Luteal phase in infertility: problems of evaluation

Area of Science:

• Reproductive endocrinology
• Gynecology
• Infertility research

Background:

• Luteal phase defect is a potential cause of infertility.
• Plasma progesterone levels are often used to assess ovulation and luteal function.
• Endometrial biopsy provides direct histological assessment of the endometrium.

Purpose of the Study:

• To evaluate the diagnostic accuracy of plasma progesterone measurements compared to endometrial biopsy in infertile women.
• To determine if plasma progesterone levels can reliably identify luteal phase defects.

Main Methods:

• Studied 200 infertile women with progesterone estimations during the luteal phase.
• Assessed endometrial histology via biopsy in a subset of patients.
• Compared progesterone levels and endometrial findings between infertile groups and fertile controls.

Main Results:

• 21.5% of infertile women showed defective endometria despite adequate luteal phase progesterone.
• Plasma progesterone levels did not differ significantly between women with normal and defective endometria.
• Plasma progesterone levels in infertile women were similar to fertile controls.

Conclusions:

• Endometrial biopsy remains essential for evaluating luteal function in infertility.
• Plasma progesterone estimations alone are insufficient to detect all cases of abnormal secretory phases.
• Relying solely on luteal phase progesterone measurements can lead to missed diagnoses in infertility evaluations.