In an infeile woman. endometrial biopsy reveals proliferative changes. Which Hormone should be preferred ?

Ans. is a i.e MDPA Synthetic progesterones : Progesterone derivatives have weak antiovulatory actions. except - Chlormadione acetate eg : MDPA, Mesogestrol, Dydrogesterone, Hydroxy progesterone caproate, Nomegesterel 19 Noestosterone derivatives have strong antiovulatory actions eg- Desogestrel, Norgestimate, Gestodene, Norethindrone, Norethisterone Norgesterel In the question the infeile woman's endometrial biopsy shows proliferative changes. As we know endometrial biopsy for infeility is taken on D 21-23 with the aim to rule out anovulation. Normally on these days endometrial biopsy should show secretory changes (as ovulation occurs on D-14 and subsequent there is increase in progesterone levels in body) But in case of anovulation endometrial biopsy does not show secretory changes but show proliferative changes. The hormone which should be administered here is obviously progesterone. but that derivative of progesterone which has weak antiovulatory effect and not strong one as it would fuher inhibit anovulation So, our answer is MDPA