Reproductive biology and endocrinology : RB&E · 2026
Real-time intrauterine dissolved oxygen dynamics across the luteal phase: a potential non-invasive functional biomarker of endometrial status.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Teixidó Troyano Anna, Carbonell Socias Melchor, Cabeza Oliver Carmen, Sanfeliu de España Elisabeth, Font Zabalia Vicenç, Illan Hernandez Lidia, Perelló Barceló Maria Antonia, Pancorbo Lerma Maria Luisa, Robert Marchal Elisabet, Mendoza Cobaleda Manel, Gallart Agut Roger, Artiles Martínez Luis Manuel, Rodríguez de la Vega Otazo Monica, Suy Franch Anna, García Julio Herrero
Аннотация
BACKGROUND: Accurate, same-cycle assessment of endometrial readiness remains a major unmet need in assisted reproduction. Animal models have shown that spiral artery angiogenesis drives a midluteal rise in uterine oxygen tension, but direct, real-time measurements in humans have never been reported. We hypothesized that intrauterine dissolved O₂ profiling during the luteal phase could represent a potential functional, noninvasive biomarker of endometrial status.
METHODS: In this prospective, observational pilot feasibility study, eight healthy women aged 18-35 years with regular menstrual cycles and BMI < 30 underwent serial intrauterine pO₂ measurements across the luteal phase during a single natural cycle. Measurements were scheduled approximately every 48 h from the day of the LH surge (LH + 0) up to LH + 13/14, with minor variations due to scheduling constraints. Dissolved oxygen was recorded using a 1 mm fiber optic microsensor positioned 1 cm from the uterine fundus under ultrasound guidance. The primary outcome was intrauterine pO₂ (Torr) across the luteal phase.
RESULTS: Two distinct intrauterine oxygenation profiles were identified. Four participants exhibited a "peak" pattern characterized by early luteal low pO₂ (< 15 Torr), followed by a sharp mid-luteal rise in pO₂ (40-45 Torr at LH + 4 to LH + 6, p < 0.0001), a short plateau, and a decline by LH + 8. One participant showed an earlier and abbreviated peak. The remaining four participants maintained pO₂ values < 35 Torr throughout the luteal phase ("no-peak" pattern). Post-hoc review of baseline screening data and follow-up participant interviews identified plausible physiological, pharmacological, or lifestyle-related factors that may influence endometrial vascular maturation in the no-peak subgroup.
CONCLUSIONS: This study provides the first in vivo characterization of real-time intrauterine oxygen dynamics across the luteal phase in women. Intrauterine pO₂ profiling identified distinct temporal oxygenation patterns across the luteal phase and may reflect physiologically relevant changes in endometrial function. These preliminary findings support further evaluation of intrauterine oxygen profiling as a potential non-invasive, same-cycle functional biomarker of embryo-endometrium synchrony. Larger studies are required to validate its predictive value for implantation and live birth outcomes.
TRIAL REGISTRATION: ISRCTN85528745 (retrospectively registered on 30/01/2026).
METHODS: In this prospective, observational pilot feasibility study, eight healthy women aged 18-35 years with regular menstrual cycles and BMI < 30 underwent serial intrauterine pO₂ measurements across the luteal phase during a single natural cycle. Measurements were scheduled approximately every 48 h from the day of the LH surge (LH + 0) up to LH + 13/14, with minor variations due to scheduling constraints. Dissolved oxygen was recorded using a 1 mm fiber optic microsensor positioned 1 cm from the uterine fundus under ultrasound guidance. The primary outcome was intrauterine pO₂ (Torr) across the luteal phase.
RESULTS: Two distinct intrauterine oxygenation profiles were identified. Four participants exhibited a "peak" pattern characterized by early luteal low pO₂ (< 15 Torr), followed by a sharp mid-luteal rise in pO₂ (40-45 Torr at LH + 4 to LH + 6, p < 0.0001), a short plateau, and a decline by LH + 8. One participant showed an earlier and abbreviated peak. The remaining four participants maintained pO₂ values < 35 Torr throughout the luteal phase ("no-peak" pattern). Post-hoc review of baseline screening data and follow-up participant interviews identified plausible physiological, pharmacological, or lifestyle-related factors that may influence endometrial vascular maturation in the no-peak subgroup.
CONCLUSIONS: This study provides the first in vivo characterization of real-time intrauterine oxygen dynamics across the luteal phase in women. Intrauterine pO₂ profiling identified distinct temporal oxygenation patterns across the luteal phase and may reflect physiologically relevant changes in endometrial function. These preliminary findings support further evaluation of intrauterine oxygen profiling as a potential non-invasive, same-cycle functional biomarker of embryo-endometrium synchrony. Larger studies are required to validate its predictive value for implantation and live birth outcomes.
TRIAL REGISTRATION: ISRCTN85528745 (retrospectively registered on 30/01/2026).