A prospective controlled study of luteal and endometrial abnormalities in an infertile population.

OBJECTIVE

To investigate whether luteal and endometrial abnormalities occur more frequently in an infertile population and thus contribute to infertility.

DESIGN

Prospective controlled clinical study.

SETTING

Outpatient clinic in an academic research institution.

PARTICIPANTS

Thirty-three fertile controls and 31 infertile women without ovulatory disorders, tubal disease, or male factors.

INTERVENTIONS

All women underwent an endometrial biopsy 9 days after the LH surge followed by an IM injection of 5,000 IU hCG. Blood samples were drawn immediately before hCG administration for serum P and placental protein 14 (PP14) measurements, at 6 hours after hCG stimulation for serum P concentrations, and on day 5 after hCG administration for serum PP14 levels.

MAIN OUTCOME MEASURES

Histologic dating of the endometrium and serum P and PP14 measurements.

RESULTS

Abnormal endometrial biopsies occurred more frequently in infertile (43%) than in fertile women (9%). Except for one case, these specimens were not associated with low hCG-stimulated P levels. Serum PP14 measurements varied widely and did not discriminate subjects with abnormal endometrial development.

CONCLUSIONS

Disruption of endometrial maturation without a concomitant defect of the corpus luteum occurs more frequently in an infertile population and thus may contribute to infertility.