The artificial cycle as an effective treatment of persistently retarded endometrium in the luteal phase

• Published in: Human reproduction (Oxford) Vol. 9; no. 3; p. 409
• Main Authors: Li, T C, Warren, M A, Cooke, I D
• Format: Journal Article
• Language: English
• Published: England 01.03.1994
• Subjects: Abortion, Habitual - drug therapy; Abortion, Habitual - etiology; Abortion, Habitual - physiopathology; Adult; Endometrium - physiopathology; Female; Goserelin - administration & dosage; Goserelin - therapeutic use; Humans; Infertility, Female - drug therapy; Infertility, Female - etiology; Infertility, Female - physiopathology; Luteal Phase - physiology; Pregnancy; Progesterone - administration & dosage; Progesterone - therapeutic use; Prospective Studies
• ISSN: 0268-1161
• DOI: 10.1093/oxfordjournals.humrep.a138518

The objective of this study was to examine the results of two hormonal treatment modalities on subjects who had persistently abnormal endometrial development in the luteal phase. A prospective study design was used to investigate 14 women who had persistently retarded endometrium associated with infertility (n = 11) or recurrent miscarriage (n = 3). Treatment A consisted of progesterone supplementation in the form of i.m. progesterone at a daily dose of 25-50 mg starting on day luteinizing hormone (LH) + 1 for 14 days. Treatment B consisted of artificial cycles produced after down-regulation of the hypothalamic-pituitary-ovarian axis with Goserelin (3.6 mg s.c.) followed by the administration of a standard hormone replacement therapy. Endometrial biopsy was taken on day 19 of the artificial cycle or days LH + 5 to +7 in the progesterone supplementation cycle. A histological study was made of the endometrial specimens by standard dating criteria and morphometry. The artificial cycle resulted in normal development in all subjects (n = 11), whereas progesterone supplementation restored normal endometrial development in only seven of 11 (64%) subjects. We conclude that persistently retarded endometrium could be treated more effectively with the artificial cycle than with progesterone supplementation.