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 ovulator y 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 TU 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 concentrat ions, and on day 5 after hCG administration for serum PP14 levels. Mai n Outcome Measures: Histologic dating of the endometrium and serum P a nd 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-stimula ted P levels. Serum PP14 measurements varied widely and did not discri minate subjects with abnormal endometrial development.Conclusions: Dis ruption of endometrial maturation without a concomitant defect of the corpus luteum occurs more frequently in an infertile population and th us may contribute to infertility.