VOLUME 118, ISSUE 2, P419
Ricardo F. Savaris, M.D., Ph.D., Bruce A. Lessey, M.D., Ph.D.
To the Editor:
We read with great interest the article published by Klimczak et al. (1), and we have several concerns. First, the investigators tried to compare results with our previous work in which we performed biopsies in ovulatory cycles before in vitro fertilization stimulation (2). In this study, Klimczak et al. (1) examined samples in ovarian hyperstimulated cycles. The timing of performing a biopsy is important because serum progesterone levels are altered during hyperstimulation, a biopsy performed close to the time of embryo transfer can potentially affect implantation, and retrieval itself can cause inflammation and potentially influence B-cell lymphoma 6 (BCL6) expression. Moreover, ReceptivaDx testing has not been recommended in hyperstimulated cycles.