The endometrial biopsy for diagnosis of luteal phase deficiency

Juan Balasch; Juan A. Vanrell; Montserrat Creus; Manuel Márquez; Jesús González-Merlo

doi:10.1016/s0015-0282(16)48990-9

Diagnostics Endometrial Assessment

The endometrial biopsy for diagnosis of luteal phase deficiency

Balasch J, Vanrell JA, Creus M, Márquez M, González-Merlo J

Published November 1985 Fertility and Sterility, 44(5), 699-701

DOI 10.1016/s0015-0282(16)48990-9 PMID 4054350

RRM Academy Synopsis

Luteal phase deficiency diagnosis needs 2 or more endometrial biopsies

A sequential study of 300 women evaluated for infertility found that the biopsy result changed significantly between cycles in 240 women biopsied twice. The authors conclude that diagnosing luteal phase deficiency takes at least two biopsies from separate cycles. The authors also advise a third biopsy when the first two disagree.

Study at a glance, sequential study of 300 women: Diagnosing luteal phase deficiency takes at least two biopsies. Source: Balasch J et al., 1985, PMID 4054350.

Key Findings

Researchers analyzed 660 endometrial biopsy specimens from 300 patients. Of these, 240 women had two biopsies and 60 women had three, each in a separate cycle, whatever the earlier findings.
In the 240 women with two biopsies, the McNemar test showed a highly significant tendency for the first result, normal or abnormal, to change at the second biopsy.
In the 60 women with three biopsies, the result did not change significantly, second to third or first to last. The Cochran Q test agreed (Q = 0.10, P > 0.90).
The authors' study suggests that evaluating luteal function takes at least two specimens from different cycles, and a third when the first two findings diverge.

Interpretation

This study followed 300 women who were being evaluated for infertility. Researchers took a tissue sample from the uterine lining in more than one cycle for each woman, to see if the result stayed the same. Each woman had regular periods and had ovulated, as confirmed by basal body temperature charts. One pathologist read every sample. A result counted as abnormal when it lagged 2 or more days behind the expected date. The findings support larger studies of this kind of testing across multiple cycles.

RRM Context

Luteal phase deficiency is a question about the ovulatory cycle, and each cycle differs from the last. Cycle-charting-informed evaluation tracks that variation over consecutive cycles. NaProTechnology times its luteal-phase assessments from the charted Peak Day. Restorative reproductive medicine seeks the cause of a short luteal phase, and data from several cycles help that search.

Our editorial summary of this paper, not the article's abstract.

Abstract

We studied endometrial luteal phase in specimens from 660 biopsies done in 300 patients from our infertility clinic. A minimum of two (240 women) or three (60 women) endometrial biopsy specimens from separate cycles were taken regardless of the previous histologic findings in all patients. Statistical analysis of results by the McNemar and the Cochran Q tests for the significance of changes leads us to conclude that a minimum of two, and even three, endometrial biopsy specimens are needed for diagnosis of luteal phase deficiency.

Topics

Diagnostics › Endometrial Assessment › Luteal Phase Biopsy · Menstrual Cycle › Cycle Disorders › Ovulatory Disturbances · Research Methods › Study Design › Cohort Studies

Juan Balasch, Juan A. Vanrell, Montserrat Creus, Manuel Márquez, Jesús González-Merlo

J Balasch, J Vanrell, M Creus, M Márquez, J González-Merlo

PMID 4054350 4054350 DOI 10.1016/s0015-0282(16)48990-9 10.1016/s0015-0282(16)48990-9 Balasch et al. 1985, Balasch 1985

Keywords

Biopsy, Endometrium/pathology, Female, Humans, Luteal Phase, Menstruation Disturbances/diagnosis

The endometrial biopsy for diagnosis of luteal phase deficiency

Luteal phase deficiency diagnosis needs 2 or more endometrial biopsies

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

Related research

Keywords