The Feasibility of a Less Invasive Method to Assess Endometrial Maturation--Comparison of Simultaneously Obtained Uterine Secretion and Tissue Biopsy

BJOG. 2009 Jan;116(2):304-12. doi: 10.1111/j.1471-0528.2008.02039.x.


Objective: To compare the assessment of endometrial maturation parameters in endometrial secretion samples obtained by a novel minimally invasive technique with those assessed in tissue biopsies.

Design: Prospective study.

Setting: University Hospital.

Population: Healthy female volunteers attending a gynaecological outpatient clinic.

Methods: Endometrial secretion fluid and tissue sampling 5 days after a spontaneous ovulation assessed with ultrasound.

Main outcome measures: Progesterone (P) receptor, Ki-67 expression and the Noyes criteria were used to date endometrial biopsies. In the endometrial fluid samples, glycodelin A (GdA), leukaemia inhibitory factor (LIF) and P levels were analysed, and protein content and electrophoresis patterns were determined.

Results: All data were correlated to estradiol (E2) and P serum concentrations. The dating according to histology and immunohistochemical staining patterns correlated significantly with GdA levels (r=0.376, P=0.048) in endometrial fluid samples as well with serum levels of E2 (r=0.568, P=0.001) and P (r=0.408, P=0.023). No correlation was observed between tissue dating and LIF levels and protein content in endometrial fluid samples.

Conclusions: The measurement of GdA in endometrial secretion samples may provide a less invasive method for assessing endometrial maturation in potential conception cycles without disrupting implantation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / analysis
  • Biomarkers / blood
  • Body Fluids / chemistry
  • Electrophoresis, Gel, Two-Dimensional
  • Embryo Implantation*
  • Endometrium / cytology
  • Endometrium / metabolism
  • Endometrium / physiology*
  • Feasibility Studies
  • Female
  • Glycodelin
  • Glycoproteins / analysis
  • Humans
  • Immunohistochemistry
  • Ki-67 Antigen / analysis
  • Leukemia Inhibitory Factor / analysis
  • Pregnancy
  • Pregnancy Proteins / analysis
  • Progesterone / analysis
  • Progesterone / blood
  • Prospective Studies
  • Receptors, Progesterone / analysis


  • Biomarkers
  • Glycodelin
  • Glycoproteins
  • Ki-67 Antigen
  • LIF protein, human
  • Leukemia Inhibitory Factor
  • PAEP protein, human
  • Pregnancy Proteins
  • Receptors, Progesterone
  • Progesterone