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Assessing for an “Endometrial Factor”
Immunohistochemistry • Lessey et al, 1995
• Kliman et al, 2006
Histology
• Noyes et al, 1950
• Coutifaris et al, 2004 • Murray et al, 2004
Doppler/Ultrasound • Kupesick et al, 2001
• Kasius et al, 2014
Transcriptomics (RNA)
• •
Riesewijk et al, 2003 Simon et al, 2005
Secretomics (proteins)
• Van der Gaast et al, 2002, 2009 • Vilella et al, 2013
Hysteroscopy
• Cicinelli et al, 2008 • Bouet et al, 2016
Endometrial Stem Cells • Gargett et al, 2009
• Cervello et al, 2010, 2011
Endometrial Microbiome
Role of Progesterone
• LH surge promotes luteinization of granulosa cellsP
• ART: luteal P supplementation → higher pregnancy
rates (ASRM, 2008) → improves endometrium
• Cochrane Review 2013: P supplementation could improve live birth rate in recurrent miscarriage
• Coomarasamy et al, 2015: RCT of P 400 mg BID vs. placebo, no difference in live birth
However, P initiated after +ve hCG, as late as 6 wks’ gestation
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