Balasch, J., Jové, I. C., Márquez, M., & Vanrell, J. A. (1990). Early follicular phase follicle-stimulating hormone treatment of endometrial luteal phase deficiency. Fertility and Sterility, 54(6), 1004-1007. https://doi.org/10.1016/s0015-0282(16)53995-8
Balasch J, Jové IC, Márquez M, Vanrell JA. Early follicular phase follicle-stimulating hormone treatment of endometrial luteal phase deficiency. Fertil Steril. 1990;54(6):1004-1007. doi:10.1016/s0015-0282(16)53995-8
Balasch, Juan, et al. "Early follicular phase follicle-stimulating hormone treatment of endometrial luteal phase deficiency." Fertility and Sterility, vol. 54, no. 6, 1990, pp. 1004-1007.
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Early-cycle FSH corrected luteal phase deficiency in 7 of 15 women
Early-cycle FSH injections corrected the uterine lining defect in 7 of 15 women with luteal phase deficiency. In this 1990 Barcelona study, biopsies documented the defect in at least two cycles. Of 5 women with a corrected defect and no other infertility factor, 2 had a baby.
Key Findings
Seven of 15 women (46.7%) with endometrial luteal phase deficiency showed normal endometrial dating during the first treated cycle.
Two of 5 women with a corrected defect and no other infertility factor conceived on FSH given for six cycles. Both carried singleton pregnancies to term.
Five additional women with normal luteal function had a third biopsy during FSH treatment, and the normal secretory pattern held in every case.
Hormone levels were similar in control and treatment cycles, and no side effects were noted.
Interpretation
The study is a small prospective series of 15 women, each judged against her own earlier untreated cycle, with no separate control group. The pathologist did not know which cycles were treated. Only 5 women had a corrected defect and no other infertility factor, and 2 of them became pregnant. The authors propose two possible forms of luteal phase deficiency, one tied to abnormal follicle development and one following normal follicle events. They say a method to tell the forms apart is still needed.
RRM Context
Restorative reproductive medicine asks why a luteal phase fell short. The authors suggest some cases may arise in the follicular phase, before ovulation. The lining defect often coexisted with normal midluteal progesterone. All 15 women had normal-length luteal phases on temperature charts, so the lag showed only on biopsy.
Our editorial summary of this paper, not the article's abstract.
Abstract
Fifteen infertile women with inadequate luteal phase, histologically documented in at least two separate cycles, and normal midluteal plasma levels of progesterone (greater than or equal to 10 ng/mL), estradiol (70 to 300 pg/mL), and prolactin (less than 20 ng/mL) received "pure" follicle-stimulating hormone (pFSH), 150 IU intramuscularly, for 4 days (days 1 to 4 of the cycle). The endometrial defect was corrected in 7 of the 15 (46.7%) patients during the first treated cycle. Hormonal levels were similar in control and treatment cycles. Two of 5 patients with no additional infertility factors except luteal phase deficiency (LPD) became pregnant and carried to term singleton pregnancies. In 5 additional infertile patients with normal luteal function as assessed by endometrial histological study (2 cycles) and hormone measurements (first study cycle), a third biopsy was performed in a consecutive cycle under pFSH administration. In no case was the normal secretory pattern impaired. It is concluded that (1) some forms of LPD may be successfully treated by early follicular pFSH therapy and (2) pFSH does not alter the normal endometrial secretory pattern.
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