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

Authors

  • MH van der Gaast,

    1. Department of Obstetrics and Gynaecology, Division of Reproductive Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
    2. Department of Obstetrics and Gynaecology, Reinier de Graaf Hospital, Delft, the Netherlands
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  • NS Macklon,

    Corresponding author
    1. Department of Obstetrics and Gynaecology, Division of Reproductive Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
    2. Department of Reproductive Medicine and Gynaecology, University Medical Centre, Utrecht, the Netherlands
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  • K Beier-Hellwig,

    1. Department of Anatomy and Reproductive Biology, RWTH Aachen University, Aachen, Germany
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  • CA Krusche,

    1. Department of Anatomy and Reproductive Biology, RWTH Aachen University, Aachen, Germany
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  • BCJM Fauser,

    1. Department of Obstetrics and Gynaecology, Division of Reproductive Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
    2. Department of Reproductive Medicine and Gynaecology, University Medical Centre, Utrecht, the Netherlands
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  • HM Beier,

    1. Department of Anatomy and Reproductive Biology, RWTH Aachen University, Aachen, Germany
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  • I Classen-Linke

    1. Department of Anatomy and Reproductive Biology, RWTH Aachen University, Aachen, Germany
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Dr NS Macklon, Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands. Email n.s.macklon@umcutrecht.nl

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 (E2) 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 E2 (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.

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