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© 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

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.

Details

Title
Use of clomiphene citrate protocol for controlled ovarian stimulation impairs endometrial maturity
Author
Montenegro, Ivan Sereno; Kuhl, Cristiana Palma; de Almeida, Schneider Raquel; Zachia Suzana de Azevedo; Durli Isabel Cirne Lima de Oliveira; Terraciano, Paula Barros; Rivero, Raquel Camara; Passos, Eduardo P
University/institution
U.S. National Institutes of Health/National Library of Medicine
Pages
90-96
Publication year
2021
Publication date
2021
Publisher
Sociedade Brasileira de Reprodução Humana (Brazilian Society of Assisted Reproduction)
ISSN
15175693
e-ISSN
15180557
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2622271020
Copyright
© 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.