Physiopathological aspects of corpus luteum defect in infertile patients with mild/minimal endometriosis.
OBJECTIVE
We describe a physiopathological model to the luteal insufficiency of infertile patients with mild/minimal endometriosis with normal hormone measurements in the early follicular phase.


METHODS
We designed a case-control study with 24 patients, 14 fertile with in-phase endometrium (control group) and 10 infertile with mild/minimal endometriosis and luteal insufficiency (study group). The histologic dating of endometrium was performed during cycle days 23-25 and serum TSH, FSH, LH, prolactin, and estradiol levels were measured during the early follicular phase (cycle day 3). Progesterone serum levels were measured in three different occasions during the luteal phase.


RESULTS
Patients with out-of-phase endometrium have lower estradiol levels (P = 0.031) and decreased progesterone secretion (P = 0.012) during the late luteal phase. Serum prolactin, TSH, FSH, and LH levels were similar between the groups (P > 0.05).


CONCLUSIONS
The physiopathology of luteal phase defect in infertile patients with mild/minimal endometriosis is associated with a small and large luteal cells dysfunction, characterized by abnormal follicular phase (lower estradiol serum levels) and lower progesterone LH-dependent secretion.
Obstetrics and Gynecology Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil. sabino@via-rs.net
João Sabino
JS
Cunha-Filho
Jorge Luiz
JL
Gross
Carlos Aogusto
CA
Bastos de Souza
Nadiane Albuquerque
NA
Lemos
Camila
C
Giugliani
Fernando
F
Freitas
Eduardo Pandolfi
EP
Passos
D003338:Corpus Luteum / Q000503:physiopathology*; D004715:Endometriosis / Q000503:physiopathology*; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000503:physiopathology*
D004958:Estradiol