What Is a Luteal Phase Defect?

Luteal dysfunction refers to insufficient endocrine function of the luteum formed after ovulation of the ovary, resulting in insufficient secretion of progesterone, insufficient conversion of endometrial secretion, ovulatory dysfunction, and unfavorable implantation of fertilized eggs, which can lead to infertility or habits Sexual abortion.

Basic Information

nickname

Luteal phase defect

English name

luteal insufficiency

Visiting department

Gynecology

Multiple groups

Women of childbearing age

Common causes

May be related to insufficient luteinizing hormone and follicle stimulating hormone secreted by the pituitary

Common symptoms

Shortened menstrual cycle, frequent menstruation, infertility or miscarriage

Contagious

no

Causes of Luteal Insufficiency

The cause is currently unknown. The maintenance of normal luteal function depends on the perfection of thalamus-pituitary-ovarian gonad axis function. Most scholars believe that the cause of luteal insufficiency may be due to insufficient luteinizing hormone (LH) and follicle stimulating hormone (FSH) secreted by the pituitary. The pituitary secretes too much and too little prolactin (PRL); the follicles themselves are immature and are not sensitive to gonadotropins; the corpus luteum itself does not synthesize progestins or the proportion of estrogen is not coordinated.

Clinical manifestations of luteal dysfunction

Patients with corpus luteum insufficiency usually have no symptoms. If there are clinical manifestations, it is mainly shortened menstrual cycle, frequent menstruation, infertility or abortion, and abortion mainly occurs in early pregnancy.

Corpus luteum insufficiency test

Progesterone test

Progesterone in the blood was measured at 18 to 28 days of menstruation. Its content below normal indicates luteal dysfunction.

2. Ultrasound detection of ovulation

The period from ovulation to menstruation should be about 14 days, if less than 12 days, the corpus luteum is insufficient.

3. Measure basal body temperature

It is the easiest method, but it is also the less accurate method. Get up every morning and record your temperature.

4. Diagnosis and curettage

On the 26th day of the menstrual cycle, take the endometrium for histological examination. If the endometrium is poorly secreted or the endometrium is two days behind the curettage day, the corpus luteum is considered insufficient.

Luteal dysfunction diagnosis

The diagnosis of luteal dysfunction can be based on basal body temperature, blood progesterone determination, and endometrial biopsy. The basal body temperature of these patients is biphasic, but the rise and fall are slow, the rise is less than 0.3 ° C, the duration is only 9 to 10 days, and sometimes the follicular period is prolonged. On the eighth day of basal body temperature rise, blood progesterone was below 10 ng / ml. In the past, endometrial biopsy was generally performed on the 21st to 22nd days of menstruation. The endometrial phase was less than 2 days as the diagnostic standard. Now, some patients with clinically diagnosed luteal dysfunction are found to have unruptured follicular syndrome by laparoscopy. Therefore, the diagnosis of this disease should also be combined with B-ultrasound and laparoscopy.

Luteal dysfunction treatment

1. The most commonly used method

The most common treatment for corpus luteum insufficiency is to supplement the lack of progesterone in the body. Generally, progesterone is injected intramuscularly and progesterone is administered orally.

2. Drug-stimulated luteal therapy

Chorionic gonadotropins are mainly used to promote follicular growth. In addition, for luteal dysfunction caused by too high prolactin in the blood, drugs that reduce prolactin, such as bromocriptine, need to be used.

Of course, how to apply these drugs has different effects on the treatment effect. Too much or too little will not only achieve different treatment effects from person to person, but will also produce certain side effects.