Histological dating of timed endometrial biopsy tissue is not related to fertility status

Christos Coutifaris, Evan R. Myers, David S. Guzick, Michael Peter Diamond, Sandra A. Carson, Richard S. Legro, Peter G. McGovern, William D. Schlaff, Bruce R. Carr, Michael P. Steinkampf, Susan Silva, Donna L. Vogel, Phyllis C. Leppert

Research output: Contribution to journalArticle

204 Citations (Scopus)

Abstract

To assess the ability of histological dating to discriminate between women of fertile and infertile couples. The utility of histological dating of endometrium in the evaluation of infertile couples is uncertain. Prospective multicenter study, with subjects randomly assigned to biopsy timing. Criterion standard for infertility was 12 months of unprotected, regular intercourse without conception and for fertility at least one live birth within 2 years. University-based infertility practices. Volunteer subjects (847) recruited at 12 clinical sites participating in the National Institutes of Health-funded Reproductive Medicine Network. Inclusion criteria included ages 20-39 years, regular menstrual cycles, and no hormonal treatment or contraceptive use for 1 month before the study. Fertile controls were excluded if they had a history of infertility, recurrent pregnancy loss, or recent breastfeeding. Subjects underwent daily urinary LH testing. After detection of the LH surge, subjects were randomized to biopsy in the mid (days 21-22) or the late (days 26-27) luteal phase. Pathologists at each site estimated the cycle day based on standard criteria. For the primary analysis, an out-of-phase biopsy was defined as a greater than 2-day delay in the histological maturation of the endometrium. The proportion of out-of-phase biopsies in fertile and infertile women was compared using logistic regression models with age at randomization as a covariate. Comparisons were also made between fertile vs. infertile at the midluteal or late luteal phase time points. Biopsies were evaluated (301 mid and 318 late; N = 619). Out-of-phase biopsy results poorly discriminated between women from fertile and infertile couples in either the midluteal (fertile: 49.4%, infertile: 43.2%) or late luteal phase (fertile: 35.3%, infertile 23.0%). Results did not substantially differ using alternative definitions of out-of-phase or standardized cycle day. Histological dating of the endometrium does not discriminate between women of fertile and infertile couples and should not be used in the routine evaluation of infertility.

Original languageEnglish (US)
Pages (from-to)1264-1272
Number of pages9
JournalFertility and Sterility
Volume82
Issue number5
DOIs
StatePublished - Jan 1 2004
Externally publishedYes

Fingerprint

Fertility
Biopsy
Infertility
Luteal Phase
Endometrium
Logistic Models
Reproductive Medicine
Aptitude
National Institutes of Health (U.S.)
Live Birth
Menstrual Cycle
Random Allocation
Contraceptive Agents
Breast Feeding
Multicenter Studies
Volunteers
Prospective Studies
Pregnancy

Keywords

  • Infertility
  • endometrial biopsy
  • endometrium
  • luteal phase defect
  • uterine receptivity

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Coutifaris, C., Myers, E. R., Guzick, D. S., Diamond, M. P., Carson, S. A., Legro, R. S., ... Leppert, P. C. (2004). Histological dating of timed endometrial biopsy tissue is not related to fertility status. Fertility and Sterility, 82(5), 1264-1272. https://doi.org/10.1016/j.fertnstert.2004.03.069

Histological dating of timed endometrial biopsy tissue is not related to fertility status. / Coutifaris, Christos; Myers, Evan R.; Guzick, David S.; Diamond, Michael Peter; Carson, Sandra A.; Legro, Richard S.; McGovern, Peter G.; Schlaff, William D.; Carr, Bruce R.; Steinkampf, Michael P.; Silva, Susan; Vogel, Donna L.; Leppert, Phyllis C.

In: Fertility and Sterility, Vol. 82, No. 5, 01.01.2004, p. 1264-1272.

Research output: Contribution to journalArticle

Coutifaris, C, Myers, ER, Guzick, DS, Diamond, MP, Carson, SA, Legro, RS, McGovern, PG, Schlaff, WD, Carr, BR, Steinkampf, MP, Silva, S, Vogel, DL & Leppert, PC 2004, 'Histological dating of timed endometrial biopsy tissue is not related to fertility status', Fertility and Sterility, vol. 82, no. 5, pp. 1264-1272. https://doi.org/10.1016/j.fertnstert.2004.03.069
Coutifaris, Christos ; Myers, Evan R. ; Guzick, David S. ; Diamond, Michael Peter ; Carson, Sandra A. ; Legro, Richard S. ; McGovern, Peter G. ; Schlaff, William D. ; Carr, Bruce R. ; Steinkampf, Michael P. ; Silva, Susan ; Vogel, Donna L. ; Leppert, Phyllis C. / Histological dating of timed endometrial biopsy tissue is not related to fertility status. In: Fertility and Sterility. 2004 ; Vol. 82, No. 5. pp. 1264-1272.
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