Patients under study in a programme of in-vitro-fertilisation and regarded as "normocyclic" were divided into 3 groups, depending on prior therapy: Patients in group I received clomiphene for follicle stimulation, and for ovulation HCG. Those in group II received in addition HMG for follicle maturation. Those in group III received HMG and HCG. When sonographs revealed a mature follicle about to rupture and the serum oestradiol increased, the follicle was aspirated to collect the ova. In 34 patients either no ova could be obtained, or the ova collected could not be fertilised, or because the oestradiol levels fell, no follicle was aspirated. In these 34 patients a biopsy of the endometrium was obtained some time between the 11th to 21st day of the cycle and studied histologically. Only ten of the 34 patients had a normally functioning endometrium suitable for implantation. The remaining patients revealed functional disturbances ranging from insufficient secretion to deficient proliferation to atrophy. Six biopsies could not be evaluated (advanced atrophy?). The women in group III showed the best results. The poor results obtained in group I and II were related in part to the anti-oestrogenic effect of clomiphene. Aspiration of the follicle seemed to have no deleterious effect on the endometrium. Five of the male partners of the 10 patients with a normal endometrial histology had a pathologic spermiogram. As compared to the endocrinological parameters, the histological studies revealed a high rate of pathologic endometria.(ABSTRACT TRUNCATED AT 250 WORDS)
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http://dx.doi.org/10.1055/s-2008-1035889 | DOI Listing |
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