The feasibililty of a less invasive method to assess endometrial maturation--comparison of simultaneously obtained uterine secretion and tissue biopsy

van der Gaast, M.H., Macklon, N., Beier-Hellwig, K., Krusche, C.A., Fauser, B.C., Beier, H.M. and Classen-Linke, I. (2009) The feasibililty of a less invasive method to assess endometrial maturation--comparison of simultaneously obtained uterine secretion and tissue biopsy. BJOG: An International Journal of Obstetrics & Gynaecology, 116 (2), 304-312. (doi:10.1111/j.1471-0528.2008.02039.x).

Abstract

Objective: to compare the assessment of endometrial maturation parameters in endometrial secretion samples obtained by a novel minimally invasive technique with those assessed in tissue biopsies.

Design: prospective study.

Setting: university hospital.

Population: healthy female volunteers attending a gynaecological outpatient clinic.

Methods: endometrial secretion fluid and tissue sampling 5 days after a spontaneous ovulation assessed with ultrasound.

Main outcome measures: progesterone (P) receptor, Ki-67 expression and the Noyes criteria were used to date endometrial biopsies. In the endometrial fluid samples, glycodelin A (GdA), leukaemia inhibitory factor (LIF) and P levels were analysed, and protein content and electrophoresis patterns were determined. RESULTS: All data were correlated to estradiol (E2) and P serum concentrations. The dating according to histology and immunohistochemical staining patterns correlated significantly with GdA levels (r=0.376, P=0.048) in endometrial fluid samples as well with serum levels of E2 (r=0.568, P=0.001) and P (r=0.408, P=0.023). No correlation was observed between tissue dating and LIF levels and protein content in endometrial fluid samples.

Conclusions: the measurement of GdA in endometrial secretion samples may provide a less invasive method for assessing endometrial maturation in potential conception cycles without disrupting implantation.

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