The yellow body is a small structure, richly vascularized, performing secretory functions, and therefore included in the endocrine system. This is what remains of a ruptured follicle, immediately after the egg is released. The name of the corpus luteum comes from the yellow color of lutein, which is stored by the granulosa cells surrounding the egg before it is released.
The corpus luteumproduces and secretes progesterone, one of the basic female sex hormones. The primary secretory task of the corpus luteum is the production of progesterone, which in turn is the main hormone responsible for preparing the endometrium for possible implantation of a fertilized egg, and then for supporting pregnancy before this function is taken over by the placenta. As it has already been emphasized, the corpus luteum can be called the secretory structure. In addition to the aforementioned progesterone, the production of other hormonally active substances is observed, such as estrogens, prostaglandins and relaxin.
Corpus luteum
- The menstrual body , otherwise known as the menstrual body - is formed immediately after ovulation, i.e. the release of the egg. The function of this structure usually lasts for about 10-12 days, so almost the entire second part of the cycle. In a situation where fertilization has not taken place, the yellow body is transformed into a whitish body, which, as it can be presumed, is not rich in lutein. It disappears on its own after a few months.
- Pregnancy yellow body- the process of its formation does not differ from the one described above, with the only difference that it does not disappear spontaneously. The resulting yellow body, in the event of fertilization, increases its dimensions and produces progesterone even up to 9-10 weeks of pregnancy, i.e. until this function is taken over by the placenta. The transformation into a whitish body does not take place until after delivery.
- Lactating yellow body- as the name suggests, it appears during lactation, after the rupture of the first ovarian follicle. Conversion into a proteinaceous body, on the other hand, takes place after the end of lactation.
Causes of the disturbed function of the corpus luteum
Corpus luteum failure means that the amount of progesterone produced is inadequate todemand or the secretion time is less than 10-12 days. This condition mainly translates into fertility problems and more frequent miscarriages. Progesterone is the parent hormone responsible for preparing the uterus for embryo implantation. Its secretion is the result of the stimulation of one of the pituitary gland hormones - LH, which in turn acts on a feedback mechanism dependent on the superior secretory organ - the hypothalamus. The deficiency of the corpus luteum may also result from abnormal maturation of the ovarian follicle. As a result, the corpus luteum is either not formed at all or its function is clearly impaired. The proper functioning of the corpus luteum is also dependent on the concentration of other hormones, including TSH and prolactin, as well as on the condition of the ovaries (this is mainly about possible pathologies that may occur within them).
Symptoms of corpus luteum failure
The main symptoms that may indicate a malfunction of the corpus luteum are:
- difficulty getting pregnant
- habitual miscarriages
- abnormal vaginal spotting - before menstruation
- mastopathy, i.e. breast pain / discomfort
- change in the length of the menstrual cycle - lengthening / shortening
Diagnosis of corpus luteum failure
In order to recognize the malfunction of the corpus luteum, several tests should be performed:
- basal body temperature measurement, after a 6-hour rest, the increase in temperature is a reflection of the increased concentration of progesterone (effect on cellular metabolism). Temperature measurement should be carried out in the second phase of the menstrual cycle, immediately after ovulation. The correct functioning of the corpus luteum can be determined only when the increased temperature lasts for at least 6 days.
- assessment of progesterone concentration - three times in the luteal phase, and their sum should be higher than 40 µmol, while the single result should not be lower than 5 ng / ml
- assessment of prolactin concentration,
- TSH concentration assessment
- endometrial biopsy, during hysteroscopy between day 24 and day 26 of the cycle. The doctor assesses the transformation of the uterine mucosa.
Treatment of deficiency of the corpus luteum
Due to the different etiologies of the disorder, treatment should depend on the cause of the condition. Only in this way, the selected therapy guarantees the effectiveness of treatment. If the malfunction of the corpus luteum results from a dysfunction of the hypothalamic-pituitary-ovarian connection, care should be taken to stimulate the maturation of the ovarian follicle. Then either menopausal or chorionic gonadotrophin (hCG) are givenClomiphene Citrate. In women with known hyperprolactinaemia, bromocriptine is the drug of first choice. On the other hand, patients with a thyroid dysfunction have a regulated thyroid hormone in the first place. The lack of a clear cause of the deficiency of the corpus luteum is an indication for the inclusion of progesterone. The drug is administered from the 14th to the 28th day of the cycle. Usually, treatment of luteal phase failure is directed to couples trying to conceive. In the case of ineffectiveness of the therapeutic procedure, assisted reproductive techniques remain - intra-uterine insemination or in vitro fertilization.