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Luteal phase defect in habitual abortion: progesterone in saliva
M Tulppala1, U M Björses, U H Stenman
1Department I of Obstetrics and Gynecology, University Central Hospital of Helsinki, Finland.
Objective:
To re-evaluate the occurrence of luteal phase defect (LPD) in habitual abortion and to determine the value of salivary progesterone (P) assay in its diagnosis.
Design:
Prospective study on patients with a history of at least three consecutive miscarriages.
Setting:
Departments I and II of Obstetrics and Gynecology, University Central Hospital of Helsinki, Helsinki, Finland.
Patients:
Forty-six patients (27 primary and 19 secondary aborters) and 12 healthy control women without a history of abortion.
Results:
Eight patients (17.4%, 5 primary and 3 secondary aborters) exhibited a delay of greater than 2 days in endometrial maturation during two consecutive cycles, whereas in 38 patients (82.6%) endometrial maturation corresponded to the actual cycle day. Salivary P showed a distinct ovulatory rise, but no statistically significant differences were evident between patients (with or without LPD) and healthy control women.
Conclusions:
An endometrial maturation defect may be a factor in 17.4% of patients with habitual abortion, but this cannot be detected by salivary P assay.