycles.


CONCLUSIONS
While a normal EFT does not guarantee a successful pregnancy, an abnormal EFT appears to be associated with pregnancy failure. This may be useful in identifying women who need adjustments to their stimulation protocols prior to progressing to a physically, emotionally, and financially costly cycle.
Kliman
H J
HJ
Yale University, New Haven, CT, USA.
Honig
S
S
Walls
D
D
Luna
M
M
McSweet
J C
JC
Copperman
Alan B
AB
D000328:Adult; D019927:Cyclin E / Q000378:metabolism*; D003944:Diagnostic Techniques, Obstetrical and Gynecological; D004624:Embryo Transfer; D004717:Endometrium / Q000166:cytology / Q000378:metabolism / Q000502:physiology*; D005069:Evaluation Studies as Topic; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007150:Immunohistochemistry; D011247:Pregnancy; D011256:Pregnancy Outcome; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism*
D019927:Cyclin E; D018809:Proliferating Cell Nuclear Antigen; C413374:p27 antigen