Comparison of transdermal versus oral estradiol on endometrial receptivity

• Published in: Fertility and sterility Vol. 65; no. 2; pp. 332 - 336
• Main Authors: Krasnow, Joel S., Lessey, Bruce A., Naus, Gregory, Hall, Lori-Linell H., Guzick, David S., Berga, Sarah L.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.1996; Elsevier Science
• Subjects: Administration, Cutaneous; Administration, Oral; Adult; Biological and medical sciences; Cross-Over Studies; Endometrial biopsy; endometrium; Endometrium - drug effects; Endometrium - physiology; Estradiol - administration & dosage; Estradiol - pharmacology; Female; Hormones. Endocrine system; Humans; luteal phase deficiency; Medical sciences; ovum donation; Pharmacology. Drug treatments; Progesterone - administration & dosage; Progesterone - blood; Prospective Studies; endometrium; Endometrial biopsy; luteal phase deficiency; ovum donation; Human; Ovocyte donation; Estrogen; Oral administration; Histology; Estradiol; Ovarian hormone; Progestagen; Percutaneous route; Assay; Chemotherapy; Biopsy; Female; Serum; Progesterone; Sex steroid hormone; Endometrium; Comparative study
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/S0015-0282(16)58094-7

To compare the effects of oral micronized E2 with transdermal E2 on endometrial receptivity in women undergoing oocyte donation. Prospective, randomized, crossover trial. Serum E2 and P concentrations were measured on cycle days 14 and 22 (luteal day +8). Endometrial biopsies were obtained on day 22 and read in a blinded fashion for histology and β-3-integrin expression. University-based donor oocyte program. Twenty-seven patients presenting for donor oocytes. Endometrial histology and β-3-integrin expression. The endometrial glandular histology in women given oral micronized E2 was delayed by a mean of 1.6 days in comparison to that of women given transdermal E2. Seventy percent of women given oral E2 displayed a lag ≥4 days whereas 29.6% given transdermal E2 displayed a similar lag. Serum E2 levels were 1,194±108.8pg/mL (mean±SEM; conversion factor to SI unit, 3.671) in women on oral micronized E2 and 117.4±14.0pg/mL in those on transdermal E2. The supraphysiologic serum E2 levels associated with oral micronized E2 may have a deleterious impact on endometrial receptivity. The development of more physiologic hormone replacement protocols may enhance endometrial receptivity and lead to improved clinical pregnancy rates.