The endometrial biopsy as a guide to the treatment of the luteal phase defect associated with hyperprolactinemia.

Twenty-five hyperprolactinemic patients were given the diagnosis of associated luteal phase defect (LPD) on the basis of endometrial biopsy. Fifteen patients were found to have glandular stromal synchrony, and 10 had glandular stromal asynchrony (GSA). After 3 months of initial bromocriptine therapy, the patients were divided into two groups and treated separately on the basis of the endometrial histologic pattern found. Persistent GSA was complemented with clomiphene citrate. The raw pregnancy rates were identical for both groups. Progesterone values between the two groups were not significantly different. Life-table analysis projected the cumulative pregnancy rate on the basis of the protocol of therapy administered. The efficacy of utilizing a combined drug approach based on the endometrial biopsy seems prudent in managing the fertility rate of the hyperprolactenemic patient with LPD.