The aluteal cycle: A severe form of the luteal phase defect

Abstract

Ten patients with the syndrome of regular menstrual cycles and extremely deficient or absent luteal function have been investigated. Fifty-nine of 98 cycles studied showed no evidence of luteal function. The remaining 39 cycles were characterized by severe luteal dysfunction. Occult miscarriages were occasionally documented. Improvement of ovarian steroidogenesis was attempted using exogenous gonadotropins and clomiphene citrate. Substitution for ovarian steroidogenesis was attempted with progesterone, vaginal suppositories, or intramuscular injections. Progesterone proved to be the most successful therapeutic approach, as judged by the induction of successful pregnancy. In view of this fact, the term “aluteal” is suggested instead of “anovulatory” to describe a menstrual cycle of 25 to 30 days in length associated with a monophasic basal body temperature chart and a nonsecretory endometrial pattern on the first day of bleeding. Possible etiologies of this clinical picture are discussed.