LUTEAL-PHASE DEFECTS AND ECTOPIC PREGNANCY

Objective: To determine whether luteal phase defect (LPD) may be an et iologic factor in ectopic pregnancy (EP). Design: All patients who wer e seen over a g-year period with the chief complaint of infertility un derwent an extensive infertility workup and were followed prospectivel y. The diagnoses of the causes of infertility were assigned retrospect ively. Setting: Two hospital-based tertiary care reproductive endocrin e-infertility units. Patients: A total of 1,077 infertility patients w ere evaluated. Of the 633 who became pregnant, the infertility had bee n due to LPD in 51 and to anovulation in 210. Main Outcome Measures: A ll the infertility patients who became pregnant were followed to deter mine whether they miscarried, developed an EP, or had a viable birth. The incidence of EP and miscarriage in the patients whose infertility was found to be due to LPD were compared with a control group in whom the infertility was due to anovulation. Results: The EP rate in the pa tients with LPD was significantly higher than in a control group whose infertility was due to anovulation (6 of 51 pregnancies versus 6 of 2 10 pregnancies, respectively). The spontaneous abortion rate in LPD ca ses also was highly significantly greater than in the control group (1 9 of 51 pregnancies Versus 12 of 210 pregnancies, respectively). The E P and spontaneous abortion rates also were higher in patients with LPD who were untreated than in those who were treated. Conclusions: This study suggests that there is a significantly increased incidence of tu bal EP in patients with LPD and that when patients with LPD become pre gnant early ultrasound should be performed to rule out EP. The study a lso indicated that spontaneous abortion occurs in a significantly high percentage of LPD cases.