luteal insufficiency
Introduction
Introduction to luteal insufficiency Insufficient function of the corpus luteum is also called luteal function. It means that the ovary is not completely formed after ovulation, resulting in insufficient secretion of progesterone, which makes the endometrium fail to switch in time, which is not conducive to the implantation of fertilized eggs. Therefore, it often leads to infertility or habitual abortion. Abnormalities in the luteal phase, abnormal endometrial progesterone secretion due to delayed or altered endometrial secretion in women may result in insufficiency of luteal function in women. Insufficient function of the corpus luteum can lead to follicular dysplasia, incomplete luteal formation, and imbalance in the ratio of estrogen and progesterone secreted by the corpus luteum itself. There are many infertility caused by luteal insufficiency, accounting for 3%-10% of all infertility. Patients with this disease usually have no symptoms of discomfort, but may have no ovulation in several menstrual cycles, sometimes with excessive menstruation or prolonged menstruation. The most common method for the treatment of luteal insufficiency is to supplement the deficiency of progesterone in the body. Generally, it is administered intramuscularly with progesterone and oral progesterone, and chorionic gonadotropin can also be used to promote corpus luteum function. basic knowledge Sickness ratio: 0.1% Susceptible people: good for married women Mode of infection: non-infectious Complications: habitual abortion
Cause
Cause of luteal insufficiency
Abnormal luteal phase (35%):
Abnormalities in the luteal phase, abnormal endometrial progesterone secretion due to delayed or altered endometrial secretion in women may result in insufficiency of luteal function in women.
Hormone secretion disorders (35%):
Luteinizing hormone, follicle stimulating hormone, and women's follicle stimulating hormone and luteinizing hormone secretion disorders may cause female follicles and dysfunction of the corpus luteum to cause abnormalities in the secretion of ketones during ovulation, resulting in dysfunction of the corpus luteum.
Endometriosis (10%):
Endometriosis, female endometriosis can cause a significant increase in prostaglandins released by patients, which affects the corpus luteum function of women.
Other systemic diseases (10%):
Systemic diseases, due to malnutrition or physical weakness, can also cause luteal insufficiency in women.
Prevention
Luteal dysfunction prevention
1. After the menstruation is clean, drink red dates and longan water every day.
2, pay attention to the health of the reproductive organs and vulva, to avoid causing other diseases.
3, to maintain a happy spirit, bad mood can lead to inhibition of pituitary function, causing infertility.
4, moderation of life, excessive frequency will make the endocrine system disorder is not conducive to conception.
5. Eat high-protein foods and ginger soup, lamb, vegetables, and fruits. Drink plenty of water to keep your stools open.
Complication
Luteal dysfunction complications Complications habitual abortion
First, leading to menstrual disorders in women : some women with luteal insufficiency will have menstrual disorders, such as significantly shortened menstrual cycle, menorrhagia, abnormal leucorrhea, frequent menstruation, prolonged menstruation, etc., so that women suffer a lot of pain.
Second, induced habitual abortion : luteal insufficiency, corpus luteum can not secrete enough progesterone, the endometrium can not be affected by progesterone for the corresponding changes in pregnancy, leading to women even after conception, it is difficult to maintain pregnancy, resulting in miscarriage, Habitual abortion and other phenomena.
Third, trigger infertility: because the corpus luteum can not be degraded according to the cycle or the incomplete destruction of the corpus luteum and only secrete a small amount of progesterone, so that the endometrium can not fall off regularly according to normal time, the uterus before menstruation still remains in the lining In the early stage of secretion, and later the endometrium is not sensitive to the response of progesterone, the gland is slightly curved, which makes it difficult for women to conceive, and finally leads to infertility.
Symptom
Symptoms of luteal insufficiency Common symptoms Abortion female infertility menstruation for a long time and ... Menstrual period back pain menstrual cycle changes
1. Infertility: Because the corpus luteum can not be attenuated or incompletely degraded, the progesterone can continue to secrete a small amount of progesterone, so that the endometrium can not be peeled off at normal time. The pre-menstrual endometrium still stays in the early stage of secretion, and the secretion reaction is poor. This makes women difficult to conceive.
2, abortion: due to luteal insufficiency can not secrete enough progesterone, therefore, even after gestational dysfunction in patients with normal pregnancy, it is difficult to maintain pregnancy, leading to miscarriage, habitual abortion.
3, menstrual disorders: some patients with luteal dysfunction will have menstrual disorders, such as shortened menstrual cycle, menorrhagia, frequent menstruation, menstrual extension (up to 9-10 days or even longer, and other symptoms.
Examine
Examination of corpus luteum insufficiency
First, the basic body temperature examination: basal body temperature examination is one of the inspection methods for luteal insufficiency infertility, and is the most convenient and commonly used method. The high temperature phase rises slowly, and the high temperature phase has a depression, which indicates luteal dysfunction. Therefore, the change of basal body temperature is also a symptom of luteal insufficiency.
Second, the blood progesterone concentration check: blood progesterone concentration test is also a method to check the corpus luteum insufficiency. Experts say that the determination of progesterone concentration in blood is an important reliable indicator of corpus luteum function and the most common symptom of luteal insufficiency.
Third, endometrial tissue examination: endometrial tissue examination is also one of the examination methods for luteal insufficiency. Experts say that the time taken for the endometrium is more than the seventh day of the luteal phase, the high temperature phase.
Diagnosis
Diagnosis and identification of luteal insufficiency
Diagnostic criteria
Basic body temperature diagnosis method : Record the measured basal body temperature using the correct measurement method. If the high temperature phase (generally between 36.9-37.1 °C) is less than 12 days, or the basal body temperature is climbing, the body temperature rises for more than 3 days. Above; or the unevenness of the basal body temperature (also known as saddle body temperature). All three cases can be diagnosed as luteal function.
Blood progesterone assay : The basal body temperature of these patients is often biphasic, but the rise and fall are slow, the increase is less than 0.3 ° C, the duration is only 9-11 days, and sometimes the follicular phase is prolonged. In this case, serum tests can be performed on the 8th day when the basal body temperature rises (if progesterone has been used, it is not suitable), and if the blood progesterone is less than 10 ng/ml, it is a luteal function.
1. Blood progesterone is measured at 18 to 28 days after menstruation. If the content is lower than normal, it indicates luteal insufficiency.
2, ultrasound detection of ovulation, the time from menstruation after ovulation should be about 14 days, if less than 12 days is the lack of luteal function.
3. Measuring the basal body temperature is the easiest method, but it is also the most inaccurate method. It is measured every morning, then the body temperature is recorded, and the body temperature sheet is drawn.
4, diagnosis and curettage, on the 26th day of the menstrual cycle, the endometrium for histological examination, if the endometrial secretion is poor or behind the two days of the intima of the scraping day, consider the luteal function.
