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Endometrial biopsy during hormone replacement cycle in donor oocyte recipients before in vitro fertilization-embryo
D A Potter1, C A Witz, W N Burns
1Department of Obstetrics and Gynecology, The University of Texas Health Sciences Center at San Antonio, USA. dpotter@flash.net
Objective:
To examine the usefulness of a trial cycle of hormone replacement therapy (HRT) and endometrial biopsy before the actual ET cycle in recipients of donated oocytes.
Design:
Retrospective review.
Setting:
Clinical practice at the South Texas Fertility Center, San Antonio, Texas.
Patient(S):
Thirty-six concurrent patients who underwent a trial cycle of HRT with endometrial biopsy before the ET cycle with donated oocytes fertilized in vitro.
Intervention(S):
Patients > or =40 years of age received 100 mg of i.m. progesterone in oil daily; patients <40 years of age received 50 mg daily. Endometrial biopsies were performed during the late luteal phase of the trial cycle.
Main Outcome Measure(S):
Histologic dating of the biopsy specimens was correlated with the chronologic date of the biopsy.
Result(S):
Five of 20 patients > or =40 years of age had out-of-phase biopsies. All 16 patients <40 years of age had in-phase biopsies. All out-of-phase biopsies subsequently were corrected with higher doses of progesterone. Pregnancy rates after fresh and frozen ETs were not significantly different between the two age groups.
Conclusion(S):
Patients > or =40 years of age are at risk of having out-of-phase endometrial biopsies while they are receiving standard HRT despite receiving higher doses of progesterone. Trial HRT cycles with endometrial biopsies are recommended.