Objective: To determine the effects of controlled ovarian hyperstimulation (COH) on endometrial maturation.
Design: Prospective, before and after evaluation of midluteal endometrial biopsies in oocyte donor's spontaneous and subsequent COH cycles.
Setting: Tertiary academic medical center assisted reproductive technologies clinic.
Patient(s): Nineteen oocyte donors.
Intervention(s): Exogenous gonadotropins, endometrial biopsies.
Main outcome measure(s): Endometrial histology and an immunohistochemical marker of uterine receptivity, the alphavbeta3 vitronectin.
Result(s): Glandular and stromal dyssynchrony was more common after COH in 16 (80%) of 20 cycles than 6 (30%) of 20 spontaneous cycles (P <.05). Glandular lag was more frequent in COH cycles and unaffected by progesterone administration. The beta3 subunit of the alphavbeta3 vitronectin receptor was present in 9 (45%) of 20 spontaneous and 2 (10%) of 20 COH cycles (P <.05).
Conclusion(s): Exogenous gonadotropin use in healthy reproductive age women did not result in endometrial evidence of a luteal phase defect. A greater incidence of glandular-stromal dyssynchrony resulted from the use of exogenous gonadotropins. The presence of alphavbeta3 was noted in most endometrial specimens demonstrating in phase glandular maturation. We conclude that endometrial dyssynchrony that results from delayed glandular development most likely represents a normal histologic variant.