Wentz, A. C., Herbert, C. M., Maxson, W. S., & Garner, C. H. (1984). Outcome of progesterone treatment of luteal phase inadequacy. Fertility and Sterility, 41(6), 856-862. https://doi.org/10.1016/s0015-0282(16)47898-2
Wentz AC, Herbert CM, Maxson WS, Garner CH. Outcome of progesterone treatment of luteal phase inadequacy. Fertil Steril. 1984;41(6):856-862. doi:10.1016/s0015-0282(16)47898-2
Wentz, Anne Colston, et al. "Outcome of progesterone treatment of luteal phase inadequacy." Fertility and Sterility, vol. 41, no. 6, 1984, pp. 856-862.
For EndNote, Zotero or Mendeley:
License
No open license is recorded for this paper. Reuse terms are set by the publisher.
Among 45 women who had a biopsy during treatment, 37 of 45 (82%) showed an in-phase biopsy. In 7 of 45 (16%), the defect was not corrected.
Among 38 women with two out-of-phase biopsies who took progesterone alone, 16 pregnancies were documented, 14 during treatment. Twelve of 14 delivered.
Among 20 women with a history of early pregnancy loss, 8 of 10 (80%) treated with progesterone delivered.
Interpretation
The study is a retrospective chart review from one center. Follow-up was mostly by telephone survey and was missing for seven women. The review had no control group and no randomization, so it cannot show that progesterone caused the deliveries. Eight women went untreated, and the authors did not analyze them as a comparison. The authors did not analyze failure to conceive, because many women also had endometriosis, pelvic adhesions, cervical factor or male factor. Treatment followed the suspected cause, so the arms differ by design. The authors call the results a trend and write that numbers in the pregnancy-loss subgroup were too low to conclude progesterone helped.
RRM Context
The authors looked for other treatable causes first. They matched treatment to the suspected cause. Women with thyroid or prolactin problems were treated for those and left out. Women with long follicular phases received clomiphene citrate. This follows the restorative reproductive medicine principle of evaluation before treatment. The paper also lists male factor among other diagnoses that can coexist.
Our editorial summary of this paper, not the article's abstract.
Abstract
Diagnosis, choice of therapy, and pregnancy outcome were analyzed in 79 women evaluated for luteal phase inadequacy. Criteria for the diagnosis were established, and groups at risk for luteal inadequacy were identified. Treatment choices, tailored to the suspected cause, included progesterone suppositories in 54 women, with 23 pregnancies and 19 deliveries; clomiphene citrate in 6 women, with 2 pregnancies and deliveries; and combined treatment in 7 women, with 5 pregnancies and 4 deliveries. Eight women received no treatment, including three who underwent endometrial biopsy in the cycle of conception and who subsequently delivered. These data suggest that careful diagnosis and the proper choice of treatment are important, and that progesterone supplementation may result in improved pregnancy outcome for patients with infertility and pregnancy wastage who have luteal phase inadequacy.
05dq2gs74 