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Progesterone resistance

MedGen UID:
337889
Concept ID:
C1849699
Disease or Syndrome
Synonym: PSEUDOCORPUS LUTEUM INSUFFICIENCY
 
Gene (location): PGR (11q22.1)
 
Monarch Initiative: MONDO:0009909
OMIM®: 264080

Definition

Progesterone prepares the endometrium for blastocyst implantation and allows maintenance of pregnancy. The major sources of progesterone are the corpus luteum during the second half of the menstrual cycle and at the beginning of pregnancy, and the placenta. The main hormones responsible for stimulation of progesterone secretion are luteinizing hormone (LH) for the corpus luteum of the menstrual cycle and chorionic gonadotropin for the corpus luteum of pregnancy. Complete end-organ resistance to progesterone would be incompatible with reproductive competence in females. Males would not be expected to be affected since progesterone has no known function in men. Failure of the uterus to respond to progesterone would lead to the development of a 'constantly proliferative' endometrium incompatible with blastocyst implantation. Partial resistance to progesterone, on the other hand, would be expected to be associated with various degrees of incomplete maturation of the endometrium, perhaps expressed clinically as infertility or early abortions. The syndrome would present with the clinical and histologic picture of a luteal phase defect in which the life span of the corpus luteum and the plasma progesterone concentrations would be normal or elevated. [from OMIM]

Clinical features

From HPO
Female infertility
MedGen UID:
5795
Concept ID:
C0021361
Pathologic Function
Infertility in a woman.
Abnormality of metabolism/homeostasis
MedGen UID:
867398
Concept ID:
C4021768
Finding

Professional guidelines

PubMed

Clemenza S, Capezzuoli T, Eren E, Garcia Garcia JM, Vannuccini S, Petraglia F
Minerva Obstet Gynecol 2023 Jun;75(3):288-297. Epub 2022 Oct 18 doi: 10.23736/S2724-606X.22.05157-0. PMID: 36255163
Koninckx PR, Fernandes R, Ussia A, Schindler L, Wattiez A, Al-Suwaidi S, Amro B, Al-Maamari B, Hakim Z, Tahlak M
Front Endocrinol (Lausanne) 2021;12:745548. Epub 2021 Nov 25 doi: 10.3389/fendo.2021.745548. PMID: 34899597Free PMC Article
Practice Committees of the American Society for Reproductive Medicine and the Society for Reproductive Endocrinology and Infertility
Fertil Steril 2021 Jun;115(6):1416-1423. Epub 2021 Apr 4 doi: 10.1016/j.fertnstert.2021.02.010. PMID: 33827766

Recent clinical studies

Etiology

Yildiz S, Kinali M, Wei JJ, Milad M, Yin P, Adli M, Bulun SE
Fertil Steril 2023 May;119(5):869-882. Epub 2023 Feb 1 doi: 10.1016/j.fertnstert.2023.01.041. PMID: 36736810Free PMC Article
Practice Committees of the American Society for Reproductive Medicine and the Society for Reproductive Endocrinology and Infertility
Fertil Steril 2021 Jun;115(6):1416-1423. Epub 2021 Apr 4 doi: 10.1016/j.fertnstert.2021.02.010. PMID: 33827766
Westin SN, Fellman B, Sun CC, Broaddus RR, Woodall ML, Pal N, Urbauer DL, Ramondetta LM, Schmeler KM, Soliman PT, Fleming ND, Burzawa JK, Nick AM, Milbourne AM, Yuan Y, Lu KH, Bodurka DC, Coleman RL, Yates MS
Am J Obstet Gynecol 2021 Feb;224(2):191.e1-191.e15. Epub 2020 Aug 15 doi: 10.1016/j.ajog.2020.08.032. PMID: 32805208Free PMC Article
Bianchi P, Benagiano G, Brosens I
Gynecol Endocrinol 2017 Mar;33(3):173-178. Epub 2017 Jan 12 doi: 10.1080/09513590.2016.1259408. PMID: 28079409
Haydardedeoglu B, Zeyneloglu HB
Womens Health (Lond) 2015 Aug;11(5):619-23. Epub 2015 Oct 8 doi: 10.2217/whe.15.48. PMID: 26448139

Diagnosis

Chen S, Liu Y, Zhong Z, Wei C, Liu Y, Zhu X
Front Immunol 2023;14:1134663. Epub 2023 Feb 14 doi: 10.3389/fimmu.2023.1134663. PMID: 36865552Free PMC Article
Koninckx PR, Fernandes R, Ussia A, Schindler L, Wattiez A, Al-Suwaidi S, Amro B, Al-Maamari B, Hakim Z, Tahlak M
Front Endocrinol (Lausanne) 2021;12:745548. Epub 2021 Nov 25 doi: 10.3389/fendo.2021.745548. PMID: 34899597Free PMC Article
Bulun SE, Yildiz S, Adli M, Wei JJ
Hum Reprod Update 2021 Oct 18;27(6):1086-1097. doi: 10.1093/humupd/dmab017. PMID: 34131719Free PMC Article
Practice Committees of the American Society for Reproductive Medicine and the Society for Reproductive Endocrinology and Infertility
Fertil Steril 2021 Jun;115(6):1416-1423. Epub 2021 Apr 4 doi: 10.1016/j.fertnstert.2021.02.010. PMID: 33827766
Taylor HS, Kotlyar AM, Flores VA
Lancet 2021 Feb 27;397(10276):839-852. doi: 10.1016/S0140-6736(21)00389-5. PMID: 33640070

