Luteal phase deficiency and infertility: difficulties encountered in diagnosis and treatment

Abstract

Uncertainty concerning the importance of luteal phase defects as a cause of female infertility is closely related to problems of diagnosis. A study was undertaken of the consistency of the parameters used in daignosing luteal phase deficiency in 14 patients; results of randomized treatment regimens were also compared. Specific diagnostic criteria utilizing the basal body temperature (BBT) chart, endometrial biopsy, and progesterone levels were used. Prolactin and luteinizing hormone levels were measured at the time of progesterone determinations. Of the 29 cycles studied, only one third showed consistent abnormalities in BBT chart, endometrial biopsy, and progesterone levels. Discrepancy between the endometrial biopsy and the progesterone level occurred in at least 50% of all cycles studied. Prolactin levels were elevated in only 1 patient, suggesting a minor role for altered prolactin metabolism in luteal phase deficiency. Randomized treatment with progesterone vaginal suppositories, clomiphene citrate, and no treatment resulted in pregnancy in 5 of 14 patients (36%).