Correlation between Estradiol and Progesterone Hormone Levels and Endometrial Thickness, Pattern and Vascularization in Patients Undergoing In Vitro Fertilization

Inayah Afrilia(1*), Dedy Hendry(2)

(1) Obstetrics and Gynecology Department, Faculty of Medicine, Andalas University, Dr. M. Djamil Central General Hospital Padang, West Sumatera, Indonesia
(2) Division of Reproductive Fertility and Endocrinology, Department of Obstetrics and Gynecology, RSUP Dr M. Djamil, Unversitas Andalas, Padang, Indonesia
(*) Corresponding Author

DOI: https://doi.org/10.25077/aoj.7.2.416-421.2023

Abstract


Introduction: Currently there is a shift in trends in in vitro fertilization programs related to embryo transfer. Embryo transfer is largely determined by the window of implantation related to endometrial receptivity. Endometrial pattern, thickness and vascularity are biomarkers of endometrial receptivity. Estrogen and progesterone are known to have a role in the development of this biomarker.

Methods: This study used a cross-sectional design. The study was conducted from January to December 2022 at the Morula IVF Fertility Clinic Padang, RSU Bunda Medical Center (BMC) Padang.

Results: At the end of the study, there were 100 respondents with an average age of 25-29 years, most of them were overweight, and almost all of them had primary infertility, and the average duration of infertility was 6.75 ± 3.98 years. At the time of ovulation trigger, the mean estradiol levels were 3070.32 ± 1186.985 pg/ml, progesterone 1.10 ± 0.57 ng/ml, and E2/P4 ratio 3.64 ± 3.10. Most of the respondents had type A endometrial pattern, type I vascularity, and the mean endometrial thickness was 11.58 ± 2.94 mm. There is a statistically significant relationship between estradiol and endometrial thickness and vascularity. In addition, a relationship was also found between progesterone and E2/P4 with endometrial vascularization. However, there is no significant relationship between progesterone and the E2/P4 ratio with the endometrial pattern.

Conclusion: Estrogen, progesterone and E2/P4 are related to endometrial vascularization and estrogen is related to thickness. None of these hormones are associated with endometrial pattern.


Keywords


estrogen, progesterone, endometrial pattern, endometrial thickness, endometrial vascularization

Full Text:

PDF

References


Wong KM, van Wely M, Verhoeve HR, Kaaijk EM, Mol F, van der Veen F, et al. Transfer of fresh or frozen embryos: A randomised controlled trial. Human Reproduction. 2021 Apr 1;36(4):998–1006.

Basirat Z, Adib Rad H, Esmailzadeh S, Gholam Ali Jorsaraei S, Hajian-Tilaki K, Pasha H, et al. Comparison of pregnancy rate between fresh embryo transfers and frozen-thawed embryo transfers following ICSI treatment. Vol. 14, Int J Reprod BioMed. 2016.

Seyedoshohadaei F, Rahmani K, Allahveisi A, Rezaei M, Rezaie MJ, Zandvakili F, et al. Fresh or Frozen Embryo Transfer in The Antagonist In Vitro Fertilization Cycles: A Retrospective Cohort Study. Int J Fertil Steril. 2022 Oct 1;16(4):256–62.

Data pasien Klinik Morula IVF Padang. Padang; 2020.

Roque M, Bedoschi G, Cecchino GN, Esteves SC. Fresh versus frozen blastocyst transfer. Vol. 394, The Lancet. Lancet Publishing Group; 2019. p. 1227–8.

Insogna IG, Lanes A, Lee MS, Ginsburg ES, Fox JH. Association of Fresh Embryo Transfers Compared with Cryopreserved-Thawed Embryo Transfers with Live Birth Rate among Women Undergoing Assisted Reproduction Using Freshly Retrieved Donor Oocytes. JAMA - Journal of the American Medical Association. 2021 Jan 12;325(2):156–63.

Shetty RK, Nadkarni PK, Singh PP, Singh P, Nadkarni AA, Nadkarni VK. Fresh versus frozen embryo transfer: a retrospective cohort study. Int J Reprod Contracept Obstet Gynecol. 2019 Aug 26;8(9):3774.

