Use of clomiphene citrate protocol for controlled ovarian stimulation impairs endometrial maturity.

Autor:	Montenegro IS; Gynecology and Obstetrics Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.; Gynecology and Obstetrics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Embryology and Cellular Differentiation Lab, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.; Pathology Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.; Postgraduate Program in Health Sciences: Gynecology and Obstetrics of Universidade Federal do Rio Grande do Sul., Kuhl CP; Gynecology and Obstetrics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Embryology and Cellular Differentiation Lab, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.; Postgraduate Program in Health Sciences: Gynecology and Obstetrics of Universidade Federal do Rio Grande do Sul., Schneider RA; Gynecology and Obstetrics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Embryology and Cellular Differentiation Lab, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.; Postgraduate Program in Health Sciences: Gynecology and Obstetrics of Universidade Federal do Rio Grande do Sul., Zachia SA; Embryology and Cellular Differentiation Lab, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil., Durli ICLO; Gynecology and Obstetrics Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.; Gynecology and Obstetrics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Embryology and Cellular Differentiation Lab, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.; Postgraduate Program in Health Sciences: Gynecology and Obstetrics of Universidade Federal do Rio Grande do Sul., Terraciano PB; Gynecology and Obstetrics Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.; Gynecology and Obstetrics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Embryology and Cellular Differentiation Lab, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.; Postgraduate Program in Health Sciences: Gynecology and Obstetrics of Universidade Federal do Rio Grande do Sul., Rivero RC; Gynecology and Obstetrics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Pathology Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil., Passos EP; Gynecology and Obstetrics Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.; Gynecology and Obstetrics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Embryology and Cellular Differentiation Lab, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.; Postgraduate Program in Health Sciences: Gynecology and Obstetrics of Universidade Federal do Rio Grande do Sul.
Jazyk:	angličtina
Zdroj:	JBRA assisted reproduction [JBRA Assist Reprod] 2021 Feb 02; Vol. 25 (1), pp. 90-96. Date of Electronic Publication: 2021 Feb 02.
DOI:	10.5935/1518-0557.20200056
Abstrakt:	Introduction: Despite recent advances in assisted reproduction techniques and recent knowledge regarding embryo and endometrium quality, implantation and birth rates remain low. The objective of this study was to investigate whether clomiphene citrate alters endometrial maturation in infertile patients. Methods: In a prospective self-matched cohort study, we assessed the ovulation of women in spontaneous and stimulated cycles (with clomiphene citrate). We determined the ovulation day by ultrasound scanning. In both cycles, we took four blood samples (BS1 - at early proliferative phase, BS2 - at mid proliferative phase, BS3 - after ovulation and BS4 - at mid luteal phase) to determine the serum concentrations of FSH, LH, estradiol and progesterone. We retrieved an endometrial biopsy five days after ovulation, followed by blinded analysis and classification according to Noyes criteria, in both cycles. Results: Twenty-two participants completed the study. There were significant differences in FSH BS3 (p=0.001), in LH BS3 and BS4 (p<0.001 and p=0.049, respectively), in estradiol BS2, BS3 and BS4 (p<0.001, p=0.024 and p<0.001, respectively) and in progesterone BS3 and BS4 (p=0.028 and p<0.001, respectively). Considering Noyes criteria, there was a one-day delay when comparing the stimulated cycle with the spontaneous cycle (p=0.004), and a two-day delay when comparing the stimulated cycle with the biopsy day. Conclusion: This study indicates that ovarian stimulation with clomiphene citrate delays the endometrial maturity, and could possibly impair the implantation process due to asynchrony.
Databáze:	MEDLINE
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