GnRH antagonists may affect endometrial receptivity.
OBJECTIVE
HOXA10 is an essential regulator of endometrial receptivity. To determine the effect of GnRH antagonists on endometrial receptivity, we assessed endometrial HOXA10 expression in GnRH antagonist, GnRH agonist, and natural cycles.


METHODS
Prospective case-control study.


METHODS
University academic medical center.


METHODS
Nineteen subjects were included: 12 subjects underwent controlled ovarian hyperstimulation with recombinant FSH and used either a GnRH antagonist or a GnRH agonist; seven control subjects underwent natural cycles.


METHODS
Pipelle endometrial biopsies were obtained 11 days after hCG administration or spontaneous LH surge in untreated cycles, respectively. Immunohistochemistry was used to assess HOXA10 protein expression in endometrial glands and stroma.


METHODS
Endometrial HOXA10 protein expression.


RESULTS
HOXA10 expression was significantly decreased in endometrial stromal cells in GnRH antagonist-treated cycles compared with GnRH agonist-treated cycles or natural cycle control subjects. There was no significant difference in glandular cell HOXA10 expression among the three groups.


CONCLUSIONS
Use of GnRH antagonists may be associated with impaired HOXA10 expression in endometrial stromal cells and thus may affect endometrial receptivity.
Rackow
Beth W
BW
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticutt.
Kliman
Harvey J
HJ
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticutt.
Taylor
Hugh S
HS
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticutt. Electronic address: hugh.taylor@yale.edu.
D000328:Adult; D001706:Biopsy; D016022:Case-Control Studies; D004717:Endometrium / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000031:analogs & derivatives / Q000037:antagonists & inhibitors* / Q000494:pharmacology; D000080905:Homeobox A10 Proteins; D018398:Homeodomain Proteins / Q000235:genetics / Q000378:metabolism; D006727:Hormone Antagonists / Q000494:pharmacology*; D006801:Humans; D016729:Leuprolide / Q000494:pharmacology; D010062:Ovulation Induction / Q000379:methods*; D011446:Prospective Studies; D012333:RNA, Messenger / Q000378:metabolism; D017154:Stromal Cells / Q000187:drug effects / Q000378:metabolism / Q000473:pathology
D005300:Fertility Agents, Female; D000080905:Homeobox A10 Proteins; D018398:Homeodomain Proteins; D006727:Hormone Antagonists; D012333:RNA, Messenger; C069634:HOXA10 protein, human; D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide; C061018:ganirelix; C062876:cetrorelix