Corticosteroids, androgens, progestogens and oestrogens in the endometrial microenvironment, and their association with endometrial progression and function

Autores de IIS La Fe

• Almudena Devesa Peiró

  Autor

• María Elena Labarta Demur

  Autor

• Marina López Nogueroles

  Autor

• Patricia Sebastián León

  Autor

• Nuria Pellicer De Castellvi

  Autor

• 

  Marcos Meseguer Escrivá

  Autor

• Patricia Díaz Gimeno

  Autor

Participantes ajenos a IIS La Fe

• Marti-Garcia, Diana

Grupos

• Biomarcadores, Medicina Genómica, Estadística y Análisis masivo de datos en Reproducción humana asistida

  

  Investigador Principal

  Marcos Meseguer Escrivá

• Endocrinología Reproductiva e Infertilidad

  Leader

  José Remohí Giménez

• Medicina Reproductiva

  

  Investigador Principal

  José Morales Roselló

Abstract

Research question: How does the intracrine action of progestagens, oestrogens, androgens and corticosteroids affect endometrial tissue progression and function? Design: In this prospective observational study, 76 patients (<50 years old, no uterine pathologies and at least one failed IVF cycle) undergoing endometrial biopsy collection for endometrial evaluation between 2018 and 2021 were included. The concentrations of 11 steroid metabolites (cortisone, cortisol, progesterone, oestrone, 2-methoxyestrone, oestradiol, oestriol, testosterone, androstenedione, 17 alpha-hydroxyprogesterone and 17-hydroxypregnenolone) were measured by ultra-performance liquid chromatography-tandem mass spectrometry in the endometrial tissue samples collected during the mid-secretory phase. Endometrial dating and reproductive outcomes (relative to the next good-quality fresh or frozen embryo transfer after the biopsy) were analysed in relation to endometrial steroid concentrations using Barnard's test; correlations between metabolite concentrations were measured by Pearson's correlation co-efficient. Results: Endometrial cortisol concentrations increased with age, whereas oestrone and 17 alpha-hydroxyprogesterone concentrations had inverse relationships with body mass index (all P < 0.05). No statistically significant differences were found in age or body mass index related to endometrial progression and reproductive outcomes. Low endometrial progesterone (<40.07 mu g/g), along with high endometrial cortisol (>2.18 ng/g) and testosterone concentrations (>= 0.52 ng/g), were mainly associated with out-of-phase endometria. Although low oestrone (<21.27 ng/g) and high androstenedione endometrial concentrations (>= 1.35 ng/g) impaired reproductive success, low oestradiol (<1.15 ng/g) endometrial concentrations favoured conception (all P < 0.05). Conclusions: In addition to progesterone and oestrogens, other steroid hormones are involved in intracrine signalling, and are probably necessary for acquiring adequate endometrial competence and supporting conception.

Keywords

• steroid hormone biosynthetic metabolites; endometrial receptivity; estrone; cortisol; testosterone; intracrinology