Ovulation-inducing drugs versus progesterone therapy for infertility in patients with luteal phase defects

The efficacy of ovulation-inducing drugs (OVI) for treating infertility related to luteal phase defects (LPD) was compared with the efficacy of progesterone vaginal suppositories (PVS). Patients were divided into two groups: (1) LPD secondary to immature follicles and (2) pure LPD, in which the follicle was mature. Twenty-four of 31 women (77%) with pure LPD conceived (one aborted) during the first 6 months, compared with only 3 of 27 (11%) treated with OVI--and 2 of 3 aborted. However, in women with LPD secondary to immature follicles, 14 of 20 (70%) treated with OVI and PVS conceived (and one aborted) compared with 7 of 10 conceiving (70%) with OVI only (four aborted), and 3 of 12 conceived (25%) with PVS only (none aborted). Thus, both PVS and OVI are effective in treating LPD; follicular maturation studies help determine the proper choice. PVS appears to decrease the risk of abortion in both categories.