THE ARTIFICIAL CYCLE AS AN EFFECTIVE TREATMENT OF PERSISTENTLY RETARDED ENDOMETRIUM IN THE LUTEAL-PHASE

The objective of this study was to examine the results of two hormonal treatment modalities on subjects who had persistently abnormal endome trial development in the luteal phase. A prospective study design was used to investigate 14 women who had persistently retarded endometrium associated with infertility (n = 11) or recurrent miscarriage (n = 3) . Treatment A consisted of progesterone supplementation in the form of i.m. progesterone at a daily dose of 25-50 mg starting on day luteini zing hormone (LH)+1 for 14 days. Treatment B consisted of artificial c ycles produced after down-regulation of the hypothalamic - pituitary - ovarian axis with Goserelin (3.6 mg s.c.) followed by the administrat ion of a standard hormone replacement therapy. Endometrial biopsy was taken on day 19 of the artificial cycle or days LH+5 to +7 in the prog esterone supplementation cycle. A histological study was made of the e ndometrial specimens by standard dating criteria and morphometry. The artificial cycle resulted in normal development in all subjects (n = 1 1), whereas progesterone supplementation restored normal endometrial d evelopment in only seven of 11 (64%) subjects. We conclude that persis tently retarded endometrium could be treated more effectively with the artificial cycle than with progesterone supplementation.