Accelerated endometrial maturation in the luteal phase of cycles utilizing controlled ovarian hyperstimulation: impact of gonadotropin-releasing hormone agonists versus antagonists

Saadat, Peyman; Boostanfar, Robert; Slater, Cristin C; Tourgeman, David E; Stanczyk, Frank Z; Paulson, Richard J

doi:10.1016/j.fertnstert.2003.11.050

« Previous Next »Fertility and Sterility
Volume 82, Issue 1 , Pages 167-171, July 2004

Accelerated endometrial maturation in the luteal phase of cycles utilizing controlled ovarian hyperstimulation: impact of gonadotropin-releasing hormone agonists versus antagonists

Peyman Saadat, M.D.
- Keck School of Medicine of the University of Southern California, Los Angeles, and Good Samaritan Hospital, Los Angeles, California, USA
- Reprint requests: Peyman Saadat, M.D., Department of Obstetrics and Gynecology, Women's and Children's Hospital, 1240 North Mission Road, Room 8K9, Los Angeles, California 90033, USA (FAX: 323-226-2850; Phone: (323) 226-3026
Robert Boostanfar, M.D.
- Keck School of Medicine of the University of Southern California, Los Angeles, and Good Samaritan Hospital, Los Angeles, California, USA
Cristin C Slater, M.D.
- Keck School of Medicine of the University of Southern California, Los Angeles, and Good Samaritan Hospital, Los Angeles, California, USA
David E Tourgeman, M.D.
- Keck School of Medicine of the University of Southern California, Los Angeles, and Good Samaritan Hospital, Los Angeles, California, USA
Frank Z Stanczyk, Ph.D.
- Keck School of Medicine of the University of Southern California, Los Angeles, and Good Samaritan Hospital, Los Angeles, California, USA
Richard J Paulson, M.D.
- Keck School of Medicine of the University of Southern California, Los Angeles, and Good Samaritan Hospital, Los Angeles, California, USA

Received 7 April 2003; received in revised form 25 November 2003; accepted 25 November 2003.

Abstract

Objective

To evaluate the endometrium obtained during the luteal phase of controlled ovarian hyperstimulation (COH) cycles utilizing gonadotropin-releasing hormone (GnRH) antagonists, and to compare these findings with those obtained in cycles utilizing a GnRH agonist and with artificial cycles among recipients.

Design

Prospective evaluation of oocyte donors.

Setting

University-based in vitro fertilization (IVF) center.

Patient(s)

Fifteen oocyte donors undergoing standard COH were enrolled in 1 of 3 COH groups, and 40 recipients of oocyte donation were used as a control group.

Intervention(s)

Controlled ovarian hyperstimulation and endometrial biopsy.

Main outcome measure(s)

Histological dating of endometrial biopsies, serum estradiol (E₂) and progesterone levels.

Result(s)

On the day of oocyte retrieval, endometrial maturation was advanced by an average of 5.8 ± 0.4 days in the antagonist group and 5.9 ± 0.7 days in the agonist group. This advancement persisted on day 7 postoocyte retrieval. Serum progesterone levels were elevated before human chorionic gonadotropin (hCG) administration, but remained similar in both groups.

Conclusion(s)

Controlled ovarian hyperstimulation is associated with elevated progesterone levels in the late follicular phase and accelerated endometrial maturation in the subsequent luteal phase. No significant differences exist between preretrieval serial serum progesterone levels and luteal phase endometrial histology between cycles utilizing GnRH agonists or antagonists.

Keywords: Controlled ovarian hyperstimulation, GnRH antagonist, GnRH agonist, endometrial maturation, progesterone, oocyte donation