EFFECT OF PROGESTOGEN THERAPY ON FOLLICULAR DEVELOPMENT, RELATED HORMONE CONCENTRATIONS AND FERTILIZATION IN-VITRO IN UNSTIMULATED CYCLES AND UNEXPLAINED AND ENDOMETRIOSIS-ASSOCIATED INFERTILITY

Evidence of pituitary-ovarian dysfunction in unexplained and endometri osis-associated infertility has been reported previously, Hormone-supp ressive therapy is often used in an attempt to improve fertility, alth ough benefits have not been proven. Our study examines the effect of p rogestogen (medroxyprogesterone acetate) treatment on women with endom etriosis-associated and unexplained infertility, compared with women w ith tubal damage as functional controls, Pre-ovulatory follicular size and serum and follicular fluid hormone concentrations were measured, and oocyte collection and in-vitro fertilization were attempted, in na tural cycles totally unperturbed by exogenous gonadotrophins, for two cycles before and two cycles following treatment with medroxyprogester one acetate for 2 months, In the endometriosis and unexplained inferti lity groups, compared with the tubal group, the treatment led to signi ficant reductions in the integrated luteinizing hormone (LH) values (4 83 versus 664, 559 versus 762 and 864 versus 820 notional IU/l respect ively), There were no changes in serum oestradiol or follicular fluid oestradiol, progesterone, follicle stimulating hormone or LH concentra tions after treatment, The results suggest that progestogen therapy ha s no beneficial effect on the pituitary-ovarian dysfunction which cont ributes to endometriosis-associated and unexplained infertility.