Endometrial human chorionic gonadotropin (hCG) expression is a marker for adequate secretory transformation of the endometrium

  • Sindy SchugEmail author
  • Anja Baunacke
  • Maren Goeckenjan
  • Lars-Christian Horn
  • Gabriele Pretzsch
  • Gerolf Zimmermann
  • Henry AlexanderEmail author
Gynecologic Endocrinology and Reproductive Medicine



Successful embryo implantation into the endometrium depends on embryonic characteristics and proper endometrial development. Reproductive medicine often focuses on embryo quality, whereas reliable diagnostic tests for endometrial receptivity are still needed. We previously found that human chorionic gonadotropin (hCG), one of the earliest proteins secreted by the embryo, was also expressed by the luteal phase endometrium around the implantation window. Here, we tested our hypothesis of endometrial hCG as an implantation marker.


Endometrial biopsies and serum samples were taken from patients undergoing routine infertility diagnostics. Correlations of immunohistochemically detected endometrial hCG expression with adequate endometrial secretory transformation, the infiltration of CD45-positive leukocytes, clinical diagnostic parameters, and endometrial thickness were analyzed.


A highly significant correlation between the endometrial score, as a measurement for regular secretory transformation, and the intensity of hCG staining was found. The invasion of CD45-positive leukocytes increased with progressing endometrial secretory transformation and rising endometrial hCG expression. In addition, serum progesterone concentrations correlated with hCG expression by the endometrial glands.


Our results suggest endometrial hCG as a possible diagnostic parameter characterizing the endometrial secretory transformation and, thus, possibly also its implantation capability.


Human chorionic gonadotropin hCG Endometrium Implantation marker Reproductive medicine 



Assisted reproductive technologies


Human chorionic gonadotropin beta subunit


Embryo transfer


Human chorionic gonadotropin




Luteinizing hormone


Periodic acid-schiff



The authors thank Regina Scherling for expert technical assistance.

Author contributions

SS: data analysis and manuscript writing. AB: Protocol/project development, data collection and management, data analysis, and manuscript writing/editing. MG: data analysis. LCH: data analysis and manuscript editing. GP: contribution of endometrial specimens. GZ: protocol/project development, data analysis, and manuscript editing. HA: protocol/project development and manuscript editing.


S. Schug was supported by the German Research Foundation (DFG, Grant SO 1231/1-1) and a junior research grant awarded by the University of Leipzig Medical School.

Compliance with ethical standards

Conflict of interest

We declare that we have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

404_2019_5130_MOESM1_ESM.pptx (876 kb)
Supplementary material 1 (PPTX 877 kb)


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© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Research Laboratory of the Department of Obstetrics and Gynecology, Division of Human Reproduction and Endocrinology, Medical SchoolUniversity of LeipzigLeipzigGermany
  2. 2.Department of Gynecology and ObstetricsUniversity of DresdenDresdenGermany
  3. 3.Institute of Pathology, Department of Breast, Gynecological and Perinatal PathologyUniversity Hospital of LeipzigLeipzigGermany
  4. 4.Women’s HospitalUniversity Hospital of LeipzigLeipzigGermany

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