Effect of exogenous gonadotropins on endometrial maturation in oocyte donors

Objective: To determine the effects of controlled ovarian hyperstimulation (COH) on endometrial maturation. Design: Prospective, before and after evaluation of midluteal endometrial b iopsies in oocyte donor's spontaneous and subsequent COH cycles. Setting: Tertiary academic medical center assisted reproductive technologie s clinic. Patient(s): Nineteen oocyte donors. Intervention(s): Exogenous gonadotropins, endometrial biopsies. Main Outcome Measure(s): Endometrial histology and an immunohistochemical m arker of uterine receptivity, the alpha nu beta 3 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). Gland ular lag was more frequent in COH cycles and unaffected by progesterone adm inistration. The beta 3 subunit of the alpha nu beta 3 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 exoge nous gonadotropins. The presence of alpha nu beta 3 was noted in most endom etrial specimens demonstrating in phase glandular maturation. We conclude t hat endometrial dyssynchrony that results from delayed glandular developmen t most likely represents a normal histologic variant. (C) 1998 by American Society for Reproductive Medicine.