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  • Title: Estrogen and progesterone receptors of the out-of-phase endometrium in female infertile patients.
    Author: Hirama Y, Ochiai K.
    Journal: Fertil Steril; 1995 May; 63(5):984-8. PubMed ID: 7720943.
    Abstract:
    OBJECTIVE: To examine the role of steroid hormone receptor compartmentalization in infertile women with "in-phase" or "out-of-phase" endometrium. DESIGN: Nonrandomized prospective clinical study. SETTING: A university clinic. PATIENTS: Twenty-nine infertile patients without evidence of endometriosis, tubal factor, male factor, galactorrhea, or hyperandrogenism were enrolled. Sixteen patients had in-phase endometrium and a P level > or = 10 ng/mL (conversion factor to SI unit, 3.18) (group A). Four patients had out-of-phase endometrium and a P level > 10 ng/mL (group B). Four patients had in-phase endometrium and a P level < 10 ng/mL (group C), and five patients had out-of-phase endometrium and a P level < 10 ng/mL (group D). MAIN OUTCOME MEASURES: Each patient underwent determination of serum P and endometrial sampling on postovulatory days 6 to 9 based on serum LH measurement. Dating according to endometrial histology and biochemical assessment of estrogen receptor (ER) and P receptor (PR) were performed on each sample. RESULTS: The level of cytosol ER was significantly lower in out-of-phase endometrium regardless of serum P level. There were no significant differences in the levels of cytosol PR and nuclear ER and PR among groups. In a long-term follow-up study, 6 of 29 patients became pregnant. The cytosol ER:PR ratio in these patients was found to fit a single straight regression line (y = 0.34x - 2.2). CONCLUSION: Out-of-phase endometrium probably depends on inadequate cytosol ER. An appropriate cytosol ER:PR ratio may be important to become pregnant.
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