P14. Endometrial receptivity in women with a history of reproductive failures

Sergey Aganezov (RU), Kristina Ponomarenko (RU), Anastasia Morotskaya (RU), Natalia Aganezova (RU)

[Aganezov] I.I. Mechnikov North-Western State Medical University, St. Petersburg, [Ponomarenko] I.I. Mechnikov North-Western State Medical University, St. Petersburg, [Morotskaya] I.I. Mechnikov North-Western State Medical University, St. Petersburg, [Aganezova] I.I. Mechnikov North-Western State Medical University, St. Petersburg

Context. Insufficient secretory phase of an endometrial cycle in the ovulatory ovarial cycle can be an independent cause of reproductive disorders. Objective. To study the histological and receptivity characteristics of the endometrium in women with an abnormal reproductive function in the anamnesis. Methods. Ultrasound (control of folliculogenesis, ovulation), hormonal (determination of estradiol (E2) and progesterone (P) levels (6-8 days after ovulation) in blood) examinations, morphological examination of endometrial biopsy specimens were performed. Participant(s). 84 women 23-40 years old (mean age 32.4±0.1) with a history of reproductive failures were examined. Women had a normal level of gonadotropic and thyreoid hormones, prolactin, androgens. Intervention(s). Ultrasound examination of the pelvic organs, a puncture of the ulnar vein, pipelle biopsy of the endometrium on day 6-8 after ovulation were performed. Result(s). In 62% (n=52) women, morphological (histological and immunohistochemical) characteristics of insufficient secretory phase of the endometrial cycle (group 1) were revealed; in 38% (n=32) – the endometrium corresponded to the mid secretory phase (group 2). H-Score ER and PR values in the endometrium in groups 1 and 2, respectively, were: ER in the glands – 199.2±10.7 and 112.8±9.9 (p=0.000003), in the stroma – 153.9±11,7 and 119.4±13.0 (p=0.087); PR in the glands – 237.7±10.5 and 27.2±5.6 (p=4*10^{-13}), in the stroma – 266.5±5.1 and 275.6±3.2 (p=0.54). E2 levels in the blood in the groups were comparable: 704.6±47.1 pmol/L and 585.5±46.3 pmol/L (p=0.2). The P content in the blood corresponded to ovulatory values. In women, the P level in the blood was 47.1±2.8 nmol/L and 37.2±3.3 nmol/L (p=0.009), respectively. M-echo thickness (12-14 days of the menstrual cycle) did not differ in the groups: respectively 8.1±0.4 mm and 8.8±0.5 mm (p=0.3). Conclusion(s). Almost two thirds of the women in the observed cohort had a decreased endometrial receptivity status. The ovulatory level P in the blood is not a key informative and diagnostic criterion for excluding the inadequate secretory phase of the endometrium.