Fan L, Tang N, Yao C, Wei X, Tang Y, Li J, et al. Association Between Fresh Embryo Transfers and Frozen–Thawed Embryo Transfers Regarding Live Birth Rates Among Women Undergoing Long Gonadotropin-Releasing Hormone Antagonist Protocols. Front Cell Dev Biol. 2022 Apr 28;10.

Hou Z, Zhang Q, Zhao J, Xu A, He A, Huang X, et al. Value of endometrial echo pattern transformation after hCG trigger in predicting IVF pregnancy outcome: a prospective cohort study. Reprod Biol Endocrinol. 2019 Sep 5;17(1):74.

Zhang T, Li Z, Ren X, Huang B, Zhu G, Yang W, et al. Endometrial thickness as a predictor of the reproductive outcomes in fresh and frozen embryo transfer cycles. Medicine (United States). 2018 Jan 1;97(4).

Chen H, Li J, Cai S, Zeng S, Yin C, Kuang W, et al. Impact of body mass index (BMI) on the success rate of fresh embryo transfer in women undergoing first in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment. Int J Obes. 2022 Jan 9;46(1):202–10.

Liao SJ, Wang R, Hu C, Pan W, Pan W, Yu D, et al. Analysis of endometrial thickness patterns and pregnancy outcomes considering 12,991 fresh IVF cycles. BMC Med Inform Decis Mak. 2021 Dec 1;21(1).

Babayev E, Matevossian K, Hensley C, Zhang JX, Bulun SE. Baseline Endometrial Thickness or Endometrial Thickness Change in Response to Estrogen Is Not Predictive of Frozen Embryo Transfer Success in Medicated Cycles. Reproductive Sciences. 2020 Dec 1;27(12):2242–6.

Silva Martins R, Helio Oliani A, Vaz Oliani D, Martinez de Oliveira J. The predictive value of serial serum estradiol and serial endometrial volume on endometrial receptivity on assisted reproductive technology cycles. BMC Pregnancy Childbirth. 2021 Dec 1;21(1).

Quaas AM, Gavrizi SZ, Peck JD, Diamond MP, Legro RS, Robinson RD, et al. Endometrial thickness after ovarian stimulation with gonadotropin, clomiphene, or letrozole for unexplained infertility, and association with treatment outcomes. Fertil Steril. 2021 Jan 1;115(1):213–20.

Chan JM, Sukumar AI, Ramalingam M, Ranbir Singh SS, Abdullah MF. The impact of endometrial thickness (EMT) on the day of human chorionic gonadotropin (hCG) administration on pregnancy outcomes: a 5-year retrospective cohort analysis in Malaysia. Fertil Res Pract. 2018 Dec;4(1).

Polim A, Handayani N, Aprilliana T, Silvia R, Sirait B, Boediono A, et al. Association between estradiol levels and clinical outcomes of IVF cycles with single blastocyst embryo transfer. Asian Pacific Journal of Reproduction. 2021 Mar 1;10(2):49–55.

Fournier SB, D’errico JN, Stapleton PA. Uterine Vascular Control Preconception and During Pregnancy. Compr Physiol. 2021 Jul 1;11(3):1871–93.

Lv Y, Du S, Huang X, Hao C. Follicular fluid estradiol is an improved predictor of <em>in&nbsp;vitro</em> fertilization/intracytoplasmic sperm injection and embryo transfer outcomes. Exp Ther Med. 2020 Oct 2;20(6):1–1.

Corbacioglu A, Baysal B. Effects of Steroid Hormone Levels on the Ultrasound Appearance of the Preovulatory Endometrium in Controlled Ovarian Hyperstimulation Cycles. lnt J Fertil Steril. 2012;5(4):203–6.

Mamedalieva NM, Kurmanova AM, Baikoshkarova SB, Issenova S, Bishekova B, Anartayeva GZ. The effectiveness of micronized progesterone in the complex therapy of ‘thin endometry’ syndrome. Gynecological Endocrinology. 2021;37(S1):26–30.

