ENDOMETRIAL RESPONSES IN ARTIFICIAL CYCLES - A PROSPECTIVE, RANDOMIZED STUDY COMPARING 3 DIFFERENT PROGESTERONE DOSAGES

Objective To examine the endometrial response to three different regimens of progesterone. Design A prospective, randomized study. Setting The Jessop Hospital for Women, Sheffield. Subjects 14 women with premature ovarian failure divided into two equal groups. Interventions Three different regimens of hormone replacement therapy containing standard, high and low progesterone dosages. One group received the standard regimen in one cycle and high dosage regimen in another cycle. The second group received the standard regimen in one cycle and low dosage regimen in another cycle. The order of the two dosage regimens was randomized by lottery. Main outcome measures Ultrasonographic measurement of endometrial thickness and morphological study of endometrial biopsy specimens taken on day 19 of the cycle using the traditional dating criteria and morphometric techniques. Results Compared with standard regimen cycles, the endometrial response in cycles treated with the low dosage regimen showed significant retardation of overall endometrial development and changes in a number of morphometric measurements. The response of endometrial glands to the high dosage regimen was similar to that of the standard regimen, although the stromal cell diameter was increased. Conclusions In women receiving hormone replacement therapy normal endometrial development depends on an adequate dosage of progesterone, but increased dosage above our standard regimen does not produce any further change in the glandular component of the endometrium.