The feasibility of a less invasive method to assess endometrial maturation - Comparison of simultaneously obtained uterine secretion and tissue biopsy

Objective: To compare the assessment of endometrial maturation parameters in endometrial secretion samples obtained by a novel minimally invasive technique with those assessed in tissue biopsies. Design: Prospective study. Setting: University Hospital. Population: Healthy female volunteers attending a gynaecological outpatient clinic. Methods: Endometrial secretion fluid and tissue sampling 5 days after a spontaneous ovulation assessed with ultrasound. Main outcome measures: Progesterone (P) receptor, Ki-67 expression and the Noyes criteria were used to date endometrial biopsies. In the endometrial fluid samples, glycodelin A (GdA), leukaemia inhibitory factor (LIF) and P levels were analysed, and protein content and electrophoresis patterns were determined. Results: All data were correlated to estradiol (E2) and P serum concentrations. The dating according to histology and immunohistochemical staining patterns correlated significantly with GdA levels (r = 0.376, P = 0.048) in endometrial fluid samples as well with serum levels of E2(r = 0.568, P = 0.001) and P (r = 0.408, P = 0.023). No correlation was observed between tissue dating and LIF levels and protein content in endometrial fluid samples. Conclusions: The measurement of GdA in endometrial secretion samples may provide a less invasive method for assessing endometrial maturation in potential conception cycles without disrupting implantation.

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