Jordan J, Craig K, Clifton D K, Soules M R
Department of Obstetrics and Gynecology, University of Washington, Seattle.
Fertil Steril. 1994 Jul;62(1):54-62. doi: 10.1016/s0015-0282(16)56815-0.
To assess the sensitivity and specificity of common clinical tests used for the diagnosis of luteal phase defect (LPD).
The sensitivity and specificity of these tests for predicting low integrated P levels over the luteal phase were calculated.
Outpatient reproductive endocrinology and infertility clinic at a university medical center.
Fifty-eight strictly defined normal women were used to determine normal integrated luteal phase P levels. The study population was a separate 34 women who either were normal (n = 15) or were being evaluated for infertility or recurrent abortion (n = 19). These 34 study subjects all had the following tests performed in the same menstrual cycle: daily reproductive hormone levels, daily assessment of preovulatory follicle size, late luteal endometrial biopsies, and BBT charts.
Basal body temperature, maximum preovulatory follicle size, dated endometrial biopsies, and serum P levels (single and multiple) were used in an attempt to predict which patients had low integrated P levels.
Unacceptably low sensitivity and/or specificity levels were found for the following tests: appearance of BBT charts, luteal phase length, and preovulatory follicle diameter. Timed endometrial biopsy was found to have marginally acceptable sensitivity and specificity levels whether dated by next menstrual period or midcycle events. The best test for the prediction of low integrated P was a single serum P level from the midluteal phase that was < 10 ng/mL (31.8 nmol/L) or a sum of three random serum P measurements that was < 30 ng/mL (95.4 nmol/L) (also obtained in the midluteal phase).
Luteal phase defect is a relatively uncommon but important cause of infertility and/or habitual abortion. The recommended test for the determination of LPD is a midluteal phase single serum P level < 10 ng/mL or the sum of three serum P levels that is < 30 ng/mL. The endometrial biopsy is a second line test that is only recommended when LPD needs to be evaluated in a treated cycle (ovulation induction or supplemental P).
评估用于诊断黄体期缺陷（LPD）的常见临床检查的敏感性和特异性。
计算这些检查预测黄体期整合孕酮水平降低的敏感性和特异性。
一所大学医学中心的门诊生殖内分泌与不孕症诊所。
58名严格定义的正常女性用于确定正常的黄体期整合孕酮水平。研究人群为另外34名女性，其中15名正常，19名因不孕症或复发性流产接受评估。这34名研究对象在同一个月经周期内均进行了以下检查：每日生殖激素水平、排卵前卵泡大小的每日评估、黄体晚期子宫内膜活检以及基础体温图。
基础体温、排卵前最大卵泡大小、确定日期的子宫内膜活检以及血清孕酮水平（单次和多次）用于尝试预测哪些患者的黄体期整合孕酮水平较低。
发现以下检查的敏感性和/或特异性水平低得令人无法接受：基础体温图表现、黄体期长度和排卵前卵泡直径。无论根据下次月经日期还是月经周期中期事件确定日期，定时子宫内膜活检的敏感性和特异性水平勉强可以接受。预测黄体期整合孕酮水平降低的最佳检查是黄体中期单次血清孕酮水平<10 ng/mL（31.8 nmol/L）或三个随机血清孕酮测量值之和<30 ng/mL（95.4 nmol/L）（同样在黄体中期获得）。
黄体期缺陷是不孕症和/或习惯性流产相对少见但重要的原因。推荐用于确定黄体期缺陷的检查是黄体中期单次血清孕酮水平<10 ng/mL或三个血清孕酮水平之和<30 ng/mL。子宫内膜活检是二线检查，仅在需要在治疗周期（促排卵或补充孕酮）中评估黄体期缺陷时才推荐使用。
