Abstract
The increase in progesterone (P4) levels on the day of human chorionic gonadotropin (hCG) administration have a negative effect on endometrial receptivity. There are few reports regarding the expression of homeobox A10 (HOXA10) as one of many biomolecular factors of endometrial receptivity. To evaluate the effect of increased P4 concentration on the day of hCG administration on HOXA10, a total of 16 Macaca nemestrina were divided into three dose groups of recombinant-follicle stimulating hormone (rFSH) (30IU, 50IU, and 70IU) and one control group. Injection of rFSH combined with gonadotropin release hormone (GnRH) at 160 ug/day was given subcutaneously using a long protocol technique. Blood samples for estradiol (E2) and (P4) concentration measurements were taken on the day of injecting hCG in the final follicular phase, while the collection of endometrial tissue for HOXA10 measurement was carried out 8 to 10 days after hCG administration. E2 and P4 were measured by ELISA, whereas HOXA10 expression was measured with immunohistochemical (IHC) techniques. The concentration of E2 and P4 was found to be higher in dose groups compared with the natural group, but no significant differences were found within the group. For the Hscore for HOXA10 expression, no significant differences within dose groups were found. In addition, no significant differences for the Hscore for HOXA10 were found when compared to E2 groups. Significantly, the Hscore of HOXA10 was found to be >1 ng/mL in the P4 group compared with the Hscore HOXA10 in the P4 natural group (p = 0.022). The high concentration of P4 caused by ovarian hyperstimulation in the follicular phase stimulates the expression of HOXA10 in the secretion phase.
Highlights
Controlled ovarian hyperstimulation (COH), a combination of recombinant-follicle stimulating hormone and gonadotropin release hormone (GnRH) agonist or antagonist protocol, is a standard procedure in In Vitro Fertilization (IVF) to stimulate the maturation of many ovarian follicles
A progesterone threshold value of more than 1.5 ng/mL on the day of human chorionic gonadotropin (hCG) administration significantly reduces pregnancy rates compared to a progesterone level of
We evaluated the effect of progesterone on the day of hCG administration with a threshold value of more than 1 ng/mL against homeobox A10 (HOXA10) expression as a marker of endometrial receptivity
Summary
Controlled ovarian hyperstimulation (COH), a combination of recombinant-follicle stimulating hormone (rFSH) and gonadotropin release hormone (GnRH) agonist or antagonist protocol, is a standard procedure in In Vitro Fertilization (IVF) to stimulate the maturation of many ovarian follicles. The increase in progesterone levels at the end of follicular or on the day of hCG administration, in the COH procedure, reaches 38% [3]. Some researchers have reported that progesterone hypersecretion on the day of hCG administration negatively affects the pregnancy rate [4,5,6,7,8,9,10], whereas other researchers obtained different results [11]. We evaluated the effect of progesterone on the day of hCG administration with a threshold value of more than 1 ng/mL against HOXA10 expression as a marker of endometrial receptivity. This study aimed to compare HOXA10 expression levels in Macaca nemestrina endometrium between the progesterone (P4) > 1 ng/mL and P4 < 1 ng/mL in the stimulated cycle compared with P4 in the natural cycle
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