A prospective controlled study of luteal and endometrial abnormalities in an infertile population

To investigate whether luteal and endometrial abnormalities occur more frequently in an infertile population and thus contribute to infertility.

Prospective controlled clinical study.

Outpatient clinic in an academic research institution.

Thirty-three fertile controls and 31 infertile women without ovulatory disorders, tubal disease, or male factors.

All women underwent an endometrial biopsy 9 days after the LH surge followed by an IM injection of 5,000 IU 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 concentrations, and on day 5 after hCG administration for serum PP14 levels.

Histologic dating of the endometrium and serum P and PP14 measurements.

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-stimulated P levels. Serum PP14 measurements varied widely and did not discriminate subjects with abnormal endometrial development.

Disruption of endometrial maturation without a concomitant defect of the corpus luteum occurs more frequently in an infertile population and thus may contribute to infertility.