In recent years, the number of women who are infertile is increasing, and many women who have been preparing for pregnancy for a long time still have no movement, which inevitably makes them feel bored. With the rapid development of medicine, more and more causes of female infertility have been detected, among which luteal insufficiency is easy to be ignored. Luteinizing insufficiency is a common disease among women nowadays. It is an important manifestation of female endocrine disorder and one of the important causes of female infertility.
What is luteal insufficiency?
Luteal insufficiency refers to the incomplete formation of corpus luteum after ovulation, resulting in insufficient secretion of progesterone, which prevents the endometrium from converting in time and is not conducive to the fertilization of eggs, thus often leading to infertility or habitual abortion. The maintenance of normal luteal function depends on the perfect functioning of the thalamus-pituitary-ovarian gonadal axis. Luteinizing hormone and follicle stimulating hormone secreted by the pituitary gland are insufficient, prolactin secreted by the pituitary gland is too much or too little, the follicles themselves are immature and insensitive to gonadotropins, and the luteal gland itself does not synthesize enough progesterone or the ratio between progesterone and estrogen is not harmonious, all of which may lead to luteal insufficiency.
The natural incidence of the disorder is 5% in fertile women, 3.5%-10% in infertility, and 4%-60% in early pregnancy miscarriage 35% in habitual abortion.
Luteal insufficiency cannot be separated from the six factors
1, follicular dysplasia
An important cause of luteal insufficiency is follicular dysplasia. Since luteal development is the continuation of follicular development, any factors that affect follicular growth and development will affect luteal function.
2. Hyperprolactinemia
Studies have pointed out that an appropriate amount of prolactin is necessary to maintain normal corpus luteum function. Excessive prolactin can directly affect the synthesis of progesterone by acting on β-hydroxysteroid dehydrogenase in the ovary, leading to shortening of the luteal phase, amenorrhea, overflow of milk and infertility. It has been reported that about 40% of patients with luteal insufficiency are accompanied by hyperprolactinemia.
3.Endometriosis
In patients with endometriosis, luteal insufficiency accounts for 25% to 45%. The relationship between endometriosis and luteal insufficiency is still unclear.
4. Luteinized unruptured follicle syndrome
With the development of reproductive endocrinology, the integrated use of real-time ultrasound and endoscopy has led to a more detailed and specific understanding of the etiology of infertility. A study of luteal insufficiency reported that of 47 patients with luteal insufficiency, laparoscopy and hormone measurement confirmed 16 cases (34%) as LUFS.
5. Hospital-based factors
Clomiphene can cause luteal insufficiency. In a group of clomiphene ovulation cases, it was found that although ovulation occurred in the 50 mg dose group, luteal insufficiency was observed in 20% of the cases. The mechanism may be that clomiphene directly affects the response of the endometrium to hormones. Vinpocetine has a luteolytic effect, and some other drugs, such as vinpocetine, rehablon and antiemetic, can also cause luteal insufficiency.
6.Miscarriage
According to statistics, 83% of miscarriage patients can resume ovulation, but their blood progesterone values are lower than normal, and once they are pregnant again, the miscarriage rate is high. This may be related to the low level of blood progesterone value, endometrial dysplasia affects the implantation of pregnant eggs.
Can I still get pregnant if I have luteal insufficiency?
Luteal insufficiency is the main cause of infertility in women. Even if a patient with luteal insufficiency gets pregnant, she is prone to miscarriage, therefore, patients with luteal insufficiency should be regulated before getting pregnant.
The most common treatment for luteal insufficiency is to supplement the progesterone deficiency in the body, usually with intramuscular injections of progesterone and oral progesterone.
There is also pharmacological stimulation of luteal therapy, mainly with chorionic gonadotropin to promote follicular growth. In addition, for luteal insufficiency caused by too high prolactin in the blood, prolactin-lowering drugs such as bromocriptine are used.
Of course, how these drugs are applied plays a different role in the effectiveness of the treatment. Too much or too little of them will not only fail to achieve the treatment effect that varies from person to person, but will also produce certain side effects. Therefore, treatment must be carried out under the guidance of a regular hospital physician.