ENSAYO CLÍNICO ALEATORIZADO PARA CONOCER LA CORRELACIÓN ENTRE EL NIVEL DE PROGESTERONA TISULAR Y SÉRICA RESPONSABLE DE LA RECEPTIVIDAD ENDOMETRIAL PARA LA IMPLANTACIÓN EMBRIONARIA

Abstract

INTRODUCTION_x000D_ Progesterone is an essential hormone for the regulation of the menstrual cycle, and its fluctuations can impact the goal of the cycle, which is gestation. Despite its importance, there is a lack of detailed studies on standard progesterone levels during the process. Therefore, it is necessary to determine these levels during the endometrial preparation process and correlate them with endometrial receptivity._x000D_ The objective of this study is to assess whether tissue Progesterone (Pt) and serum Progesterone (Ps) are related to the window of implantation (VDI) as a biomarker._x000D_ MATERIALS AND METHODS_x000D_ A prospective randomized crossover clinical trial was conducted from April to November 2022. Twenty-two patients undergoing a trial of hormone replacement therapy (THS) were enrolled. They were randomized to undergo endometrial biopsies on day 3.5 (DP3.5) of progesterone treatment, day 5 (DP5), and day 6.5 (DP6.5). The Pt and endometrial receptivity were studied._x000D_ RESULTS_x000D_ A total of 44 endometrial biopsies were performed, and the mean age of the patients was 36.45 +/- 3.95 years. The study revealed a linear relationship between Pt and VDI only on DP3.5 (p 0.04), while no linear relationship was observed on DP5 (p 0.23) and DP6.5 (p 0.77)._x000D_ The study identified the Pt range in receptive patients on DP5, where 80% of them exhibited receptivity between (180-80 ngP4/ml), and a cutoff point of 120 ngP4/ml was determined with a sensitivity of 67% and specificity of 40%._x000D_ DISCUSSION AND CONCLUSIONS_x000D_ The study's results highlight the importance of progesterone in endometrial receptivity but do not demonstrate its utility as a biomarker for endometrial receptivity._x000D_ While there were no significant differences between serum progesterone, tissue progesterone, and endometrial lining in distinguishing between different receptivity states, categorizing patients by receptivity groups did allow for a significant distinction of the post-receptive state._x000D_ The multivariate analysis identified an association between tissue progesterone and serum progesterone at the beginning of the window of implantation, indicating that tissue progesterone depends on serum progesterone by 94% at that moment. Thus, the study suggests that there is an association between progesterones and that it is crucial at the beginning of treatment.

Date of Award	20 Oct 2023
Original language	Spanish
Supervisor	Miguel Angel Checa Vizcaino (Director)