The luteal phase of cycles utilizing controlled ovarian hyperstimulation and the possible impact of this hyperstimulation on embryo implantation

B. A. Kolb, R. J. Paulson, P. F. Kaplan, M. C M Cadieux, K. A. Burry, S. R. Henderson, Phillip Patton

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

OBJECTIVE: Our purpose was to evaluate the early luteal phase of assisted reproductive cycles utilizing controlled ovarian hyperstimulation and to compare these results with those obtained in unstimulated cycles. STUDY DESIGN: We undertook a descriptive study analyzing luteal phase serum progesterone levels, endometrial histologic features, and endometrial surface ultrastructure by scanning electron microscopy of cycles utilizing controlled ovarian hyperstimulation. Study samples were obtained from 7 oocyte donors undergoing controlled ovarian hyperstimulation for the purpose of follicle aspiration in oocyte donation. Control (unstimulated) serum progesterone samples were obtained from 19 patients undergoing in vitro fertilization in unstimulated cycles. Prospective recipients of oocyte donation (n = 20) undergoing mock cycles of exogenous estradiol and progesterone acted as controls for the endometrial biopsies. RESULTS: Serum progesterone levels on the day of human chorionic gonadotropin administration were twofold higher in the study group than in the unstimulated group (1.1 ± 0.8 vs 0.5 ± 0.2 ng/ml, mean ± SD, p <0.01). On the day of follicle aspiration, progesterone levels were much higher in the study group (8.5 ± 2.2 vs 0.5 ± 0.1 ng/ml, p <0.001). Histologic dating of endometrial biopsies revealed that the study group was advanced by nearly 2 days as compared with the group having artificial cycles. Pinopods, ultrastructural markers of the implantation window, were present in only one of seven study cycles as compared with all of the four artificial cycles. CONCLUSIONS: The early luteal phase of cycles undergoing controlled ovarian hyperstimulation is characterized by markedly elevated serum progesterone levels during the periovulatory period, advanced endometrial histologic features, and an absence of endometrial pinepods at the time of embryo implantation. We speculate that these high levels of progesterone in the early luteal phase cause premature endometrial luteinization and a premature appearance of the implantation window, thus providing an explanation for the observed decrease in endometrial receptivity.

Original languageEnglish (US)
Pages (from-to)1262-1269
Number of pages8
JournalAmerican Journal of Obstetrics and Gynecology
Volume176
Issue number6
DOIs
StatePublished - 1997
Externally publishedYes

Fingerprint

Luteal Phase
Progesterone
Oocyte Donation
Serum
Luteinization
Biopsy
Chorionic Gonadotropin
Fertilization in Vitro
Electron Scanning Microscopy
Oocytes
Estradiol
Tissue Donors

Keywords

  • Endometrial receptivity
  • Endometrium
  • In vitro fertilization
  • Oocyte donation
  • Scanning electron microscopy

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

The luteal phase of cycles utilizing controlled ovarian hyperstimulation and the possible impact of this hyperstimulation on embryo implantation. / Kolb, B. A.; Paulson, R. J.; Kaplan, P. F.; Cadieux, M. C M; Burry, K. A.; Henderson, S. R.; Patton, Phillip.

In: American Journal of Obstetrics and Gynecology, Vol. 176, No. 6, 1997, p. 1262-1269.

Research output: Contribution to journalArticle

Kolb, B. A. ; Paulson, R. J. ; Kaplan, P. F. ; Cadieux, M. C M ; Burry, K. A. ; Henderson, S. R. ; Patton, Phillip. / The luteal phase of cycles utilizing controlled ovarian hyperstimulation and the possible impact of this hyperstimulation on embryo implantation. In: American Journal of Obstetrics and Gynecology. 1997 ; Vol. 176, No. 6. pp. 1262-1269.
@article{846f1bed68a348bf99036910b3ac9964,
title = "The luteal phase of cycles utilizing controlled ovarian hyperstimulation and the possible impact of this hyperstimulation on embryo implantation",
abstract = "OBJECTIVE: Our purpose was to evaluate the early luteal phase of assisted reproductive cycles utilizing controlled ovarian hyperstimulation and to compare these results with those obtained in unstimulated cycles. STUDY DESIGN: We undertook a descriptive study analyzing luteal phase serum progesterone levels, endometrial histologic features, and endometrial surface ultrastructure by scanning electron microscopy of cycles utilizing controlled ovarian hyperstimulation. Study samples were obtained from 7 oocyte donors undergoing controlled ovarian hyperstimulation for the purpose of follicle aspiration in oocyte donation. Control (unstimulated) serum progesterone samples were obtained from 19 patients undergoing in vitro fertilization in unstimulated cycles. Prospective recipients of oocyte donation (n = 20) undergoing mock cycles of exogenous estradiol and progesterone acted as controls for the endometrial biopsies. RESULTS: Serum progesterone levels on the day of human chorionic gonadotropin administration were twofold higher in the study group than in the unstimulated group (1.1 ± 0.8 vs 0.5 ± 0.2 ng/ml, mean ± SD, p <0.01). On the day of follicle aspiration, progesterone levels were much higher in the study group (8.5 ± 2.2 vs 0.5 ± 0.1 ng/ml, p <0.001). Histologic dating of endometrial biopsies revealed that the study group was advanced by nearly 2 days as compared with the group having artificial cycles. Pinopods, ultrastructural markers of the implantation window, were present in only one of seven study cycles as compared with all of the four artificial cycles. CONCLUSIONS: The early luteal phase of cycles undergoing controlled ovarian hyperstimulation is characterized by markedly elevated serum progesterone levels during the periovulatory period, advanced endometrial histologic features, and an absence of endometrial pinepods at the time of embryo implantation. We speculate that these high levels of progesterone in the early luteal phase cause premature endometrial luteinization and a premature appearance of the implantation window, thus providing an explanation for the observed decrease in endometrial receptivity.",
keywords = "Endometrial receptivity, Endometrium, In vitro fertilization, Oocyte donation, Scanning electron microscopy",
author = "Kolb, {B. A.} and Paulson, {R. J.} and Kaplan, {P. F.} and Cadieux, {M. C M} and Burry, {K. A.} and Henderson, {S. R.} and Phillip Patton",
year = "1997",
doi = "10.1016/S0002-9378(97)70344-2",
language = "English (US)",
volume = "176",
pages = "1262--1269",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - The luteal phase of cycles utilizing controlled ovarian hyperstimulation and the possible impact of this hyperstimulation on embryo implantation

