Endometrial biopsies during treatment with subcutaneous pulsatile gonadotropin-releasing hormone and luteal-phase human chorionic gonadotropin.
A high incidence of luteal phase defect (LPD) has been reported using subcutaneous pulsatile gonadotropin-releasing hormone for induction of ovulation. We reviewed all patients treated with the combination of subcutaneous pulsatile gonadotropin-releasing hormone during the follicular phase and human chorionic gonadotropin during the luteal phase (GnRH-hCG) who underwent endometrial biopsy during a treatment cycle. All of these patients had biopsy-proven LPD which persisted despite traditional therapy with progesterone vaginal suppositories and/or clomiphene citrate. The mean number of biopsies out of phase per patient prior to GnRH-hCG treatment was 2.8 +/- 0.2 (+/- SEM). When treated with GnRH-hCG, 15/16 patients (94%) showed a normal endometrial biopsy. The probability of this result occurring by chance alone allowing for a 50% treatment independent correction rate is less than .001. These results show that the combination of subcutaneous pulsatile gonadotropin-releasing hormone and luteal-phase human chorionic gonadotropin can result in normal endometrial maturation in a high percentage of cycles when administered as described. It appears to be an effective alternative to traditional treatment modalities for luteal phase defect should one be needed.
Campbell
B F
BF
University of Minnesota Medical School, Department of Obstetrics and Gynecology, Minneapolis.
Phipps
W R
WR
Nagel
T C
TC
Tagatz
G E
GE
D001707:Biopsy, Needle; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000627:therapeutic use*; D004717:Endometrium / Q000473:pathology*; D005260:Female; D005498:Follicular Phase; D006801:Humans; D007260:Infusion Pumps; D007279:Injections, Subcutaneous; D008183:Luteal Phase; D003341:Luteolysis; D010906:Pituitary Hormone-Releasing Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies
D006063:Chorionic Gonadotropin; D010906:Pituitary Hormone-Releasing Hormones