The impact of luteal phase inadequacy in an infertile population

Article Abstract:

Infertility can be caused by a defect in the luteal phase of the menstrual cycle. The corpus luteum, which forms after the release of an egg during ovulation, fails to produce enough progesterone essential in preparing the uterus for a pregnancy. Since there are many other factors that can influence fertility, the outcome of treatment for luteal phase inadequacy was evaluated. Luteal phase inadequacy was diagnosed when an endometrial biopsy, a sample of the lining of the uterus performed on the 25th day of the menstrual cycle, indicated an a lag in progesterone production for at least two menstrual cycles. The effect of luteal phase inadequacy on fertility was studied among 197 women undergoing a total of 242 biopsies. The influence of clomiphene citrate, an agent that stimulates the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), upon luteal phase inadequacy was also studied. There were 24 out-of-phase endometrial biopsies detected among the 137 women receiving clomiphene. Seven out of the 24 (29.2 percent) women had two out-of-phase biopsy results. A total of 5.1 percent had a diagnosis of luteal phase inadequacy. The probability of an out-of-phase endometrial biopsy occurring by chance was 4.2 out of 137 (3.1 percent). In all the women, luteal phase inadequacy was not the only reason for infertility. Pregnancy was achieved by 53 out of 130 women (41 percent) without the defect, and by two women out of seven women with luteal phase defect (28.6 percent). In the clomiphene-treated women, pregnancy was achieved in 15 out of 26 (57.7 percent) women with corrected luteal phase defect and 21 out of 34 (61.8 percent) women without the defect. Although the incidence of luteal phase defect was increased slightly after clomiphene citrate, there were no differences in the pregnancy rates for women with or without clomiphene citrate-induced luteal phase defects. Pregnancy rates are thus not affected by confirmed luteal phase inadequacy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Causes of, Fertility, Infertility, Female, Female infertility, Luteal phase defects, Clomiphene

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Absorption of oral progesterone is influenced by vehicle and particle size

Article Abstract:

Symptoms of menopause can be treated by the replacement of the female hormone estrogen. When it was found that estrogen therapy can cause uterine cancer, progesterone was added to the regime to decrease the complications of estrogen alone. Therapy with synthetic progestin is used to replace natural progesterone, a hormone produced by the ovaries and placenta that affects the uterus. Oral progesterone, thought to be short-lived in the body and to be poorly absorbed by the intestines, was manipulated to improve its availability to the body. In an effort to determine which factors influence the availability of oral progesterone in the body, the size of the particle and the vehicle of progesterone were analyzed. The level of progesterone in the blood was measured over a six-hour period in seven patients. The progesterone particle was manipulated in a variety of ways: milled with and without oil, made smaller (micronized) with and without oil, coated or non-coated, or milled plain. The oral administration of all types of progesterone caused increased blood levels of progesterone. Availability of micronized progesterone in oil peaked sooner. Thus, changing the physical characteristics of oral progesterone can improve absorption.

Drug therapy, Menopause, Progesterone

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Coculture of human embryos with buffalo rat liver cells for women with decreased prognosis in in vitro fertilization

Article Abstract:

Adding a solution of buffalo rat liver cells to the developing embryo before implantation seems to improve the pregnancy rates for selected women having difficulty getting pregnant with in vitro fertilization. Implantation and pregnancy rates were compared for 135 women implanted with rat liver treated embryos and 68 women implanted with untreated embryos. Overall, implantation and pregnancy rates were similar for the two groups. However, pregnancy rates were improved among women given treated embryos who had had previously unsuccessful in vitro fertilizations or who had dysfunctional ovulation cycles.

Methods, Usage, Liver cells, Hepatocytes, Fertilization in vitro, Human, Human fertilization in vitro, Cell culture, Tissue culture

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