Progesterone receptors content of the endometrium in patients with luteal phase defect and its relationship to endometrium maturation and serum progesterone level

Luteal phase defect [LPD], a disorder characterized by delayed secretory endometrial maturation is associated with infertility and/or recurrent abortion. This endometrial retardation may not be a result of deficient progesterone secretion, but rather a consequence of endometrial failure to respond adequately to progesterone stimulation. This study included 20 patients with LPD suffering of infertility or habitual abortion and 20 control cases. All cases were subjected to endometrial biopsy on the 26th day of the cycle to assess maturation, immunostaining of the endometrial tissue for progesterone receptor content and serum progesterone level on the 25th and 26th days of the same cycle. The endometrial maturation had a lag of 4.46 days in infertile cases and 4.86 days in habitual aborters. The difference was insignificant. The serum progesterone levels showed no significant difference between study and control cases. The glandular progesterone receptors were higher in LPD cases, while stromal receptors were more in the control cases. These results suggested that serum progesterone determination is not ideal for LPD prediction. Estimation of progesterone receptors in the endometrium is valuable as failure of down regulation of glandular progesterone receptors in late luteal phase may be an etiologic factor in LPD

Steroid receptors in the endometrium of women using long acting progestin contraceptive [Norplant]

Norplant is a progesterone only contraceptive subdermal implant which releases continuous low lose of progestin. It is long lasting, effective and reversible. Since, progesterone has an antiestrogenic effect which involves inhibition of estrogen receptors, this prolonged progestin may have an effect on the steroid receptors content of the endometrium. This work involved study of the estrogen and progesterone receptors in the endometrium of norplant users by immunohistochemical staining of paraffin embedded endometrial biopsy. The study included three groups of norplant users each formed of 20 cases. The first group had norplant for one year, the second for two years and the third for three years. A control group of 20 cases who were not under any hormonal therapy was also included. The results showed that in control cases proliferative endometrium had estrogen and progesterone receptors significantly higher than secretory endometrium. There was significant inhibition of both receptors in the proliferative endometrium of norplant users than control cases. In secretory endometrium, the receptors were not significantly different in norplant users and control. The period of norplant use did not affect the steroid receptors content. It was concluded that norplant has a depressive effect on the level of endometrial estrogen and progesterone receptors. This may be an additional mechanism to its contraceptive action and may affect future pregnancy