The artificial cycle as an effective treatment of persistently retarded endometrium in the luteal phase

The objective of this study was to examine the results of twohormonal treatment modalities on subjects who had persistentlyabnormal endometrial development in the luteal phase. A prospectivestudy design was used to investigate 14 women who had persistentlyretarded endometrium associated with infertility (n = 11) orrecurrent miscarriage (n = 3). Treatment A consisted of progesteronesupplementation in the form of i.m. progesterone at a dailydose of 25–50 mg starting on day luteinizing hormone (LH)+1for 14 days. Treatment B consisted of artificial cycles producedafter down-regulation of the hypothalamic-pituitary-ovarianaxis with Goserelin (3.6 mg s.c.) followed by the administrationof a standard hormone replacement therapy. Endometrial biopsywas taken on day 19 of the artificial cycle or days LH +5 to+7 in the progesterone supplementation cycle. A histologicalstudy was made of the endometrial specimens by standard datingcriteria and morphometry. The artificial cycle resulted in normaldevelopment in all subjects (n = 11), whereas progesterone supplementationrestored normal endometrial development in only seven of 11(64%) subjects. We conclude that persistently retarded endometriumcould be treated more effectively with the artificial cyclethan with progesterone supplementation.