AU - Kolb, B. A.

AU - Paulson, R. J.

AU - Kaplan, P. F.

AU - Cadieux, M. C M

AU - Burry, K. A.

AU - Henderson, S. R.

AU - Patton, Phillip

PY - 1997

Y1 - 1997

N2 - OBJECTIVE: Our purpose was to evaluate the early luteal phase of assisted reproductive cycles utilizing controlled ovarian hyperstimulation and to compare these results with those obtained in unstimulated cycles. STUDY DESIGN: We undertook a descriptive study analyzing luteal phase serum progesterone levels, endometrial histologic features, and endometrial surface ultrastructure by scanning electron microscopy of cycles utilizing controlled ovarian hyperstimulation. Study samples were obtained from 7 oocyte donors undergoing controlled ovarian hyperstimulation for the purpose of follicle aspiration in oocyte donation. Control (unstimulated) serum progesterone samples were obtained from 19 patients undergoing in vitro fertilization in unstimulated cycles. Prospective recipients of oocyte donation (n = 20) undergoing mock cycles of exogenous estradiol and progesterone acted as controls for the endometrial biopsies. RESULTS: Serum progesterone levels on the day of human chorionic gonadotropin administration were twofold higher in the study group than in the unstimulated group (1.1 ± 0.8 vs 0.5 ± 0.2 ng/ml, mean ± SD, p <0.01). On the day of follicle aspiration, progesterone levels were much higher in the study group (8.5 ± 2.2 vs 0.5 ± 0.1 ng/ml, p <0.001). Histologic dating of endometrial biopsies revealed that the study group was advanced by nearly 2 days as compared with the group having artificial cycles. Pinopods, ultrastructural markers of the implantation window, were present in only one of seven study cycles as compared with all of the four artificial cycles. CONCLUSIONS: The early luteal phase of cycles undergoing controlled ovarian hyperstimulation is characterized by markedly elevated serum progesterone levels during the periovulatory period, advanced endometrial histologic features, and an absence of endometrial pinepods at the time of embryo implantation. We speculate that these high levels of progesterone in the early luteal phase cause premature endometrial luteinization and a premature appearance of the implantation window, thus providing an explanation for the observed decrease in endometrial receptivity.

AB - OBJECTIVE: Our purpose was to evaluate the early luteal phase of assisted reproductive cycles utilizing controlled ovarian hyperstimulation and to compare these results with those obtained in unstimulated cycles. STUDY DESIGN: We undertook a descriptive study analyzing luteal phase serum progesterone levels, endometrial histologic features, and endometrial surface ultrastructure by scanning electron microscopy of cycles utilizing controlled ovarian hyperstimulation. Study samples were obtained from 7 oocyte donors undergoing controlled ovarian hyperstimulation for the purpose of follicle aspiration in oocyte donation. Control (unstimulated) serum progesterone samples were obtained from 19 patients undergoing in vitro fertilization in unstimulated cycles. Prospective recipients of oocyte donation (n = 20) undergoing mock cycles of exogenous estradiol and progesterone acted as controls for the endometrial biopsies. RESULTS: Serum progesterone levels on the day of human chorionic gonadotropin administration were twofold higher in the study group than in the unstimulated group (1.1 ± 0.8 vs 0.5 ± 0.2 ng/ml, mean ± SD, p <0.01). On the day of follicle aspiration, progesterone levels were much higher in the study group (8.5 ± 2.2 vs 0.5 ± 0.1 ng/ml, p <0.001). Histologic dating of endometrial biopsies revealed that the study group was advanced by nearly 2 days as compared with the group having artificial cycles. Pinopods, ultrastructural markers of the implantation window, were present in only one of seven study cycles as compared with all of the four artificial cycles. CONCLUSIONS: The early luteal phase of cycles undergoing controlled ovarian hyperstimulation is characterized by markedly elevated serum progesterone levels during the periovulatory period, advanced endometrial histologic features, and an absence of endometrial pinepods at the time of embryo implantation. We speculate that these high levels of progesterone in the early luteal phase cause premature endometrial luteinization and a premature appearance of the implantation window, thus providing an explanation for the observed decrease in endometrial receptivity.

KW - Endometrial receptivity

KW - Endometrium

KW - In vitro fertilization

KW - Oocyte donation

KW - Scanning electron microscopy

UR - http://www.scopus.com/inward/record.url?scp=0030878704&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030878704&partnerID=8YFLogxK

U2 - 10.1016/S0002-9378(97)70344-2

DO - 10.1016/S0002-9378(97)70344-2

M3 - Article

C2 - 9215183

AN - SCOPUS:0030878704

VL - 176

SP - 1262

EP - 1269

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 6

ER -