Abstract
Objective: Estrogens play a key role in uterine receptivity by regulating endometrial proliferation and influencing uterine perfusion and contractility. Oral E2 administration is commonly used to prime endometrial receptivity for donor egg IVF-ET and frozen/thawed ETs. Yet, in some cases, endometrial thickness and perfusion appear insufficient, suggesting inappropriate estrogenization. The vaginal route has been proposed for administering drugs targeted to the uterus, because of direct uterine effects (de Ziegler, 1995). Recently, vaginal E2 administration has been shown to achieve higher endometrial tissue E2 levels than oral administration (Tourgeman et al, 1999). Further, high-frequency uterine contractions (UC) at the time of ET may result from incomplete utero-relaxing action of P in the presence of supra-physiologic E2 levels (Fanchin et al, 1999). Hence, looking for an alternate route for E2 priming that could be effective in resistant cases, we compared effects of vaginal or oral E2 administration on endometrial thickness, uterine perfusion, and UC.
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