Ayers, J. W., Birenbaum, D. L., & Menon, K. M. (1987). Luteal phase dysfunction in endometriosis: elevated progesterone levels in peripheral and ovarian veins during the follicular phase. Fertility and Sterility, 47(6), 925-929. https://doi.org/10.1016/s0015-0282(16)59224-3
Ayers JW, Birenbaum DL, Menon KM. Luteal phase dysfunction in endometriosis: elevated progesterone levels in peripheral and ovarian veins during the follicular phase. Fertil Steril. 1987;47(6):925-929. doi:10.1016/s0015-0282(16)59224-3
Ayers, Jonathan W. T., et al. "Luteal phase dysfunction in endometriosis: elevated progesterone levels in peripheral and ovarian veins during the follicular phase." Fertility and Sterility, vol. 47, no. 6, 1987, pp. 925-929.
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Endometriosis was linked to high progesterone early in the cycle
A 1987 study compared women with and without endometriosis. Women with stage I or II endometriosis had higher progesterone early in the cycle. Blood came from ovarian veins and an arm vein during surgery.
Key Findings
Women with endometriosis had significantly higher progesterone than follicular phase controls, in peripheral blood and in the average of both ovarian veins.
Average ovarian vein estradiol in the endometriosis group was 50% lower than in control women sampled at the same stage of follicular development.
Peripheral estradiol was similar in the endometriosis group and the follicular phase controls.
In peripheral blood, the progesterone to estradiol ratio in the endometriosis group was threefold higher than in follicular phase controls.
At surgery in the early follicular phase, the endometriosis patients showed several corpora lutea on both ovaries.
Interpretation
This study compared progesterone and estradiol in blood from women with stage I or II endometriosis and from women without the disease. Samples came from surgery in the early follicular phase. The authors say the pattern fits a corpus luteum that keeps making progesterone into the next cycle. They call that mechanism speculative. The findings support larger studies of luteal function in women with endometriosis.
RRM Context
Restorative reproductive medicine studies the whole ovulatory cycle. Progesterone marks ovulation and the luteal phase that follows it. This paper examines the end of that phase, when the corpus luteum should stop working. The authors compare their result to earlier reports of luteal phase problems in women with endometriosis.
Our editorial summary of this paper, not the article's abstract.
Abstract
Endometriosis has been associated with corpus luteum inadequacy and abnormalities of luteal phase progesterone (P) secretion. In this study, abnormal luteolysis, as a second factor of luteal dysfunction, was assessed in 13 women with endometriosis and 25 control patients by measurement of ovarian vein estradiol (E2) and P during the follicular phase. The results reveal that women with endometriosis have (1) significantly lower ovarian vein E2, (2) significantly higher both peripheral and ovarian vein P, and (3) threefold higher P/E2 ratios than controls during the follicular phase. These data support the concept of continued P production from an active corpus luteum well into the follicular phase of the following cycle in women with endometriosis. Failure of adequate luteolysis is a second aspect of luteal dysfunction in endometriosis and strongly supports the growing body of data confirming ovulatory asynchrony in the minimal; endometriosis infertility syndrome.
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