The variation of endometrial response to a standard hormone replacement therapy in women with premature ovarian failure. An ultrasonographic and histological study

Abstract

Summary. The endometrial response to a standard hormone replacement therapy in 18 women with premature ovarian failure was examined by serial ultrasonographic measurement of endometrial thickness and histological study of endometrial biopsy taken on day 19 of the cycle. Women with idiopathic ovarian failure (n = 10) had significantly better response than women with Turner's syndrome (n = 4), whereas women with premature ovarian failure associated with previous chemotherapy (n = 4) had an intermediate response. These observations suggest that the endometria of women with Turner's syndrome responded suboptimally to steroid hormones. However, all endometrial biopsies studied revealed secretory changes. Overall, the results of histological dating of endometrial biopsy were found to be positively correlated with endometrial thickness on day 19 of the cycle (r = 0.72, P < 0.01). The plasma concentration of oestradiol on days 15, 19 and 29 of the artificial cycle were found to be significantly higher than those on the corresponding days of the natural cycle.

Optimizing hormone therapy for future reproductive performance in women with premature ovarian failure

“…This could be due to inadequate uterine development during artificial pubertal induction or due to inherent characteristics of the endometrial and uterine receptors in women with Turner syndrome. Li et al [27] studied the endometrial response to a standard hormone replacement therapy in 18 women with POF aged 26-32 years (10 women with idiopathic POF, 4 women with Turner syndrome and 4 women with POF following chemotherapy). He concluded that following standard HT the endometrium of women with Turner syndrome was significantly less matured both in thickness and histology compared with endometrium in women with other causes of POF.…”

“…In women with POF, the lack of steroidogenic activity necessitates exogenous steroids to prepare and maintain the endometrium for implantation. For successful implantation of the embryo in women with POF, adequate endometrial preparation by either vaginal or intramuscular progesterone following sufficient estrogen priming is required [27,[41][42][43][44][45][46][47]. The decrease in the serum progesterone levels or the duration of the progesterone exposure leads to luteal phase deficiency [44,45] and inadequate endometrial receptivity, resulting in reduced implantation and pregnancy rates [46].…”

“…Several studies [27,[40][41][42][43]47,48] described the effect of various preparations of estrogen and progesterone on the development of endometrium in women with POF. The studies have been grouped according to the HT regimen used.…”

Effects of Postmenopausal Hormone Replacement Therapy on HbA1c Levels

“…In our study, we did not observe any influence of HRT on HbA 1c values after adjusting for age and BMI, and we only observed the HbA 1c -lowering effect of HRT in women aged 40 -49 years. Although the cellular mechanisms regulating the age-dependent response of HbA 1c to estrogen have yet to be elucidated, this is also the case for endometrium (28) and bone (29).…”

Role of saline infusion sonography in uterine evaluation before frozen embryo transfer cycle

“…The endometrial response to a standard HT in 18 women with premature ovarian failure was examined by Li et al (20). Histologic study of endometrial biopsy taken on day 19 of the cycle revealed secretory changes in all patients and positively correlated with endometrial thickness.…”