Cook, C. L., Rao, C. V., & Yussman, M. A. (1983). Plasma gonadotropin and sex steroid hormone levels during early, midfollicular, and midluteal phases of women with luteal phase defects. Fertility and Sterility, 40(1), 45-48. https://doi.org/10.1016/s0015-0282(16)47175-x
Cook CL, Rao CV, Yussman MA. Plasma gonadotropin and sex steroid hormone levels during early, midfollicular, and midluteal phases of women with luteal phase defects. Fertil Steril. 1983;40(1):45-48. doi:10.1016/s0015-0282(16)47175-x
Cook, Christine L., et al. "Plasma gonadotropin and sex steroid hormone levels during early, midfollicular, and midluteal phases of women with luteal phase defects." Fertility and Sterility, vol. 40, no. 1, 1983, pp. 45-48.
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Women with luteal phase defect had lower FSH early in the cycle
Women with luteal phase defect had significantly lower FSH early in the cycle. A 1983 study compared 13 infertile women with luteal phase defect (LPD) and 14 with normal biopsies. The LPD group also had lower progesterone and estrogen after ovulation.
Key Findings
Twenty-seven women with 1 year or more of infertility were grouped by endometrial biopsy: 13 with LPD and 14 with normal endometrium. Average ages were 27.9 and 28.1 years.
FSH was significantly lower in the LPD group on cycle days 2 to 3 (P < 0.01) and 8 to 9 (P < 0.05). The FSH/LH ratio was also lower.
LH levels were similar in the LPD and normal groups on both early and midfollicular days.
In the midluteal phase, progesterone and estrogen were significantly lower in the LPD group (both P < 0.02). Midluteal testosterone and prolactin levels were similar in the two groups.
Interpretation
This study followed two groups of women across one menstrual cycle. Women with LPD had lower FSH early in the cycle. They also had a lower FSH/LH ratio. After ovulation, their progesterone and estrogen were lower too. Early FSH was linked with how the luteal phase turned out later. The authors say early follicular phase FSH may support a diagnosis of LPD about as well as luteal phase progesterone or estrogen. Early FSH can also be measured sooner in the cycle. The findings support larger studies of early FSH as a marker for luteal phase defect.
RRM Context
Restorative reproductive medicine looks for why the corpus luteum underperformed. This paper points to the follicular phase, the part of the cycle before ovulation. The authors also found that LPD linked to high prolactin acts differently than LPD linked to low early FSH. Sorting LPD by its origin fits a root-cause approach.
Our editorial summary of this paper, not the article's abstract.
Abstract
Thirteen women with luteal phase defects (LPD) confirmed by endometrial biopsies and 14 with histologically normal endometria were studied for early follicular and midfollicular phase follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels and for midluteal phase progesterone, estrogen, testosterone, and prolactin levels. The results showed that the women with LPD had significantly lower FSH levels and FSH/LH ratios in the early and midfollicular phases. LH levels, however, were similar in the LPD and normal women. During the midluteal phase, the LPD women showed significantly lower levels of progesterone and estrogen and normal levels of testosterone and prolactin. These findings reaffirm the prevailing concept that events surrounding follicular growth and development can indeed influence the quality of that cycle's corpus luteum. Furthermore, LPD as a result of hyperprolactinemia appears to be a different entity from that due to inadequate follicular phase FSH.
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