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ORIGINAL RESEARCH article

Front. Endocrinol.

Sec. Developmental Endocrinology

Volume 16 - 2025 | doi: 10.3389/fendo.2025.1639481

This article is part of the Research TopicThe Systemic and Metabolic effects of 17-Beta EstradiolView all articles

Clinical Outcomes of Different 17β-Estradiol Drug Regimens and Their Impact on Endometrial Receptivity

Provisionally accepted
Pinxiu  HuangPinxiu Huang1*Beining  LuoBeining Luo1Xuehong  ZhuXuehong Zhu2Ni  TangNi Tang3Zhong  LinZhong Lin2Zhengqin  ChenZhengqin Chen1Zhuo  LiangZhuo Liang1Jinxiang  WuJinxiang Wu4Bingsheng  HuangBingsheng Huang5,6Jun  YaoJun Yao1
  • 1Affiliated Hospital of Guilin Medical University, Guilin, China
  • 2Guangxi Zhuang Autonomous region reproductive hospital, nanning, China
  • 3Guangzhou Women and Children’s Medical Center-Liuzhou Hospita, Liuzhou, China
  • 4The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
  • 5Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
  • 6Key laboratory of clinical diagnosis and treatment research of high incidence disease in Guangxi, Baise, China

The final, formatted version of the article will be published soon.

Background: Clinically, it has been observed that vaginal administration of the same dose of Micronized 17-beta estradiol hemihydrate (the Estradiol tablets of Femoston) significantly increases serum estradiol levels compared to oral administration. However, the clinical outcomes associated with this route of administration remain unclear. Additionally, the concentration of estradiol in endometrial tissue following vaginal administration of Micronized 17-beta estradiol hemihydrate (M17EH), as well as its potential impact on endometrial receptivity, has been poorly investigated. Objective: To explore the relationship between different drug regimens of M17EH hormone replacement (HRT) and serum estradiol level, endometrial thickness and embryo implantation outcome in patients with thin endometrium during the frozen-thawed embryo transfer (FET) cycle, and to analyze the estradiol concentration in endometrial tissue of oral and vaginal administration of M17EH and its influence on endometrial receptivity. Method: A retrospective analysis was conducted on patients with thin endometrium. Subjects were divided into three groups based on different estrogen formulations and administration routes: Group A [oral Estradiol Valerate Tablets (Progynova)], Group B (oral M17EH), and Group C (oral combined with vaginal M17EH). Endometrial thickness, and clinical outcomes were compared across the three groups. For Groups B and C, endometrial tissue samples were collected five days after progesterone conversion. Estradiol concentration in tissues was detected and the endometrial receptivity markers [leukemia inhibitory factor, (LIF) and Mucins, (Muc1)] were evaluated. Results: Serum estradiol levels and endometrial thickness in Group C were significantly higher than those in the other two groups (P < 0.05). While there were no statistically significant differences in abortion rate, and live birth rate among the three groups, the live birth rate was highest in Group C. Estradiol concentration in the endometrium was significantly higher following vaginal administration of M17EH compared to oral administration (P<0.05). No significant differences were observed in the expression of endometrial receptivity markers (LIF and MUC1) between oral and vaginal administration groups. Conclusion: In FET cycles, a HRT regimen combining oral and vaginal administration of Micronized 17-beta estradiol hemihydrate is more conducive to endometrial growth. Although vaginal administration results in higher estrogen levels, it does not appear to compromise endometrial receptivity.

Keywords: Micronized 17-beta estradiol hemihydrate (Femoston), Estradiol Valerate Tablets (Progynova), hormone replacement program (HRT), Frozen-thawed embryo transfer (FET), Endometrial receptivity

Received: 02 Jun 2025; Accepted: 01 Sep 2025.

Copyright: © 2025 Huang, Luo, Zhu, Tang, Lin, Chen, Liang, Wu, Huang and Yao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Pinxiu Huang, Affiliated Hospital of Guilin Medical University, Guilin, China

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