Luteal phase evaluation after clomiphene-chorionic gonadotrophin-induced ovulation

Area of Science:

• Reproductive Endocrinology
• Gynecology

Background:

• Ovulation induction using clomiphene citrate and human chorionic gonadotropin (hCG) is a common infertility treatment.
• Assessing treatment efficacy typically involves basal body temperature (BBT) charting and plasma progesterone levels.
• Endometrial receptivity is critical for successful implantation and pregnancy.

Purpose of the Study:

• To evaluate the endometrial response to clomiphene and hCG therapy.
• To determine the correlation between plasma progesterone, endometrial histology, and BBT in infertile patients undergoing ovulation induction.
• To identify potential deficiencies in endometrial development despite adequate hormonal profiles.

Main Methods:

• Fifty infertile patients undergoing clomiphene and hCG treatment were assessed.
• Plasma progesterone levels were measured.
• Endometrial histology was performed to evaluate the secretory pattern.
• Basal body temperature (BBT) charts were analyzed for luteal phase characteristics.

Main Results:

• Five patients (10%) showed defective endometria and low progesterone despite normal BBT charts.
• Forty-five patients (90%) had elevated progesterone levels compared to fertile controls.
• However, 19 of these 45 patients (42.3%) exhibited defective endometrial secretory patterns.
• This indicates a potential for endometrial luteal phase deficiency.

Conclusions:

• Standard monitoring (BBT, progesterone) may not fully capture endometrial receptivity issues in clomiphene-treated cycles.
• Endometrial histology is a valuable tool for monitoring treatment response.
• Supplemental therapy may be necessary to address endometrial luteal phase defects in patients undergoing ovulation induction.