Effect of Ovarian Stimulation with Recombinant Follicle-stimulating Hormone, Gonadotropin Releasing Hormone Antagonists, and Human Chorionic Gonadotropin on Endometrial Maturation on the Day of Oocyte Pick-up

Objective: To assess the effect of ovarian stimulation with recombinant FSH, GnRH antagonists, and hCG on endometrial maturation on the day of oocyte pick-up.

Design: Prospective study.

Setting: Tertiary referral center.

Patient(s): Fifty-five women undergoing controlled ovarian hyperstimulation for IVF/intracytoplasmic sperm injection (ICSI).

Intervention(s): [1] Ovarian stimulation with recombinant FSH, starting on day 2 of the cycle and GnRH antagonist, starting after a median of 6 days of recombinant FSH stimulation (range, 5-12 days); [2] hCG administration for ovulation induction; and [3] aspirational biopsy of endometrium at oocyte pick-up.

Main Outcome Measure(s): Endometrial histology at oocyte pick-up by Noyes criteria.

Result(s): Advancement of endometrial maturation (2.5 +/- 0.1 days) as compared to the expected chronological date was observed in all antagonist cycles at oocyte retrieval. Endometrial advancement at oocyte pick-up increased in line with values of LH at initiation of stimulation and the duration of recombinant FSH treatment before the antagonist was started.

Conclusion(s): The higher the values of LH at initiation of stimulation and the longer the duration of recombinant FSH treatment before the antagonist is started, the more advanced the endometrial maturation at oocyte pick-up.