Optimization of endometrial preparation results in a normal endometrial function test (EFT) and good reproductive outcome in donor ovum recipients

J Assist Reprod Genet. 2006 Jul-Aug;23(7-8):299-303. doi: 10.1007/s10815-006-9061-1. Epub 2006 Sep 17.

Abstract

Purpose: Numerous studies have investigated potential markers of endometrial receptivity as predictors of successful implantation. Cyclin E and p27 have recently been studied using the endometrial function test (EFT). Our objective is to determine the correlation between the expression of cyclin E and p27 and the adequacy of uterine preparation of recipients using donor oocytes.

Methods: Twenty recipients undergoing preparatory cycles with leuprolide acetate, estrogen, and progesterone. Endometrial biopsies were obtained 10-12 days after progesterone supplementation following the course of estrogen. The tissue was prepared for histological analysis and immunohistochemical staining for cyclin E assessment. The outcome of their subsequent ovum donation cycle was blinded to the reviewer of the EFT.

Results: All recipients showed normal luteal transformation. Nineteen (95%) of the recipients had a normal EFT. This is significantly higher than what we demonstrated, previously, in unexplained infertility patients, where only 40% of such patients had a normal EFT. Thirteen recipients with a normal EFT had a clinical pregnancy, while 6 did not become pregnant in their subsequent transfer cycles. The sole patient with an abnormal EFT did not conceive on 2 subsequent cycles.

Conclusions: While a normal EFT does not guarantee a successful pregnancy, an abnormal EFT appears to be associated with pregnancy failure. This may be useful in identifying women who need adjustments to their stimulation protocols prior to progressing to a physically, emotionally, and financially costly cycle.

MeSH terms

  • Adult
  • Cyclin E / metabolism*
  • Diagnostic Techniques, Obstetrical and Gynecological*
  • Embryo Transfer*
  • Endometrium / cytology
  • Endometrium / metabolism
  • Endometrium / physiology*
  • Evaluation Studies as Topic
  • Female
  • Fertilization in Vitro
  • Humans
  • Immunohistochemistry
  • Pregnancy
  • Pregnancy Outcome
  • Proliferating Cell Nuclear Antigen / metabolism*

Substances

  • Cyclin E
  • Proliferating Cell Nuclear Antigen
  • p27 antigen