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Does anovulation exist in eumenorrheic women?

Christine E Malcolm1, David C Cumming

  • 1Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada.

Obstetrics and Gynecology
|August 9, 2003
PubMed
Summary
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This study questions the existence of anovulatory cycles in eumenorrheic women, suggesting that a lower threshold for normal midluteal progesterone may be needed for accurate diagnosis.

Area of Science:

  • Reproductive Endocrinology
  • Gynecology

Background:

  • Eumenorrheic women typically have regular menstrual cycles.
  • Anovulation is often diagnosed based on midluteal progesterone levels.

Purpose of the Study:

  • To investigate the prevalence of anovulation in women with regular menstrual cycles.
  • To re-evaluate the diagnostic criteria for anovulatory cycles.

Main Methods:

  • Analysis of midluteal serum progesterone levels in 410 eumenorrheic women undergoing fertility treatment.
  • Progesterone levels were measured 7 days before the expected onset of menses.

Main Results:

  • 3.7% of eumenorrheic women showed apparently anovulatory progesterone levels (<15 nmol/L).
  • Further investigation revealed alternative explanations for low progesterone in most cases, including isolated cycle variations, improper sample timing, or advanced maternal age.

Related Experiment Videos

  • A small percentage (20%) consistently exhibited low progesterone levels, though still above the follicular range.

    • Conclusions:

    • The concept of anovulatory cycles in eumenorrheic women is questionable.
    • A lower threshold for defining normal ovulatory progesterone levels may be required.
    • Further research is needed to refine the diagnostic criteria for anovulation.