The hCG test: an approach to luteal insufficiency

Corpus luteum insufficiency often constitutes the main cause of infertility. A corpus luteum test system has therefore been added to existing diagnostic methods. Eight days after the midcyclic LH surge 15 women suffering from infertility were administered i.m. injections of varying doses (5,000, 40,000 and 80,000 IU) of hCG. This was followed by multiple radio-immunological determinations of beta-hCG, 17 beta-estradiol, 17-hydroxyprogesterone and progesterone concentrations in peripheral serum over a period of 24 h. An identical test arrangement operating with physiologic saline was used for comparison with 5 primiparae. Beta-hCG concentrations in peripheral blood showed a dose-dependent increase following hCG injections. 17 beta-Estradiol displayed a diurnal concentration pattern. There was no significant difference, however, between the estradiol concentration following placebo or any of the hCG injections. In the case of progesterone and 17-hydroxyprogesterone a significant increase was found following the hCG injections. On the basis of multiple progesterone and 17-hydroxyprogesterone determinations good, moderate and lacking responses to hCG injections were determined. These were accompanied by normal or reduced basal values of progesterone. This fact may have important consequences for future diagnostics and therapy of sterility caused by luteal insufficiency.