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Endometrial glycodelin-A expression in the luteal phase of stimulated ovarian cycles
S E Brown1, E Mandelin, S Oehninger
1The Jones Institute for Reproductive Medicine, Eastern Virginia Medical School, Norfolk, USA. sambrown99@yahoo.com
Objective:
To determine if controlled ovarian hyperstimulation (COH) affects the endometrial expression of glycodelin-A (GdA).
Design:
Prospective, controlled study.
Setting:
Tertiary infertility clinic.
Patient(S):
Fifteen oocyte donors undergoing COH cycles and 19 natural-cycle control patients.
Intervention(S):
COH, endometrial biopsies.
Main Outcome Measure(S):
Immunohistochemical scoring of endometrial GdA expression, morphologic endometrial dating, and serum E2, LH, and P4 concentrations.
Result(S):
GdA was detected in all subjects throughout the implantation window period. Immunolocalization was demonstrated in the endometrial glands and not in the stroma or on the surface. A significantly increased proportion of GdA-staining endometrial cells were noted in COH cycle patients as compared with natural-cycling control patients throughout the window of embryo implantation. Both cycle types demonstrated increasing GdA expression throughout the late luteal phase. A significant positive correlation was noted between GdA expression and serum E2 levels (r = 0.5, P<.001) in natural cycles and advanced histology in COH cycles (r = 0.63, P=.01). Neither LH nor P4 were correlated with endometrial GdA expression.
Conclusion(S):
COH cycles have a significantly increased endometrial GdA expression throughout the implantation phase of the luteal cycle when compared with normal menstrual cycles. The increased expression may affect implantation during COH cycles.