الفهرس 
Normal luteal phaseOnly 14 pages are availabe for public view
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Abstract
L u t e a l p h a s e d e f e c t h a s b e e n a m a t t e r o f c o n t r o v e r s y among g y n e c o l o g i s t s s i n c e 1949, as j o n e s a d m i t t e d t h e c o n c - e p t o f c o r p u s l u t e u m d y s f u n c t i o n w i t h i t s p o s s i b l e s e q u e l a e o f i n f e r t i l i t y and e a r l y f e t a l w a s t a g e . The i n c i d e n c e o f t h e d i s e a s e was r e p o r t e d among i n f e r - t i l e p a t i e n t s r a n g i n g f r o m 3.7 - 10.7% b u t t h i s i n c i d e n c e i n c r e a s e s among p a t i e n t s w i t h s e c o n d a r y i n f e r t i l i t y w i t h p r e v i o u s h i s t o r y o f r e c u r r e n t p r e g n a n c y w a s t a g e a s i t r e a c h e s 352. The l u t e a l p h a s e d y s f u n c t i o n h a s m u l t i p l e e t i o l o g i c a l f a c t o r s . H y p e r p r o l a c t i n a e m i a a s a n e ’ t i o l o g i c a l f a c t o r o f l u t e a l p h a s e d y s f u n c t i o n was d i s c u s s e d e x t e n s i v e l y b u t t h e d e f i n i t e e f f e c t o f p r o l a c t i n upon t h e h y p o t h a l a m u s a n d o v a r y is n o t c l e a r l y e v i d e n t . F o r t h e d i a g n o s i s o f c o r p u s l u t e u m d y s f u n c t i o n , many m e t h o d s w e r e t r i e d s t a r t i n g w i t h t h e u s e o f b a s a l body t e m p e r a t u r e c h a r t a n d u p t o c o r p u s l u t e u m b i o p s y b u t t h e m o s t a c c e p t e d meth~ds a r e d i r e c t m e a s u r e m e n t o f midluteal s e r u m p r o g e s t e r o n e e i t h e r o n e s a m p l e o r r e p e a t e d s a m p l e s a n d t i m e d e n d o m e t r i a l b i o p s y a s a n i n d i r e c t m e t h o d f o r m e a s u r i n g p r o g e s t e r o n e l e v e l . The t r e a t m e n t m o d a l i t y showed many v a r i a t i o n s a n d t h i s is u s u a l l y d u e t o u n c e r t a i n i t y o f e t i o l o g i c a l f a c t o r s . S u p p l e m e n t a r y p r o g e s t e r o n e was u s e d wit.h good r e s u l t s . A l s o , c l o m i d was t r i e d by many a u t h o r s b u t t h e d i s c r e p a n c y b e t w e e n o v u l a t i o n and p r e g n a n c y r a t e is s u s p i c i o u s t o t h e adverse e f f e c t o f c l o m i d on t h e c o r p u s luteum f u n c t i o n . B r o m o c r i p t i n e ( P a r l o d e l ) was t r i e d e x t e n s i v e l y e v e n w i t h c a s e s o f e u o p r o l a c t i n a e m i a , b u t t h e b e s t r e s u l t s were a c h i e v e d w i t h c a s e s o f h y p e r p r o l a c t i n a e m i a e i t h e r e v i d e n t o r r e l a t i v e . The aim o f o u r s t u d y is e s t i m a t i o n o f p l a s m a p r o g e s t - e r o n e and p r o l a c t i n i n p a t i e n t s c o m p l a i n i n g o f i n f e r t i l i t y d u e to l u t e a l p h a s e d e f e c t and t h e e f f e c t o f b r o m o c r i p t i n e a s a l i n e o f t r e a t m e n t o f i n f e r t i l i t y i n t h e s e c a s e s and i t s e f f e c t on serum p r o g e s t e r o n e and p r o l a c t i n . Our s t u d y i n v o l v e d 25 i n f e r t i l e women s u s p e c t e d t o h a v e luteal p h a s e d e f e c t . A thourough c l i n i c a l e v a l u a t i o n , e n d o m e t r i a l d a t i n g , serum p r o g e s t e r o n e a s s a y a n d s e r u m p r o l a c t i n a s s a y were done f o r a l l c a s e s . P a t i e n t s who p r o v e d t o h a v e L.P.D. were t r e a t e d w i t h b r o m o c r i p t i n e ( P a r l o d e l ) f o r t h r e e c o n s e q u a t i v e c y c l e s . Serum p r o g e s t e - r o n e and prolactin were m e a s u r e d a g a i n a t e a c h c y c l e o f b r o m o c r i p t i n e t h e r a p y t o f o l l o w up t h e r e s p o n s e a n d t h e e f f e c t o f t h e d r u g . I n o u r s t u d y , t h e i n c i d e n c e o f L.P.D. among t h e i n f e r - t i l e p a t i e n t s was 44%. Our r e s u l t s showed t h a t midluteal p r o g e s t e r o n e l e v e l was l o w e r among a l l c a s e s o f L . P . D . a s e v i d e n c e d by e n d o m e t r i a l d a t i n g while hyperprolactinaemia was f o u n d i n 73% o f t h e c a s e s o f lu.teal p h a s e d e f e c t . A s r e g a r d s t h e r a p y , b r o m o c r i p t i n e t h e r a p y f o r t h r e e c y c l e s h a s led t o s i g n i f i c a n t d e c r e a s e o f s e r u m p r o l a c t i n a n d s i g n i f i c a n t i m p r o v e m e n t o f c o r p u s luteurn f u n c t i o n a s e v i d e n c e d by s i g n i f i c a n t i n c r e a s e i n s e r u m p r o g e s t e r o n e . On t h e o t h e r h a n d , c a s e s o f LPD w i t h euoprolactinaemia s h o w e d i n s i g n i f i c a n t c h a n g e i n p r o l a c t i n o r p r o g e s t e r o n e l e v e l .