Effects of Varied Estrogen Doses on Endometrial Receptivity

Volunteers who wish to participate in the study, will undergo a diagnostic and screening phase to determine their eligibility. Once eligibility is determined, participants will undergo three, separate "endometrial preparatory cycles". These cycles will consist of estrogen supplementation to mimic normal, above normal, and highly elevated estradiol levels. Once supplementation is complete uterine procedures will be done to hopefully determine the effects of the estrogen levels on the uterine lining. Subcutaneous leuprolide injections, intramuscular estrogen, and progesterone injections will be used to mimic the levels needed. Blood draws will monitor the needed estradiol and progesterone levels during the injection phase of the cycle. Once the injection phase is complete, transvaginal ultrasound, uterine aspiration, and endometrial biopsy will be done.

Inclusion criteria

• Regular menstrual cycles
• Age 18-50
• Normal Baseline ultrasound
• No intra-uterine procedures in prior 90 days

Exclusion criteria

• Any contraindications to undergoing estrogen stimulation of the endometrium
• Age ≥35 years and smoking ≥15 cigarettes per day
• Multiple risk factors for arterial cardiovascular disease (smoking, diabetes, and hypertension)
• Hypertension (systolic ≥140 mmHg or diastolic ≥90 mmHg)
• Venous thromboembolism (current or history of)
• Known thrombogenic mutations
• Known ischemic heart disease
• History of stroke
• Complicated valvular heart disease (pulmonary hypertension, risk for atrial fibrillation, history of subacute bacterial endocarditis)
• Systemic lupus erythematosus (positive or unknown antiphospholipid antibodies)
• Migraine with aura at any age
• Breast cancer
• Cirrhosis
• Hepatocellular adenoma or malignant hepatoma
• History of undiagnosed abnormal uterine bleeding.
• Allergic reaction to any study drug
• Known pregnancy or delivery within the past 6 months
• Breastfeeding
• Obesity >35 kg/m2