Elsevier

Fertility and Sterility

Volume 78, Issue 2, August 2002, Pages 252-258
Fertility and Sterility

The endometrium
Intrauterine microdialysis reveals cycle-dependent regulation of endometrial insulin-like growth factor binding protein-1 secretion by human chorionic gonadotropin

Work on this article was part of the theses of Silke Lehmeyer and Johannes Möll.
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Abstract

Objective: To investigate whether hCG may directly influence endometrial differentiation and function.

Design: Controlled clinical study.

Setting: Tertiary university center.

Patient(s): Fifty-six women with infertility.

Intervention(s): An intrauterine microdialysis device (IUMD) was developed that consisted of two balloon catheters connected by microdialysis tubing (molecular weight cutoff: 2,000 kDa). The IUMD was inserted into the uterine cavity and perfused with saline for 3 hours. In 45 women, urinary hCG was then added for 5 hours. Eleven women underwent an identical procedure but without the application of hCG.

Main Outcome Measure(s): The response of the endometrium was assessed by measuring IGFBP-1 in the perfusate.

Result(s): Intrauterine secretion of IGFBP-1 was strictly confined to the late secretory phase (≥10 days after the beginning of the LH peak). This time point marks the closing of the implantation window. The application of hCG did not affect intrauterine IGFBP-1 levels before day 10 but induced a significant decrease of intrauterine IGFBP-1 levels thereafter. There was no significant change of intrauterine IGFBP-1 levels in the controls.

Conclusion(s): Intrauterine microdialysis allows a dynamic assessment of endometrial paracrine function in vivo. Human chorionic gonadotropin may be involved in the mechanisms regulating endometrial receptivity.

Keywords

Microdialysis
uterine receptivity
decidualization
implantation
gonadotropins

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