[Corpus luteum defect. Analysis of 30 cases in clinical pregnancy]. / Cuerpo lúteo deficiente. Análisis de 30 casos con embarazo clínico.

Deficient corpus luteum (DCL) is an ovulatory dysfunction little defined but real. It is said that is frequency is 3 and 10% of sterile couples and 30 to 40% of habitual abortion. Is part of the group of ovulatory aberrations together with in situ luteinization and syndrome of not broken luteinized folicle. The diagnosis is based in endometrial morphology and progesterone determination. The objective of this work is to analyze 30 cases of DCL that achieved pregnancy. The diagnosis was done based on low determination of progesterone in serum, biopsy of irregular or indysphase endometrium and all the factors, remaining normal of esterility. Average age of patients was 36 years and for sterility 3.1. Treatment consisted in clomiphen cytrate (CC) administration 100 mg daily of hCG in 21 cases, CC only in eight cases and associated to bromocriptine in one case (concomitant hyper-prolactinemia); 26 pregnancies went to term, seven of them with support of exogenous progesterone the first weeks. There were three abortions and an ectopic one. It is concluded that with a complete study of sterility that only shows low seric progesterone and/or endometrium in dysphase or irregular, the diagnosis of DCL is probable and should be treated first with CC plus hCG. The evolution of pregnancies is normal and according to these results is little acceptable the use of progesterone as a support in pregnancy.

[Treatment of functional infertility, caused by luteal deficiency, with pulsatile perfusion of gonadotropin releasing hormone]. / Luteális elégtelenségen alapuló funkcionális meddöség kezelése gonadotropin releasing hormon pulzációs adagolásával.

The prehistory of cyclical development of corpus luteum goes back to early follicular phase. Reduced secretion or defective rhythm of gonadotropin releasing hormone (GnRH) can later cause unperfect ovulation or corpus luteum insufficiency. The authors carried out a low-dose pulsatory GnRH-treatment on eight patients with luteal insufficiency, who were earlier treated unsuccessfully with other ovulation-inductive methods (clomiphene, hCG, bromocryptin). As a result of GnRH administration hypertherm period expanded, plasma progesteron level increased and three pregnancies occurred. In their opinion exogenic administration of GnRH results in an improvement of luteal function.