LUF syndrome, or the luteinization syndrome of an un-ruptured ovarian follicle, is a type of menstrual cycle disorder in which an egg is not released from a mature ovarian follicle. This leads to problems getting pregnant. What are the causes and symptoms of LUF? How is the treatment going?
LUF syndrome , orluteinization syndrome of non-ruptured follicleis a disorder of the menstrual cycle in which a mature egg is not released. Consequently, there is no possibility of fertilization. This may happen every month, but it does happen periodically, e.g. once every three months. Laboratory tests are normal, unless there is an overlap of another pathology. Treatment is difficult, requires patience and is not associated with therapeutic success in all situations. The biggest problem for women with LUF is the difficulty of getting pregnant.
LUF syndrome and the ovarian cycle
In order to understand the pathomechanism of LUF, one needs to know the course of a normal ovarian cycle. On average, a he althy woman has a menstrual cycle of 28-32 days. Any deviation from this value is an indication for extended diagnostics. The entire reproductive system is under the influence of the overriding hormonal axis that acts on the basis of feedback - this is the hypothalamic-pituitary-ovarian axis. The leading hormone that determines the work of others is GnRH - gonadoliberin, which then stimulates the pituitary gland to produce hormones that act directly on the gonads.
The ovarian cycle can be conventionally divided into two phases. The first one depends on the influence of FSH (follicle stimulating hormone), which starts with the menstrual bleeding, the second one is the luteal phase, in which the LH hormone acts mainly. In between, ovulation takes place, i.e. the rupture of a mature ovarian follicle with the release of an egg capable of fertilization. Ovulation is associated with a peak in LH secretion, referred to as the LH peak in the denomination. The remaining elements of the ovarian follicle are transformed into the corpus luteum, the function of which is focused on the production of progesterone. This substance also determines the proper implantation of the embryo at an early stage and its development. After about 14 days,If the gametes are not joined, the corpus luteum disappears, while the uterine mucosa exfoliates and is evacuated from the uterine cavity with the next menstruation. In LUF syndrome, the egg matures in the properly stimulated ovarian follicle, but no oocyte is released, i.e. a mature one female gametes. It is always locked inside. There is no doubt that pregnancy in such a case is impossible. The level of hormones responsible for the proper course of each phase is completely normal, so the cause of the problem is not a disturbed hormonal balance.
Causes of the LUF syndrome
Determining an evident causative factor is very difficult, therefore a multifactorial etiology is adopted. In the literature, one can find references to, for example, an insufficient amount of LH receptors in the ovarian follicle, inadequate to the demand. It is hypothesized that the problem may be due to decreased activity of enzymes suspended in the follicular fluid involved in the destruction of the follicle wall. Other theories include:
- persistent elevated estrogen levels
- abnormal stimulation in the hypothalamic-pituitary-gametes axis
- follicular inflammation
- endometriosis
- PCOS - polycystic ovary syndrome
- periodic increase in PRL concentration - hyperprolactinemia
- post-inflammatory adhesions within the ovary
LUF diagnostics
The diagnosis of the syndrome may be difficult due to the completely normal concentration of sex hormones. Therefore, perhaps the most likely diagnosis can be made after diagnostic laparoscopy, routinely used, for example, in the case of endometriosis. After the rupture of the ovum, the corpus luteum has a small trace on its surface - a stigma, which should be visualized in a laparoscopic examination. It is a small depression, a kind of crater. In addition to this test, it is advisable to routinely determine the body's hormone balance, not forgetting about prolactin. Of course, there is also an alternative method - the observation of the ovaries in the periovulatory period in an ultrasound examination. If no follicle rupture is observed after the LH peak, i.e. the peak secretion, during 36 h, LUF can be diagnosed.
Motherhood and LUF
LUF is closely related to problems with getting pregnant, Jet is obvious because the follicle does not rupture and an egg is released that is capable of fertilization. Despite the search for new therapies, a treatment consensus has not yet been established.You should always try to find out the root cause. If the etiology is related to endometriosis or polycystic ovary syndrome, the first thing to do is to correct the disturbed hormonal balance. It is advisable to consider the possibility of therapy with clomiphene or gonadotropins, which is to help stimulate ovulation.
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