http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2871799/?report=reader
Gene expression profile of human endometrial receptivity: comparison between natural and stimulated cycles for the same patients
Background
The adjunction of exogenous hormones for controlled ovarian stimulation (COS) may alter endometrial receptiveness. In order to identify the genes mis-regulated under COS, we compared the endometrium gene expression profiles, from the same patients, in a natural cycle and in a subsequent COS cycle.
Methods
For the same normal-responder patients (n=21), endometrial biopsies (n=84) were collected during the pre-receptive (LH+2) and receptive stages (LH+7) of a natural cycle and, subsequently, on oocyte retrieval day (hCG+2) and on transfer day (hCG+5) of a stimulated cycle. Samples were analyzed using DNA microarrays. Gene expression profiles and biological pathways involved in the endometrial receptivity were analyzed.
Results
Although endometrium transition profiles from pre-receptive to receptive phases are similar between patients, COS regimens alter endometrial receptivity in comparison with natural cycle. Under COS conditions, two endometrial profiles were identified and were associated either with a moderately altered receptivity profile for the majority of the patients or a strongly altered profile for a subcategory of patients. The receptive endometrium transcription profile under COS was defective for biological functions such as TGFβ signalling, leukocyte transendothelial migration and the cell cycle. In addition, several biological functions specifically activated under COS regimens were identified.
Conclusion
Gonadotropin treatments in COS cycles led to disruptions of the transcriptional activation of genes involved in normal endometrial receptivity. We propose that when the receptiveness of the endometrium is seriously compromised by the COS protocol, fresh embryo replacement should be cancelled, the embryo frozen, and thawed embryo replacement should be performed under natural cycles.
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