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Histological dating of timed endometrial biopsy tissue is not related to fertility status.

Abstract：

OBJECTIVE:To assess the ability of histological dating to discriminate between women of fertile and infertile couples. The utility of histological dating of endometrium in the evaluation of infertile couples is uncertain. DESIGN:Prospective multicenter study, with subjects randomly assigned to biopsy timing. Criterion standard for infertility was 12 months of unprotected, regular intercourse without conception and for fertility at least one live birth within 2 years. SETTING:University-based infertility practices. PATIENT(S):Volunteer subjects (847) recruited at 12 clinical sites participating in the National Institutes of Health-funded Reproductive Medicine Network. Inclusion criteria included ages 20-39 years, regular menstrual cycles, and no hormonal treatment or contraceptive use for 1 month before the study. Fertile controls were excluded if they had a history of infertility, recurrent pregnancy loss, or recent breastfeeding. INTERVENTION(S):Subjects underwent daily urinary LH testing. After detection of the LH surge, subjects were randomized to biopsy in the mid (days 21-22) or the late (days 26-27) luteal phase. Pathologists at each site estimated the cycle day based on standard criteria. For the primary analysis, an out-of-phase biopsy was defined as a greater than 2-day delay in the histological maturation of the endometrium. MAIN OUTCOME MEASURE(S):The proportion of out-of-phase biopsies in fertile and infertile women was compared using logistic regression models with age at randomization as a covariate. Comparisons were also made between fertile vs. infertile at the midluteal or late luteal phase time points. RESULT(S):Biopsies were evaluated (301 mid and 318 late; N = 619). Out-of-phase biopsy results poorly discriminated between women from fertile and infertile couples in either the midluteal (fertile: 49.4%, infertile: 43.2%) or late luteal phase (fertile: 35.3%, infertile 23.0%). Results did not substantially differ using alternative definitions of "out-of-phase" or standardized cycle day. CONCLUSION(S):Histological dating of the endometrium does not discriminate between women of fertile and infertile couples and should not be used in the routine evaluation of infertility.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Coutifaris C,Myers ER,Guzick DS,Diamond MP,Carson SA,Legro RS,McGovern PG,Schlaff WD,Carr BR,Steinkampf MP,Silva S,Vogel DL,Leppert PC,NICHD National Cooperative Reproductive Medicine Network.

doi

10.1016/j.fertnstert.2004.03.069

keywords:

subject

Has Abstract

pub_date

2004-11-01 00:00:00

pages

1264-72

issue

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(04)02276-9

journal_volume

pub_type

临床试验,杂志文章,多中心研究,随机对照试验

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Histological dating of timed endometrial biopsy tissue is not related to fertility status.