OBJECTIVE: To determine the effect of serum P on endometrial histology in stimulated cycles. DESIGN: Prospective clinical study. SETTING: Community hospital-based donor oocyte program. PATIENT(S): Fertile young oocyte donors and infertile donor oocyte recipients. INTERVENTION(S): Oocyte donors underwent gonadotropin stimulation after midluteal pituitary suppression. Endometrial biopsies were obtained at the time of oocyte retrieval. MAIN OUTCOME MEASURE(S): Endometrial histology and serum P levels in oocyte donors. Pregnancy and implantation rates in oocyte recipients. RESULT(S): Thirteen biopsy specimens (52.0%) showed in-phase mixed proliferative pattern (days 14 to 15), whereas 12 (48.0%) were secretory (days 16 to 17). On the day of hCG, subjects with secretory endometrium had higher P of 1.7 ng/mL (5.4 nmol/L) than women with the mixed pattern (0.8 ng/mL [2.5 nmol/L]). Progesterone > or = 0.9 ng/mL had a 78.6% positive predictive value for secretory transformation. In 75.0% of cycles with secretory endometrium, P was > or = 0.9 ng/mL, (2.9 nmol/L) as early as 2 days before hCG. Both mixed and secretory patterns were associated with similar clinical pregnancy rates (57.1% and 60.0%, respectively) and delivery rates (38.1% and 50.0%, respectively) in recipients. CONCLUSION(S): Subtle elevation of P induced secretory endometrial transformation without reduction in embryo viability.
OBJECTIVE: To determine the effect of serum P on endometrial histology in stimulated cycles. DESIGN: Prospective clinical study. SETTING: Community hospital-based donor oocyte program. PATIENT(S): Fertile young oocyte donors and infertile donor oocyte recipients. INTERVENTION(S): Oocyte donors underwent gonadotropin stimulation after midluteal pituitary suppression. Endometrial biopsies were obtained at the time of oocyte retrieval. MAIN OUTCOME MEASURE(S): Endometrial histology and serum P levels in oocyte donors. Pregnancy and implantation rates in oocyte recipients. RESULT(S): Thirteen biopsy specimens (52.0%) showed in-phase mixed proliferative pattern (days 14 to 15), whereas 12 (48.0%) were secretory (days 16 to 17). On the day of hCG, subjects with secretory endometrium had higher P of 1.7 ng/mL (5.4 nmol/L) than women with the mixed pattern (0.8 ng/mL [2.5 nmol/L]). Progesterone > or = 0.9 ng/mL had a 78.6% positive predictive value for secretory transformation. In 75.0% of cycles with secretory endometrium, P was > or = 0.9 ng/mL, (2.9 nmol/L) as early as 2 days before hCG. Both mixed and secretory patterns were associated with similar clinical pregnancy rates (57.1% and 60.0%, respectively) and delivery rates (38.1% and 50.0%, respectively) in recipients. CONCLUSION(S): Subtle elevation of P induced secretory endometrial transformation without reduction in embryo viability.
Authors: Jason M Franasiak; Eric J Forman; George Patounakis; Kathleen H Hong; Marie D Werner; Kathleen M Upham; Nathan R Treff; Richard T Scott Journal: Hum Reprod Open Date: 2018-12-20