The effect of a prolonged artificial follicular phase on endometrial development in an oocyte donation program
Tóm tắt
Stretching the duration of an artificial follicular phase in an oocyte donation program facilitates greatly the synchronization between the donor and the recipient. In order to investigate the limits of such a prolonged endopetrial preparation, 18 patients with ovarian failure were studied during 20 treatment cycles. These patients were prospectively and randomly divided into three groups (A, B, and C in eight, six, and six cycles respectively). All groups were treated with oral estradiol and estriol (at a 2∶1 ratio_, 4 mg/day for 21, 28, and 35 days, respectively. At this stage 50 mg/day of intramuscular progesterone was added for additional 7 days. Endometrial adequacy was evaluated by late follicular and midluteal endometrial biopsies. During treatment no patient suffered from breakthrough bleeding. The mean estradiol and progesterone levels during the follicular and luteal phases did not differ significantly between groups. All late follicular biopsies showed a normal proliferative endometrium with no signs of glandular cystic hyperplasia. The midluteal biopsy showed a secretory endometrium adequate for 18.6±1.8, 21.8±1.8, and 18.6±1.5 days in groups A, B, and C, respectively, with no significant glandularstromal disparity. We conclude that an artificial prolonged follicular phase does not seem to affect adversely the endometrilar preparation in an oocyte donation program.
Tài liệu tham khảo
Lutien P, Tounson A, Leeton J, Findlay J, Wood C, Renou P: The establishment and maintenace of pregnancy using in vitro fertilization and embryo donation in a patient with primary ovarian failure. Nature 1984:307:174–175
Navot D, Laufer N, Kopolovic J, Rabinovwitz R, Birkenfeld A, Lewin A, Granat M, Margalioth E, Schenker JG: Artificially induced cycles and establishment of pregnancies in the absence of ovaries. N Engl J Med 1986:314:806–811
Devroey P, Braeckmans P, Camus M, Khan I, Smitz J, Staessen C, Van Den Abbeel E, Van Waesberghe L, Wisanto A, Van Steirteghem AC: Pregnancies after replacement of fresh and frozen-thawed embryos in a donation programs.In Future Aspects in Human in Vitro-Fertilization, W. Feichtinger, P. Kemeter (eds). Berlin, Springer-Verlag. 1986, p 133
Serhal P, Craft I: Simplified treatment for ovum doration. Lancet 1987;1:687–688
Noyes RW, Hertig AT, Rock J Dating the endometrial biopsy. Fertil Steril 1950;1:3–25
World Health Organization, Task Force on Methods for the Determination of the Fertile Period, Special Programme of Research, Development and Research Training in Human Reproduction: A prospective multicentre trial of the ovulation method of natural family planning. III. Characteristics of the menstrual cycle and of the fertile phase. Fertil Steril 1983;40:773–778
Navot D, Anderson TL, Droesch K, Scott RT, Kreiner D, Rosenwaks Z: Hormonal manipulation of endometrial maturation. J Clin Endocrinol Metab 1989;68:801–807
Rosenwaks Z, Navot D, Veeck L, Liu HC, Steingold K, Kreiner D, Droesch K, Stumpf P, Muasher S: Oocyte donation—the Norfolk program. Ann NY Acad Sci 1988;541:728–741
Molina R, Castilla JA, Vergara F, Perez M, Garrido F, Henruzo AJ: Luteal cytoplasmic estradiol and progesterone receptors in human endometrium: In vitro fertilization and normal cycles. Fertil Steril 1989;51:976–979
Lutjen PJ, Findlay JK, Trounson AO, Leeton JF, Chan LK: Effect on plasma gonadotropins of cyclic steroid replacement in women with premature ovarian failure. J Clin Endocrinol Metab 1986;62:419–423
Hung TT, Ribas D, Tsuiki A, Preyer J, Slackman R, Davidson OW: Artificially induced menstrual cycle with natural estradiol and progesterone. Fertil Steril 1989;51:968–971
Rogers P, Murphy C, Cameron I, Leeton J, Hosie M, Beaton L, Macpherson A: Uterine receptivity in women receiving steroid replacement therapy for premature ovarian failure. Untrastructural and endocrinological parameters. Hum Reprod 1989;4:349–354
Loeb L: Wounds of the pregnant uterus. Proc Soc Exp Biol. Med 1907;4:93–96
Loeb L: The production of deciduomata and the relation between the ovaries and formation of the decidun. JAMA 1908;50:1897–1901
Scott RT, Rosenwaks Z: Oocyte donation-state of the art 1989 (in press)
Cameron IT, Rogers PA, Caro C, Harman J, Healy DL, Leeton JF: Oocyte donation: A review. Br J Obstet Gynecol 1989;96:893–899
Ben-Nun I, Ghetler Y, Gruber A, Jaffe R, Fejgin M: Egydonation in an in vitro fertilization program: An alternation approach to cycle synchronization and timing of embryo transfer. Fertil Steril 1989;52:683–687