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Moreover because of the discomfort and expense associated with endometrial biopsy, attention has turned to direct measurements of plasma progesterone levels as a means to rule out an inadequate luteal phase.
A single plasma progesterone level of 10 ng/ml in the luteal phase or a mean concentration of plasma progesterone of 12-13 ng/ml over 4 days at mid- luteal phase seems to exclude an inadequacy of corpus luteum function (3).
Endometrial biopsy should not be utilized in the routine evaluation of infertility.
These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional.
The biopsy is obtained through the use of an endometrial suction catheter that is inserted through the cervix into the uterine cavity.
Contraindications to the procedure include pregnancy, acute pelvic inflammatory disease, and acute cervical or vaginal infections.
Postoperative infection is rare but may be further prevented through the use of prophylactic antibiotic therapy.
Approximately 30 -50% of normal women show on biopsy an occasional DLP.
A study (2) which evaluated 1492 biopsies in 1055 women showed that diagnosis of LPD in both infertile and fertile women represents only a chance event; and hence luteal phase evaluation by histological dating of the endometrium is not worthwhile.
A critical analysis of the accuracy, reproducibility, and clinical utility of histologic endometrial dating in 130 fertile women showed that it does not have the accuracy or the precision necessary to provide a valid method for the diagnosis of luteal phase deficiency or to otherwise guide the clinical management of women with reproductive failure (4).