HUMAN ENDOMETRIAL MATURATION IS MARKEDLY IMPROVED AFTER LUTEAL SUPPLEMENTATION OF GONADOTROPIN-RELEASING-HORMONE ANALOG HUMAN MENOPAUSAL GONADOTROPIN-STIMULATED CYCLES

In human cycles stimulated for ovulation with gonadotrophin-releasing hormone (GnRH) agonists and human menopausal gonadotrophin (HMG), a lu teal phase defect has been described. To evaluate the influence on the endometrium, endometrial development in GnRH agonist/HMG stimulated c ycles was assessed in cycles with and without luteal phase supplementa tion. Endometrial histological maturation, ultrastructure and oestroge n receptor (ER) and progesterone receptor (PR) status were analysed in the mid-luteal phase. Serum concentrations of oestradiol and progeste rone were measured daily from days 1-5 of the luteal phase. Supplement ation of the luteal phase was achieved with either human chorionic gon adotrophin or natural progesterone, administered intramuscularly or in travaginally. In non-supplemented cycles all endometrial features were consistent with an impaired progesterone bioavailability. After suppl ementation of the luteal phase, fewer signs of luteal phase deficiency were visible, especially with the intravaginal route of progesterone administration. We concluded that the endometrial parameters confirm t he need for luteal support in GnRH agonist/HMG stimulated cycles.