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The feasibility of a less invasive method to assess endometrial maturation--comparison of simultaneously obtained
M H van der Gaast1, N S Macklon, K Beier-Hellwig
1Department of Obstetrics and Gynaecology, Division of Reproductive Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.
Objective:
To compare the assessment of endometrial maturation parameters in endometrial secretion samples obtained by a novel minimally invasive technique with those assessed in tissue biopsies.
Design:
Prospective study.
Setting:
University Hospital.
Population:
Healthy female volunteers attending a gynaecological outpatient clinic.
Methods:
Endometrial secretion fluid and tissue sampling 5 days after a spontaneous ovulation assessed with ultrasound.
Main Outcome Measures:
Progesterone (P) receptor, Ki-67 expression and the Noyes criteria were used to date endometrial biopsies. In the endometrial fluid samples, glycodelin A (GdA), leukaemia inhibitory factor (LIF) and P levels were analysed, and protein content and electrophoresis patterns were determined.
Results:
All data were correlated to estradiol (E2) and P serum concentrations. The dating according to histology and immunohistochemical staining patterns correlated significantly with GdA levels (r=0.376, P=0.048) in endometrial fluid samples as well with serum levels of E2 (r=0.568, P=0.001) and P (r=0.408, P=0.023). No correlation was observed between tissue dating and LIF levels and protein content in endometrial fluid samples.
Conclusions:
The measurement of GdA in endometrial secretion samples may provide a less invasive method for assessing endometrial maturation in potential conception cycles without disrupting implantation.
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