title: Clinical investigation of the menstrual cycle. III. Clinical, endometrial, and endocrine aspects of luteal defect.
abstract: This study was intended to correlate different clinical and biologic parameters to better define luteal insufficiency (LI) and to contribute to a better understanding of its origin. Endometrial patterns were used as the basis for classification of clinical cases. Of 328 outpatients with menstrual disorders and/or infertility, 88 were considered to have LI. Their cycles were compared with 79 normal cycles. Two different principal endometrial patterns of LI are described: pure LI, when the endometrium is more than 2 days out of phase; and LI with persistent estrogenic influence, when the histologic estrogenic stigmata are excessive during the luteal phase. Basal body temperature charts demonstrated menstrual cycle disturbances: either ovulation delay or a slow increase in temperature (longer than 2 days). Plasma steroid concentrations also demonstrated a perturbation of the entire menstrual cycle: progesterone levels were statistically significantly lower in LI than in normal cycles and this defect was worse when the estrogenic influence was persistent; the preovulatory estradiol peak was disturbed in all circumstances, as was the concentration of endometrial steroid receptors. These simultaneous abnormalities strongly suggest a central origin of LI.
mesh_terms: D000328:Adult; D000818:Animals; D001831:Body Temperature; D003338:Corpus Luteum / Q000503:physiopathology*; D004717:Endometrium / Q000473:pathology*; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D008598:Menstruation; D010049:Ovarian Diseases / Q000175:diagnosis; D011374:Progesterone / Q000097:blood*; D011817:Rabbits; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D011374:Progesterone; D004958:Estradiol