Yang W, Zhang T, Li Z, Ren X, Huang B, Zhu G, et al. Combined analysis of endometrial thickness and pattern in predicting clinical outcomes of frozen embryo transfer cycles with morphological good-quality blastocyst. Medicine (United States). 2018 Jan 1;97(2).

Law TSM, Cheung WC, Wu F, Zhang R, Chung JPW, Wang CC, et al. Endometrial Vascularization Characterized by Optical Coherence Tomography and Immunohistochemistry in Women Undergoing In Vitro Fertilization-Embryo Transfer Treatment. Medicina (B Aires). 2019 Mar 27;55(4):81.

Salmasi S, Sharifi M, Rashidi B. Ovarian stimulation and exogenous progesterone affect the endometrial miR-16-5p, VEGF protein expression, and angiogenesis. Microvasc Res. 2021 Jan;133:104074.

Hassan A, Hussaini HA, Ammer L, Anbari A. Uterine Artery and Endometrial Vascularity DopplerIndices and Pregnancy Outcome in ICSI. Medico-legal Update. 2020;20(4).

Khan MS, Shaikh A, Ratnani R. Ultrasonography and Doppler Study to Predict Uterine Receptivity in Infertile Patients Undergoing Embryo Transfer. The Journal of Obstetrics and Gynecology of India. 2016 Oct 8;66(S1):377–82.

Liu L, Huang J, Li TC, Hong XT, Laird S, Dai YD, et al. The effect of elevated progesterone levels before oocyte retrieval in women undergoing ovarian stimulation for IVF treatment on the genomic profile of peri-implantation endometrium. J Reprod Immunol. 2017 Jun 1;121:17–25.

Wang Y, Tian Y, Liu L, Li TC, Tong X, Zhu H, et al. The number of previous failed embryo transfer cycles is an independent factor affecting implantation rate in women undergoing IVF/ICSI treatment: A retrospective cohort study. Medicine. 2021 Mar 5;100(9):e25034.

Hasibuan A. Hubungan Kadar Estradiol dan Progesteron Terhadap Gambaran Endometrium Secara Ultrasonografi pada Fase Folikular Lanjut pada Hiperstimulasi Ovarium Terkendali [Internet] [Tesis Magister]. [Medan]: Fakultas Kedokteran; 2017 [cited 2022 Nov 4]. Available from: https://repositori.usu.ac.id/handle/123456789/19634

Klonos E, Katopodis P, Karteris E, Papanikolaou E, Tarlatzis B, Pados G. Endometrial changes in estrogen and progesterone receptor expression during implantation in an oocyte donation program. Exp Ther Med. 2020 Oct 12;20(6):1–1.

Moustafa S, Young S. Diagnostic and therapeutic options in recurrent implantation failure. F1000Res. 2020 Mar 25;9:208.

Care AS, Ingman W v., Moldenhauer LM, Jasper MJ, Robertson SA. Ovarian Steroid Hormone-Regulated Uterine Remodeling Occurs Independently of Macrophages in Mice1. Biol Reprod. 2014 Sep 1;91(3).

Ohno Y, Fujimoto Y. Endometrial oestrogen and progesterone receptors and their relationship to sonographic appearance of the endometrium. Hum Reprod Update. 1998;4(5):560–4.

Singh N, Kaur S, Malik N, Malhotra N, Vanamail P. Do increased levels of progesterone and progesterone/estradiol ratio on the day of human chorionic gonadotropin affects pregnancy outcome in long agonist protocol in fresh in vitro fertilization/intracytoplasmic sperm injection cycles? J Hum Reprod Sci. 2015 Apr 1;8(2):80–5.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Address for Correspondence:

Editorial Room Andalas Obstetrics and Gynecology Journal 3rd floor of KSM Obstetrics and Gynecology
RSUP Dr. M. Djamil Padang, Jl. Perintis Kemerdekaan Padang, Sumatara Barat, 25127