Therapy

Zhang P, Wang G
Int J Mol Sci 2023 Apr 10;24(8) doi: 10.3390/ijms24086992. PMID: 37108154Free PMC Article
Vannuccini S, Clemenza S, Rossi M, Petraglia F
Rev Endocr Metab Disord 2022 Jun;23(3):333-355. Epub 2021 Aug 17 doi: 10.1007/s11154-021-09666-w. PMID: 34405378Free PMC Article
Westin SN, Fellman B, Sun CC, Broaddus RR, Woodall ML, Pal N, Urbauer DL, Ramondetta LM, Schmeler KM, Soliman PT, Fleming ND, Burzawa JK, Nick AM, Milbourne AM, Yuan Y, Lu KH, Bodurka DC, Coleman RL, Yates MS
Am J Obstet Gynecol 2021 Feb;224(2):191.e1-191.e15. Epub 2020 Aug 15 doi: 10.1016/j.ajog.2020.08.032. PMID: 32805208Free PMC Article
Marquardt RM, Kim TH, Shin JH, Jeong JW
Int J Mol Sci 2019 Aug 5;20(15) doi: 10.3390/ijms20153822. PMID: 31387263Free PMC Article
Yilmaz BD, Bulun SE
Hum Reprod Update 2019 Jul 1;25(4):473-485. doi: 10.1093/humupd/dmz005. PMID: 30809650Free PMC Article

Prognosis

Levin G, Ein-Dor T
Transl Psychiatry 2023 Apr 28;13(1):138. doi: 10.1038/s41398-023-02439-w. PMID: 37117197Free PMC Article
Koninckx PR, Fernandes R, Ussia A, Schindler L, Wattiez A, Al-Suwaidi S, Amro B, Al-Maamari B, Hakim Z, Tahlak M
Front Endocrinol (Lausanne) 2021;12:745548. Epub 2021 Nov 25 doi: 10.3389/fendo.2021.745548. PMID: 34899597Free PMC Article
Practice Committees of the American Society for Reproductive Medicine and the Society for Reproductive Endocrinology and Infertility
Fertil Steril 2021 Jun;115(6):1416-1423. Epub 2021 Apr 4 doi: 10.1016/j.fertnstert.2021.02.010. PMID: 33827766
Westin SN, Fellman B, Sun CC, Broaddus RR, Woodall ML, Pal N, Urbauer DL, Ramondetta LM, Schmeler KM, Soliman PT, Fleming ND, Burzawa JK, Nick AM, Milbourne AM, Yuan Y, Lu KH, Bodurka DC, Coleman RL, Yates MS
Am J Obstet Gynecol 2021 Feb;224(2):191.e1-191.e15. Epub 2020 Aug 15 doi: 10.1016/j.ajog.2020.08.032. PMID: 32805208Free PMC Article
Joshi NR, Miyadahira EH, Afshar Y, Jeong JW, Young SL, Lessey BA, Serafini PC, Fazleabas AT
J Clin Endocrinol Metab 2017 Jan 1;102(1):141-149. doi: 10.1210/jc.2016-2076. PMID: 27778641Free PMC Article

Clinical prediction guides

Sorrentino F, DE Padova M, Falagario M, D'Alteri O MN, DI Spiezio Sardo A, Pacheco LA, Carugno JT, Nappi L
Minerva Obstet Gynecol 2022 Feb;74(1):31-44. Epub 2021 Jun 7 doi: 10.23736/S2724-606X.20.04718-8. PMID: 34096691
Koninckx PR, Fernandes R, Ussia A, Schindler L, Wattiez A, Al-Suwaidi S, Amro B, Al-Maamari B, Hakim Z, Tahlak M
Front Endocrinol (Lausanne) 2021;12:745548. Epub 2021 Nov 25 doi: 10.3389/fendo.2021.745548. PMID: 34899597Free PMC Article
Bulun SE, Yildiz S, Adli M, Wei JJ
Hum Reprod Update 2021 Oct 18;27(6):1086-1097. doi: 10.1093/humupd/dmab017. PMID: 34131719Free PMC Article
Practice Committees of the American Society for Reproductive Medicine and the Society for Reproductive Endocrinology and Infertility
Fertil Steril 2021 Jun;115(6):1416-1423. Epub 2021 Apr 4 doi: 10.1016/j.fertnstert.2021.02.010. PMID: 33827766
Westin SN, Fellman B, Sun CC, Broaddus RR, Woodall ML, Pal N, Urbauer DL, Ramondetta LM, Schmeler KM, Soliman PT, Fleming ND, Burzawa JK, Nick AM, Milbourne AM, Yuan Y, Lu KH, Bodurka DC, Coleman RL, Yates MS
Am J Obstet Gynecol 2021 Feb;224(2):191.e1-191.e15. Epub 2020 Aug 15 doi: 10.1016/j.ajog.2020.08.032. PMID: 32805208Free PMC Article

Recent systematic reviews

Reis FM, Coutinho LM, Vannuccini S, Batteux F, Chapron C, Petraglia F
Hum Reprod Update 2020 Jun 18;26(4):565-585. doi: 10.1093/humupd/dmaa009. PMID: 32412587Free PMC Article
Travaglino A, Raffone A, Saccone G, Insabato L, Mollo A, De Placido G, Zullo F
Eur J Obstet Gynecol Reprod Biol 2018 Dec;231:104-110. Epub 2018 Oct 10 doi: 10.1016/j.ejogrb.2018.10.025. PMID: 30342311

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