Influence of controlled ovarian hyperstimulation on uterine peristalsis in infertile women.
OBJECTIVE
Is there a difference in the characteristics of uterine peristalsis in natural and controlled ovarian hyperstimulation (COH) cycles?


CONCLUSIONS
COH significantly changed the uterine peristaltic pattern.


BACKGROUND
In natural menstrual cycles, the periodic changes of uterine peristalsis are closely related to the reproductive process.


METHODS
This is a prospective cohort study with a total of 64 subjects involved. The study was performed between May 2011 and August 2011.


METHODS
Sixty-four infertile women with regular, ovulatory menstrual cycles underwent follicular tracking in one natural cycle and after ovarian stimulation (GnRH-agonist down-regulation) in the subsequent cycle (COH). Three time points were studied in both cycles: at LH surge/HCG plus 1 day, ovulation/oocyte retrieval and 2 days after ovulation/retrieval. The study was performed in an IVF center of the university-affiliated Xiangya hospital.


RESULTS
Uterine peristaltic wave frequency was 1.31 times higher in the COH than in the natural cycle (P< 0.01). At all three time points in the COH cycle, waves moving from the cervix to fundus dominated, comprising 80-90% of the wave types observed, while 'no activity' was more frequently observed in the natural cycle. The wave frequency was positively correlated with the level of serum estradiol (E(2)) (r= 0.30; P< 0.01) and negatively correlated with the progesterone level (r= -0.48; P< 0.01) for the physiological range of steroid levels. No correlation was found between the wave frequency and supraphysiological concentrations of E(2) or progesterone.


CONCLUSIONS
The two observers were not independent and this was a limitation of the study. Quantitative measurements of wave amplitude in the different cycles should be compared in future research.


CONCLUSIONS
Uterine peristalsis was much higher in the COH cycle than in the natural cycle. The endometrial movements did not weaken to the natural level before embryo transfer, even with high levels of progesterone. The wave frequency was positively correlated with serum E(2) level and negatively correlated with that of progesterone within the physiological range. No correlation was found between the wave frequency and supraphysiological concentrations of E(2) and progesterone.
Department of Reproductive Medicine, Xiangya Hospital, Central-south University, Changsha City, Hunan Province, PR China.
Lin
L
Zhu
Yanping
Y
Li
Aizhuang
A
Xu
D000328:Adult; D015331:Cohort Studies; D015536:Down-Regulation; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D007987:Gonadotropin-Releasing Hormone / Q000378:metabolism; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D008597:Menstrual Cycle; D010062:Ovulation Induction; D011446:Prospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods; D014463:Ultrasonography / Q000379:methods; D014599:Uterus / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology*
D007987:Gonadotropin-Releasing Hormone