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A young married couple comes to the physician for infertility counseling. They have been trying to conceive for the past eighteen months with no success. They both have no children from previous relationships. They have no history of serious illness. They do not use tobacco, alcohol, or drugs. Sperm count and basal body temperature curve show no abnormalities, and midluteal progesterone level is reduced. Endometrial biopsy shows a lag of three days in endometrial maturation. Which of the following is the most appropriate treatment for this patient’s condition ?<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

A. Human menopausal gonadotropins

B. Combined oral contraceptives

C. Clomiphene

D. Progesterone vaginal suppositories

E. Danazol

F. Lupron

G. Estrogen and progesterone suppositories

H. Finasteride

I. Ciproterone


uw question




i know its a progesterone deficit but is vaginal progesterone sufficient for endometrial effect?


there is defect in luteal phase which is caused by low progesterone secretion by corpus luteam.progesterone is important for embryo implantation and maintainance of pregnancy,sodefect in its secretion may cause infertility even if ovulation takes place..defect may effect level or duration of production of prgesterone.
luteal phase defect suggested by short cycles,history of spontanous abortion,abnormal BBT or low lvels of mid luteal progesterone..
diagnosis is confirmed by endometrial biopsy..
luteal phase defect is treated with progsterone vaginal suppositoies,clomiphene citrate or hMG...may be used if PS gives no results..they increase serum FSH level and thus correct follicular maturation and oocyte expulsion..smiling face
..explaination from UW.




the reason I posted this is because I always thought that clomiphene was the treatment of choice for all luteal phase defects and the initial treatment was progesterone vagianl suppositories. So in my mind the answer was clomiphene, but UW says its those horrid suppositories. Can anyone clear this up for me?

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