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

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 (E 2 ) 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 E 2 (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.

Endometrial Dating Method Detects Individual Maturation Sequences During the Secretory Phase

“…Van der Gaast et al investigated 30 patients from a fertility clinic on day OV+5 (16). After endometrial dating, in addition to immunohistochemical investigation of hormone receptors and proliferation marker Ki-67, they noted variation in endometrial maturation corresponding to days OV+2 and +5.5.…”

“…Endometrial dating method. The endometrial biopsies were analyzed in accordance with previously published criteria (13,16) during natural cycles (OV+5 to OV+10) as well as HRT cycles (P+5 and P+10) and were dated on the basis of a novel method. Various parameters were taken into account for endometrial dating, including menstrual cycle days and histological dating criteria based on the Noyes protocol (5) for all biopsies, in combination with the immunohistochemical expression pattern of ER and PR and proliferation marker Ki-67 in 184 biopsies.…”

Venous Intravasation as a Complication and Potential Pitfall During Hysterosalpingography: Re-Emerging Study with a Novel Classification

“…[272829] Endometrium is thin in the early proliferative phase and is an advantage that helps facilitate imaging. [330] Studies have documented that HSG appearance and endometrial characteristics change with the menstrual cycle.…”

Predictive Roles of Proteomic Profiles in Assisted Reproduction-An Update

“…It was recently reported that the endometrial tissue is obtained via biopsy or curettage while uterine fluid is collected via aspiration or flushing of the fluid. Conducting proteomic studies on uterine fluid is more advantageous than endometrial tissue for various reasons [26,27]. For one, aspiration and lavage are less invasive than biopsy and curettage, and hence, expose the patients to fewer complications [23].…”

“…On the other hand, proteomic profile of the uterine fluid is less complicated than endometrial tissue proteome [27]. Furthermore, uterine fluid reflects the microenvironment of the uterus during the implantation period [23].…”