Aberrant uterine response to prostaglandin E2 as a possible etiologic factor in functional infertility

The clinical entity of functional infertility still remains unexplained and largely lacking a line of proper management. The uterine response to prostaglandin E2 (PGE2) and prostaglandin F2alpha (administered by intravenous and intrauterine routes) was evaluated during different phases of the menstrual cycle in five functionally infertile women. The results (quantitative and qualitative) were compared with those elicited among 20 fertile women. There were no apparent differences between the two groups with respect to either compound (systemic or local) when given during the proliferative or luteal phase of the cycle. However, at midcycle, about the time of ovulation (days 13 to 18), there was a salient deviation in the type of response following local instillation of PGE2; in the normal fertile group there was a definite inhibition of motility, while uteri in the functionally infertile group showed marked stimulation. The possible role of this aberrant uterine response in the etiology of functional infertility is discussed.