[Diagnostic evaluation of progesterone challenge test in amenorrheic patients (author's transl)]

Diagnostic evaluation of progesterone (P) challenge test (menstrual response and serum LH changes after P administration) was studied in 223 patients with secondary amenorrhea. Based on the serum FSH an prolactin (PRL) values amenorrheic patients were divided into three major groups; low or normal levels of FSH and PRL (Group I), high levels of PRL (Group II), high levels of FSH (Group III). Serum estradiol levels in patients with normal menstrual response to P were significantly higher than those with absent or scanty bleeding following P. Although the Group III patients with absent or scanty bleeding (Group IIIb) represented patients with ovarian failure, those with normal menstrual response to P (Group IIIa) clinically appeared to have high developed ovarian follicles. Based on the LH responses after P administration the Group I patients were further subdivided into two groups, one with LH increase following P (Group Ia) and the second with no LH increase (Group Ib). In Group Ia 92 percent ovulated with clomiphene but all in Group Ib failed to ovulate. Therefore the LH changes after P administration gave good prediction of ovulatory as well as anovulatory responses to clomiphene.