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Reproductive Physiology, Endocrinology, and Infertility

Question
10 out of 56
 

Luteal phasedefects are ovulatory disorders that can be a cause of infertility. Which of the following studies performed in the second half of the menstrual cycle is helpful in making this diagnosis?



A Serum estradiol levels

B Urinary pregnanetriol levels

C Endometrial biopsy

D Serum (FSH) levels

Ans. C

Endometrial biopsy

1. An abnormal luteal phase is defined as ovulation with a poor progestational effect in the second half of the cycle.

2. Luteal function is usually evaluated at the endometrium which is inadequately prepared for embryo implantation

3. Endometrial biopsy is crucial to the diagnosis of this defect because the endometrium will be out of phase with the time of cycle in these patients. For example, a biopsy taken on day 26 of the cycle will resemble endometrium of day 22 because of decreased progesterone stimulation

4. Progesterone levels in the mid luteal phase less than 7 suggestive of a luteal phase defect but not diagnostic.

5. Pregnanetriol, is a breakdown product of 17-hydroxyprogesterone, and levels are not helpful in diagnosing this condition Determination of the level of pregnanediol, which is a metabolic product of progesterone excreted in the urine is helpful. Serum luteinizing ho levels have no correlation with the presence of luteal phase defect.

Reproductive Physiology, Endocrinology, and Infertility Flashcard List

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