The reproductive endocrine feature and conception outcome of women with unknown etiological menstrual cycle (36–45 days) with long follicular phase

Abstract

Objective

To explore the reproductive endocrine feature and conception outcome of women with unknown etiological long menstrual cycle (LMC) (36–45 days) with long follicular phase.

Methods

In the cohort study, we included 80 women with unknown etiological long menstrual cycle of biphasic basal body temperature (BBT) lasting for 36–45 days and 87 controls with normal cycle of biphasic BBT into LMC group and NMC group, respectively. Serum hormone levels, fasting glucose, and insulin of participants were tested, and ovulation was observed by ultrasound. The conception outcome was followed up within 12 menstrual cycles.

Results

In the LMC group, the rate of abnormality of HOMA-insulin resistance index (40.0% vs. 20.7%, p < .01), luteal phase defect (30.9% vs. 13.8%, p < .05) and abnormality of FSH/LH ratio (15.6% vs. 5.7%, p < .05) were all significantly higher, but the serum estradiol level on the day before ovulation (261.10 pg/mL vs. 320.26 pg/mL, p < .01) was lower. The rate of poor ovulation quality (31.3% vs.15.4%, p < .05) in the LMC group was significantly higher than the NMC group. In the LMC group, the natural conception rate within 12 menstrual cycles was lower (41.9% vs. 66.2%, p < .01), whereas the spontaneous abortion rate in early pregnancy (29.0% vs. 9.8%, p < .05) and the conversion rate (21.6% vs. 5.2%, p < .01) to anovulation within 12 cycles were significantly higher.

Conclusions

Women with unknown etiological menstrual cycle (36–45 days) with long follicular phase have greater endocrine abnormality and higher risk of spontaneous abortion, infertility, and conversion to anovulation. Moderate early intervention may be advisable for these women, especially those who wish to get pregnant.

摘要

目的

探讨病因不明的长月经周期（LMC）（36-45天）长卵泡期女性的生殖内分泌特征及受孕结局。

方法

在队列研究中, 我们将80名病因不明的长月经周期（36-45天）双相基础体温（BBT）的女性和87名双相BBT 周期正常的对照分别纳入LMC组和NMC组。检测参与者的血清激素水平、空腹血糖和胰岛素, 并通过超声观察排卵。并随访 12 个月经周期的妊娠结局。

结果

LMC组HOMA-胰岛素抵抗指数异常率（40.0% vs. 20.7%, p < .01）、黄体期缺陷率（30.9% vs. 13.8%, p < .05）和FSH/LH 比值（15.6% vs. 5.7%, p < .05）均显着升高, 但排卵前一天的血清雌二醇水平（261.10 pg/mL vs. 320.26 pg/mL, p < .01）降低。LMC组的排卵质量不良率（31.3% vs.15.4%, p < .05）明显高于NMC组。在 LMC 组中, 12 个月经周期内的自然受孕率较低（41.9% 对66.2%, p < .01）, 而妊娠早期自然流产率（29.0% 对 9.8%, p < .05）12个周期内无排卵的转化率（21.6% vs. 5.2%, p < .01）明显更高。

结论

原因不明的月经周期（36-45天）长卵泡期的女性内分泌异常更严重, 自然流产、不孕和转为无排卵的风险更高。对于这些女性, 尤其是那些希望怀孕的女性, 可能建议进行适度的早期干预。

Keywords:

• Long follicular phase
• insulin resistance
• infertility
• spontaneous abortion
• AUB

关键词:

• 长卵泡期
• 胰岛素抵抗
• 不孕不育
• 自然流产
• 异常子宫出血

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The study was supported by institute-level science project funds from Shanghai First Maternity and Infant Hospital under Grant No. 2017B11; and Clinical science and technology innovation project of Shanghai Shenkang Hospital Development Center under Grant No. SHDC12019X34.