[Luteal defect in pregnancy as the cause of habitual abortion]

Abstract

About 15 of all women in the reproductive age are involved by recurrent abortions. The pathophysiology is different; chromosomal, infectious, immunologic and endocrine reasons and anomalities of the uterine cave are discussed. Though there is a discrepancy between the regular secretory phase needed for implantation and low progestins in early pregnancy inducing abortion, the theory of recurrent abortions induced by ovarian malfunction is critically discussed in literature. Basing on the knowledge of the regulation of ovarian function and a delayed pregnancy without ovarian function in early pregnancy in a patient with recurrent abortions, a defect of the corpus luteum-rescue is the most probable explanation. This defect characterized by regular beta-HCG- and pathological decreased progestin and estradiol levels should be treated by substitution of progestin and estradiol. Though a defect of the HCG-receptor is possible a HCG-substitution seems to be an inadequate therapy.