-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: luteal phase defects From: Rafael Haciski MD (haciski@earthlink.net) Sat Apr 8 00:11:52 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Eberhard W Lisse: "Re: Clasical C/S" Previous message: Betsy Hyde: "Re: Cytotec, cervical ripening" In reply to: guy: "Re: luteal phase defects" Next in thread: guy: "Re: luteal phase defects" Reply: guy: "Re: luteal phase defects" Progesterone levels are a +/- situation. Values alone may not be of much help, as I have on occasions seen patients go through first trimester successfully, while their progesterones levels hovered around 10 (lowest I have seen is 8, with patient pulling through without any supplementation). On the other hand, I once presented a study correlating single midluteal progesterone levels <15 with increased incidence of ILP on endometrial biopsy (EBx). Over the years of practice I have developed the following approach: ...in face of ILP on TWO biopsies: --------if BBTC shows delayed ovulation, irrespective of what midluteal prog. was, then I treat with clomiphene citrate to normalize the BBTC then reconfirm with another EBx; --------if, OTOH, the BBTC is normal, but midluteal prog. is low (<15) then I first try supplementing prog., then remeasure the levelsin next cycle to make sure they are appropriate and then reconfirm with repeat EBx ...without prior diagnosis of ILP, if a patient shows up with low progesterone, I just continue observation, with the only intent to prevent it from going below 5, which is associated with irreversible abortion; the problem is that as the level decreases I have less "wiggle room" to detect the drop in a timely fashion and respond to it, I generally become very uncomfortable below 20 and suggest to the patient supplementation when prog. goes below 15, almost insisting if it continues to decline to 10 and below. -- Rafael Haciski, MD FACOG Gynecology and Infertility Associates Baltimore, MD 410-825-0020 web......http://www.IVF-MD.com e-mail..GIA@IVF-MD.com > From: venezia.gaetano@mhsil.com (guy) > Reply-To: ob-gyn-l@obgyn.net > Date: Fri, 7 Apr 2000 12:12:31 -0500 > To: Multiple recipients of list OB-GYN-L <ob-gyn-l@forum.obgyn.net> > Subject: Re: luteal phase defects > > good points. i was also trained to do two, but has become difficult > with pt compliance. the point i made on one bx was in reference to the > recent acog audio cme in which the panel of gyn docs admited to doing > just one emb at mid luteal phase toward the end of the cycle. (secondary > to pt prefernce and pain) > i still get a wide range of pain responses to my emb's. > what do you think of progest levels...it is in the lit but am not sure > it is of much clinical value. (wash univ and st louis univ are doing > them) > thanks > guy Next message: Eberhard W Lisse: "Re: Clasical C/S" Previous message: Betsy Hyde: "Re: Cytotec, cervical ripening" In reply to: guy: "Re: luteal phase defects" Next in thread: guy: "Re: luteal phase defects" Reply: guy: "Re: luteal phase defects"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Mon Nov 2 04:44:07 2009

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.