The impact of luteal phase support on endometrial estrogen and progesterone receptor expression: a prospective randomized study

Abstract

OBJECTIVE: To assess the impact of different luteal phase support regimens on the expression of endometrial estrogen (ER) and progesterone (PR) receptors after controlled ovarian hyperstimulation in oocyte donation cycles.DESIGN: Prospective, randomized study in a university affiliated academic institution.MATERIALS AND METHODS: Twelve oocyte donors, ages 21 to 29, underwent ovarian hyperstimulation using human rFSH and Ganirelix Acetate (0.25 mg SQ/day). Participants were randomized to one of the following groups: Group I, no luteal support; Group II, vaginal suppositories of micronized P (200 mg q6 hours) starting the day after the retrieval; Group III, micronized P as in Group II plus 17 β E2 (2 mg PO/day). Endometrial biopsies were obtained on the day of oocyte retrieval and 3, 5 and 10 days following the retrieval (Table 1). Tissue microarray was used for immunohistochemical staining to detect ER and PR expression using specific monoclonal antibodies. The immunostaining intensity was assessed by HSCORE. One-way ANOVA and nonparametric analysis were used for statistical analysis where applicable.Table 1Endometrial progesterone receptor expression with different luteal phase support groupsLuteal supportNonePP + EP valueH scoreDay of Retrieval Luminal7.65.87.90.60 Glandular9.57.06.40.49 Stromal6.96.38.00.75Day 3 after retrieval Luminal3.89.34.40.04 Glandular6.78.33.30.09 Stromal6.87.45.10.99Day 5 after retrieval Luminal4.85.05.10.99 Glandular4.56.85.60.71 Stromal5.86.35.00.85Day 10 after retrieval Luminal3.04.77.00.19 Glandular3.58.04.80.13 Stromal5.84.56.00.78 Open table in a new tab CONCLUSIONS: Luteal phase support with P alone is associated with an increase in PR expression 3 days after retrieval following a GnRH antagonist stimulation protocol. No significant differences were noted in ER expression between the study groups. A larger study is on the way to increase statistical power. OBJECTIVE: To assess the impact of different luteal phase support regimens on the expression of endometrial estrogen (ER) and progesterone (PR) receptors after controlled ovarian hyperstimulation in oocyte donation cycles. DESIGN: Prospective, randomized study in a university affiliated academic institution. MATERIALS AND METHODS: Twelve oocyte donors, ages 21 to 29, underwent ovarian hyperstimulation using human rFSH and Ganirelix Acetate (0.25 mg SQ/day). Participants were randomized to one of the following groups: Group I, no luteal support; Group II, vaginal suppositories of micronized P (200 mg q6 hours) starting the day after the retrieval; Group III, micronized P as in Group II plus 17 β E2 (2 mg PO/day). Endometrial biopsies were obtained on the day of oocyte retrieval and 3, 5 and 10 days following the retrieval (Table 1). Tissue microarray was used for immunohistochemical staining to detect ER and PR expression using specific monoclonal antibodies. The immunostaining intensity was assessed by HSCORE. One-way ANOVA and nonparametric analysis were used for statistical analysis where applicable. CONCLUSIONS: Luteal phase support with P alone is associated with an increase in PR expression 3 days after retrieval following a GnRH antagonist stimulation protocol. No significant differences were noted in ER expression between the study groups. A larger study is on the way to increase statistical power.