UNEXPLAINED INFERTILITY - EVALUATION OF THE LUTEAL-PHASE - RESULTS OFTHE NATIONAL-CENTER-FOR-INFERTILITY-RESEARCH AT MICHIGAN

Objective: To evaluate the luteal phase in women with rigorously defin ed unexplained infertility. Design: Prospective study. Setting: Nation al Center for Infertility Research at Michigan. Patient(s): Evaluation of 1,885 women with infertility identified 12 women who met the rigor ously defined criteria for unexplained infertility: [I] infertility of greater than or equal to 24 months duration, with no male factor, ana tomic-functional disorders of the reproductive tract, or immunologic i nfertility; [2] normal body mass index (BMI); [3] ovulatory cycles ran ging from 26 to 32 days; [4] normal luteal phase determined by endomet rial biopsy; and [5] normal baseline hormonal profile. Controls (n = 1 2) were healthy, parous women with normal ovulatory cycles, normal hor monal screen, and were matched for age and BMI to patients. Main Outco me Measure(s): Pattern of follicular growth rate and luteal phase horm onal profile. Result(s): Women with unexplained infertility did not di ffer in menstrual cycle characteristics, follicular growth rate or mea n preovulatory follicle diameter, or endometrial biopsy dating. The me an levels of P tended to be lower in the unexplained infertility group throughout the luteal phase, but only the midluteal interval reached statistical significance. Luteal phase mean integrated P or urinary PD G levels of unexplained infertility women did not differ from those of fertile controls. The ratio of integrated Ep:P also was significantly greater in women with unexplained infertility than in fertile control s. Conclusion(s): Women with rigorously defined unexplained infertilit y have subtle hormonal anomalies during the luteal phase when compared with fertile controls.