| Abstract: | 30 Ituri women (Zaire) -- 14 Efe and 16 Balese -- were targeted as subjects in this study designed to verify that, under field conditions, the salivary steroid method can reliably discern follicular and luteal levels of progesterone in normal menstrual cycles and to examine the hypothesis that infertility among these women is due to tubal factors. Findings of normal ovulatory function in fertile women would support the hypothesis; findings of abnormal gonadal function might either indicate a chronic endocrine imbalance or the short-term effects of nutritional and other stressors. All potential subjects ranged in age between 20-35 years, were involved in stable conjugal unions, had no nursing children, and reported either no births or none within the last 6 years. 25 women completed the study. The Boston field control subjects consisted of 18 volunteers ranging in age between 18-43 years. All reported a history of regular menstrual cycles and were nither using oral steroid contraceptives nor engaged in a regular exercise program. The African women had significantly lower luteal progesterone levels than did the Boston controls. Additionally, a significantly higher proportion of the African women failed to demonstrate clear luteal activity, suggesting that a higher rate of anovulation contributed to the low average luteal progesterone levels. The composite-cross-sectional profile for the Ituri Forest women suggests that the average luteal phase for this group was shorter than for the Boston controls. Further investigations need to determine whether gonadal dysfunction such as observed in this study is a regular feature of the reproductive physiology of women in the Ituri Forest, or whether it emerges only in periods of food shortage and significant weight loss. Gonorrhea may be the major cause of infertility in the Ituri region, but it is likely that other factors directly affecting gonadal function contributed to the observed pattern of low fertility. Clearly, the study illustrates the potential usefulness of salivary steroid assays. |
