"It is important that patients and doctors know that this test is available," said Kliman. "The EFT helps a patient and doctor figure out what the next steps are when assisted reproductive technology procedures don't appear to work. The test is done only at Yale, and we currently receive biopsies from all over North America for evaluation."
In this initial study, Kliman and his colleagues looked at 33 fertile volunteers, 83 women seeking fertility treatment, and 23 women undergoing mock cycles in preparation for frozen or donor embryo transfer. The researchers compared the expression of cyclin E and p27 in these groups at many different times throughout the menstrual cycle to establish the normal and abnormal patterns of expression of the markers in the endometrium.
The endometrium is made up of stroma and glands. The endometrial stroma is the tissue that supports the glands and holds the endometrium together, much like the cake supports the fruit in a fruitcake. "Fertile women expressed cyclin E in their glands up to about cycle day 19, and then did not have any after that," said Kliman. "Infertile women, on the other hand, much more frequently expressed cyclin E well after cycle day 19, often to the end of their cycles. The stroma in both groups was the same. These results suggest that infertile women have a defect in the way the stroma communicates with glands."
Kliman said a normal endometrium is like a surfer and a wave she has caught -- with the wave being the stroma and the surfer the glands. "Just as the surfer will miss the wave if it goes by too quickly, the endometrial glands can be left behind if the stroma moves too quickly," said Kliman. "This is what happens in many women with unexplained infertility. The EFT can diagnose this problem and help guide the infertility specialist to fix the problem, which in turn will improve the chances of implantation and a successful pregnancy."
Kliman's group is currently awa
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Contact: Karen N. Peart
karen.peart@yale.edu
203-432-1326
Yale University
15-Jul-2003