Wu, C. H., & Minassian, S. S. (1987). The integrated luteal progesterone: an assessment of luteal function. Fertility and Sterility, 48(6), 937-940. https://doi.org/10.1016/s0015-0282(16)59587-9
Wu CH, Minassian SS. The integrated luteal progesterone: an assessment of luteal function. Fertil Steril. 1987;48(6):937-940. doi:10.1016/s0015-0282(16)59587-9
Wu, Chung H., and Shahab S. Minassian. "The integrated luteal progesterone: an assessment of luteal function." Fertility and Sterility, vol. 48, no. 6, 1987, pp. 937-940.
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Integrated luteal progesterone was lower in luteal phase defect cycles
In a 1987 study of 52 infertile women, 13 had a luteal phase defect on biopsy. These women had lower integrated luteal progesterone than the other 39 women. The measure turns one blood test and the luteal length into one number.
Key Findings
Total integrated luteal progesterone was significantly lower in the 13 luteal phase defect cycles than in the 39 infertile-normal cycles (P < 0.01). Mid-luteal progesterone did not differ.
Luteal length by basal body temperature averaged 11.0 days in the defect group and 13.2 days in the infertile-normal group. Follicular and cycle lengths did not differ.
Across five normal cycles, the coefficient of variation of total integrated luteal progesterone was 3.5% to 13.2% within each cycle and 25.8% with all cycles pooled.
Using one cutoff, 11 of 22 cycles below it had normal biopsies, and 2 of 30 cycles above it were luteal phase defect by biopsy.
Total integrated luteal progesterone correlated with mid-luteal progesterone (r = 0.662), estradiol (r = 0.399) and luteal length (r = 0.495), all P < 0.05.
Interpretation
This study assessed 52 infertility patients. The authors compared biopsy results with integrated luteal progesterone. Five normal cycles built the reference curve. Most cycles above the cutoff had normal biopsies. The authors note that a normal value may mean more than a low one. The findings support larger studies of this blood test as a marker of luteal function.
RRM Context
Restorative reproductive medicine looks for root causes. Low progesterone is one. A test like this gives doctors a way to measure luteal function. Within NaProTechnology, doctors use cycle-timed hormone tests to check couples before treatment starts.
Our editorial summary of this paper, not the article's abstract.
Abstract
An integrated luteal progesterone (ILPL) was calculated on the basis of a luteal progesterone (P) level with the assumption that the daily plasma P level in the luteal phase closely approximates a sine curve. The midluteal P-amplitude (K) was also obtained mathematically. Daily luteal P levels from five normal ovulatory cycles were assessed for the biologic variation of ILPL and K, then compiled to construct a normogram of the ILP during the luteal phase. The coefficient of variation of K and total ILPL in each cycle ranged from 9.7% to 24.3% and 3.5% to 13.2%, respectively. Fifty-two infertility patients were evaluated for their luteal function by the luteal P and estradiol (E2) level, K, ILPL, endometrial biopsy (EBX)-lag-day, as well as the lengths of follicular phase, luteal phase (L#), and cycle. Thirty-nine patients had EBX-lag day less than or equal to 2 days and were designated as infertile-normal (INF-NL) luteal phase, while the remaining 13 patients who had EBX-lag day greater than 2 days were considered as luteal phase defect (LPD). Significant (P less than 0.05) differences were observed between INF-NL and LPD in: luteal length (13.2 +/- 0.31 versus 11.0 +/- 0.58 days, respectively), and total ILPL (170 +/- 8.3 versus 113 +/- 8.5 ng/ml-day, respectively). No differences were seen in luteal P, E2 and K levels, nor in follicular and cycle length. Significant (P less than 0.05) correlations were observed between total ILPL and luteal P, E2, L#, and K; while a negative correlation was noted between follicular and luteal length.(ABSTRACT TRUNCATED AT 250 WORDS)
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