Luteal Phase Insufficiency And Infertility

Luteal phase deficiency (LPF) is a common cause of infertility in women. NLF is associated with dysfunction of the ovaries, primarily with weakened function of the corpus luteum of the ovary and a decrease in progesterone production. This leads to insufficient preparation of the endometrium for implantation, disruption of the fallopian tubes, and fragile implantation of the embryo.

Women who have NLF often detect it only by measuring their basal temperature (BT). At the same time, they learn that ovulation occurs too late for normal embryo implantation. Having identified NLF, many doctors begin to carry out treatment aimed at stimulating the function of the corpus luteum of the ovary and increasing the level of progesterone in the blood. However, this approach to the treatment of infertility is often unsuccessful, since NLF, as a rule, is not an independent nosological entity, but is a symptom of a gynecological disease.

NLF may be associated with disorders of the hypothalamic-pituitary system, hyperandrogenism, functional hyperprolactinemia, chronic inflammation of the uterine appendages, external endometriosis, dysfunction of the thyroid gland and other gynecological diseases.

To diagnose NLF, the level of progesterone in the blood is determined, an endometrial biopsy is performed 2-4 days before the start of menstruation, and an ultrasound scan is performed during the cycle phase. In addition, on the BT graphs, the second phase is less than 10 days, and the temperature difference between phase 1 and phase is less than 0.4 degrees.

If a disease is identified that led to NLF, it is treated. If such a disease is not detected, and if ovulation occurs, then treatment begins with replacement therapy with progesterone drugs in the second phase of the cycle. Treatment tactics with chorionic gonadotropin drugs have also been adopted, with the help of which they stimulate the function of the corpus luteum. Treatment is carried out under regular ultrasound monitoring of the condition of the endometrium, ovulation and the condition of the corpus luteum. In addition, it is necessary to avoid overstimulation, which causes the formation of ovarian cysts.

The next stage of treatment is stimulation of ovulation using Clostilbegit or direct gonadotropins (LH and FSH). These drugs increase estrogen levels and stimulate the growth of follicles in the ovaries. In this case, it is necessary to carefully monitor the process of ovulation stimulation to avoid ovarian hyperstimulation.

If ovulation stimulation does not produce results, then you can try the ICSI procedure (intracytoplasmic sperm injection). This is a method of artificial insemination in which a single sperm is injected into a mature egg. This method allows you to successfully solve the problem of infertility in NLF.

In general, the treatment of NLF and infertility associated with this disease requires an individual approach and comprehensive treatment. However, modern diagnostic and treatment methods make it possible to achieve high results in the treatment of this disease and restoration of reproductive function in women.