Expression of Endometrium During Window of Implantation

Study Overview
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Brief Summary
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The aim of this study was to investigate the expression of endometrium during window of implantation between natural cycles and artificial cycles.

Detailed Description
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Due to progress of embryo vitrification in recent years, frozen embryo transfer (FET) of in vitro fertilization (IVF) has already been a world trend. The most used two protocols of FET are natural cycles (NCs) and artificial cycles (ACs). Recent studies showed that IVF outcomes of NCs were superior to ACs. We hypothesized that the result may be because of better endometrial receptivity of NCs compared to ACs. In NCs, no hormonal agents were administrated. Thus, endometrial receptivity was not disturbed by hormone and became better. However, there were few studies to explore the issue. Therefore, the aim of this study was to investigate the expression of endometrium during window of implantation (WOI) between NCs and ACs. The study will be performed from July 1st, 2022 to December 31th, 2023 in our reproductive center. We plan to enroll 60 infertile women who have underwent IVF cycles and would like to receive endometrial receptivity assay. We divide the participants into two groups, NCs and ACs. In NCs, no hormonal agents will be used. We identify ovulation day via serial hormone data and sample endometrium during WOI (LH surge + 7 days). In ACs, first, estrogen will be given for 10 14 days and then transvaginal sonography will be conducted. When endometrial thickness reaches 8 mm at least, progesterone will be prescribed. Endometrium is sampled during WOI (P4 + 5 days). We will record basic characteristics, infertility history, hormone data, ovarian reserve and endometrial thickness of infertile women in both groups. Endometrial samples will be assessed miRNA, implantation factors, uterine NK cells and T cells in both groups.

Official Title
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To Investigate the Expression of Endometrium During Window of Implantation Between Natural Cycles and Artificial Cycles

Conditions
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Unrecognized Condition

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age: 30-44 years BMI: 18 30 kg/m2 Implantation failure at least two times Exclusion Criteria: Primary ovarian insufficiency Congenital uterine anomaly Severe intrauterine adhesion Malignancy Donor cycle

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 44 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Natural cycles<br>Endometrium will be sampled at the day of LH surge + 7 days. | |
| Artificial cycles<br>Endometrium will be sampled at the day of P4 + 5 days. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Expression of endometrium | miRNA | through study completion, an average of 1.5 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Implantation factors of endometrium | HOXA10 | through study completion, an average of 1.5 year | 
| Immune cells of endometrium | Uterine NK cells | through study completion, an average of 1.5 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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window of implantation, endometrium receptivity, frozen embryo transfer cycles, natural cycles, artificial cycles, hormone replacement therapy cycles