Daly D C, Walters C A, Soto-Albors C E, Riddick D H
Fertil Steril. 1983 Sep;40(3):305-10. doi: 10.1016/s0015-0282(16)47291-2.
Luteal phase deficiency (LPD), as diagnosed by endometrial biopsy, is not a single disorder but rather a spectrum of dysfunction that reflects both endometrial cycle and ovarian cycle abnormalities. Forty-three patients were diagnosed as having LPD by two consecutive abnormal cycles. Seven patients (16%) with hyperprolactinemia received bromocriptine, and one hypothyroid patient received thyroid replacement. The remaining patients were treated sequentially with progesterone suppositories, clomiphene, the combination, and follicle-stimulating hormone and luteinizing hormone. If no conception occurred in 6 months on a given type of therapy, treatment was advanced. Patients were rebiopsied on each medication. In all, 33 of 41 (81%) compliant patients conceived. No viable pregnancies occurred without normal endometrial maturation, regardless of the treatment modality employed. When compared with time-life table projections, pregnancies occurred at rates comparable to those of a normal population once normal endometrial maturation was obtained with therapy. The endometrial biopsy accurately reflects the functional state of both the ovarian cycle and the endometrial cycle and can be used to determine adequacy of therapy, thereby improving conception rates in patients with LPD and eliminating the need for therapeutic trials.
经子宫内膜活检诊断的黄体期缺陷（LPD）并非单一疾病，而是一系列功能障碍，反映了子宫内膜周期和卵巢周期的异常。43例患者经连续两个异常周期被诊断为LPD。7例高催乳素血症患者（16%）接受了溴隐亭治疗，1例甲状腺功能减退患者接受了甲状腺替代治疗。其余患者依次接受黄体酮栓剂、克罗米芬、联合用药以及促卵泡生成素和促黄体生成素治疗。如果在某一特定治疗方案下6个月内未受孕，则升级治疗。患者在每种药物治疗时均再次进行活检。41例依从性患者中共有33例（81%）受孕。无论采用何种治疗方式，子宫内膜未正常成熟时均未发生存活妊娠。与生命表预测时间相比，一旦通过治疗使子宫内膜正常成熟，妊娠发生率与正常人群相当。子宫内膜活检能准确反映卵巢周期和子宫内膜周期的功能状态，可用于确定治疗的充分性，从而提高LPD患者的受孕率，并无需进行治疗试验。
