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Endometrial morphology and modulation of hormone receptors during ovarian stimulation for assisted reproductive
Laura Detti1, Ghassan M Saed, Nicole M Fletcher
1Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee 38103, USA. ldetti@uthsc.edu
Objective:
To study the biochemical and morphologic implications of different hormonal levels on endometrial development during assisted reproductive technology (ART) cycles.
Design:
Prospective, controlled study.
Setting:
University center.
Patient(S):
Eleven women during a natural cycle (controls) and 11 oocyte donors during an ART cycle (treated).
Intervention(S):
At the time consistent with day-3 ET, a transvaginal ultrasound, an endometrial biopsy, and blood sampling were performed. Morphology and thickness of the endometrial stripe were recorded. Real-time reverse transcriptase-polymerase chain reaction was used to measure messenger RNA (mRNA) levels for estrogen receptor (ER)-α, ER-β, P receptor (PR)-A, and PR-B in the endometrial tissue.
Main Outcome Measure(S):
To evaluate morphologic and biochemical endometrial development.
Result(S):
Endometrium was mostly trilaminar (proliferative-like pattern) and thicker in the treated group, as opposed to homogeneous and thinner in the controls. The PR-B mRNA expression increased 41% in treated patients; PR-A mRNA expression, instead, was unchanged. Serum E(2) and P were higher in the treated group than in controls. In contrast, FSH and LH levels were lower in the treated group.
Conclusion(S):
When compared with natural cycles, exposure of the endometrium to high hormone levels during ovarian stimulation significantly increased PR-B receptor expression at the time of ET. Concurrently, a proliferative-like endometrial pattern persisted. These findings reflect a delayed endometrial development in ART.
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