Pulsatile Hormone Secretion Late in the Luteal Phase of Normal and Infertile Women During Diurnal Hours
Human luteal function can be assessed by endometrial biopsy (Noyes et al., 1950) or by progesterone (P) levels. Protocols for estimation for luteal function by P include a single determination (Israel et al., 1972), summation of three values (Abraham et al., 1974), daily measures alone (Abraham et al., 1974) or with ultrasonic monitoring of periovulatory changes in follicle morphology (Coutts et al., 1981a, 1982). Recent evidence suggests that secretion of P in rhesus monkeys (Healy et al., 1984) and normal women (Filicori et al., 1983) is episodic with approximately 4 pulses of P per 24 h. These studies suggest that proper characterization of a luteal phase as normal or abnormal may require assessment of frequency, amplitude, duration or diurnal dependency of such pulses. The practice of evaluating ovulation and the luteal phase in infertility patients with random luteal phase P levels could be erroneous if significant phasic changes are not considered in diagnostic testing. Whereas patients with ovulatory dysfunction due to the “luteinized unruptured follicle syndrome” (LUF) (Marik and Hulka, 1978; Koninckx et al., 1978) commonly have associated luteal phase inadequacy described as “poor progesterone surge” (PPS) (Coutts et al., 1981a, 1982), we compared women with normal menstrual cycles or LUF/PPS cycles to determine whether the secretory patterns of P, estradiol (E), luteinizing hormone (LH) and follicle stimulating hormone (FSH) differed.
KeywordsLuteinizing Hormone Follicle Stimulate Hormone Luteal Phase Receiver Operating Characteristic Normal Cycle
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