LHRH analogue therapy in infertile women with luteal phase defects

Management of patients with unexplained (ovulatory) infertility is a difficult clinical problem. Some of these women exhibit repetitive luteal phase defects which may or may not respond to conventional treatment with anti-oestrogens or progesterone supplementation. Ablation of the defective cycles, by rendering the patients hypogonadotrophic, and then substituting induced cycles using exogenous gonadotrophins, was employed in 10 women who had been inexplicably infertile for up to 14 years. Over a trial period of six cycles good luteal phase progesterone profiles were achieved in all instances, but only two term pregnancies occurred. A further two patients conceived but one aborted and one had a tubal pregnancy. The results are discussed critically, regarding the importance of luteal phase defects in the aetiology of infertility and the conception rates which may occur even if no specific therapy is prescribed.