Effect of medrogestone on endometrial histology and histochemistry in patients with luteal phase defects

ABSTRACT

Fifty infertile patients with luteal phase defects were the subject of this study. Progestrone in oil, [12.5 and 25 mg] and medrogestone, [5 and 10 mg] were administered daily, starting 3 days after the probable day of ovulation for 2 consecutive cycles. Endometrial biopsies were subjected to histlogical and histochemical examinations. Secretory endometrial patterns that were in phase were observed in all cases after progestrone therapy. Also, the same patterns were observed in 90% and 70% of case after Medrogestone in 5 mg and 10 mg dosage respectively. Undatable endometrial patterns with early glandular exhaustion and sometimes pseudodecidual reaction were observed with medrogestone therapy. These were detected in 10% and 30% of cases with the 5 mg and 10 mg dosage respectively. Also weak activity of the glandular succinic dehydrogenase was observed on histochemical examination of the undatable endometrial patterns. No Histologic or histochemical differences were noted, when both drugs produce secretory endometrium that was in-phase or 1 day out of phase of the cycle day. It is concluded that oral medrogestone is liable to produce early glandular exhaustion when given to patients with inadequte luteal phase. Such asynchronous maturation may interfer with blastocyst nidation. It can also be concluded that progestrone therapy, albeit inconvinent when administered intramuscularly, is the drug of choice in the treatment of luteal phase defects