Transcriptomic Evaluation of Endometrial Receptivity

Phase 1 will aim to define a normal endometrial transcriptomic signature in healthy controls without infertility. Phase 2 will elucidate endometrial transcriptomic expression in patients with diagnoses of infertility unrelated to endometrial factor. Findings from this phase will be compared to the results of phase 1.

Phase 1:

Major Inclusion: The following are major inclusion criteria:

• Regular menstrual cycles
• Age 18-50
• Normal baseline ultrasound
• No intrauterine procedures in prior 90 days

Exclusions: The following are exclusion criteria:

• Any contraindications to undergoing estrogen stimulation of the endometrium

• Current smoking status
• 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 infertility diagnosis
• History of undiagnosed abnormal uterine bleeding.
• Allergic reaction to any medication used for the preparatory cycle
• Known pregnancy or delivery within the past 6 months
• Breastfeeding
• Obesity >35 kg/m2

Phase 2

Major Inclusion: The following are major inclusion criteria:

• Age 18-50
• Diagnosis of infertility with low endometrial risk
• No intrauterine procedures in prior 90 days

Exclusions: In addition to the exclusion criteria for phase 1, patients deemed to have an elevated endometrial risk will also be excluded. This would include the following:

• Recurrent implantation failure
• Failed transfer with a euploid blastocyst
• History of Asherman's or abnormal endometrial function
• History of endometriosis