Insufficiency of the corpus luteum during pregnancy treatment. What does corpus luteum insufficiency mean? Is pregnancy possible without a corpus luteum: why is it not visualized on ultrasound

Women's work reproductive system depends on many factors, in particular on the state and functions of the ovaries. Currently, there is a large number of ways to evaluate them, which can be divided into two groups: the study of the hormonal profile (the amount of progesterone, luteinizing and follicle-stimulating hormones, estradiol, and so on), instrumental diagnostics(ultrasound, CT, MRI, biopsy). One of important components Ultrasound examination is the study of the corpus luteum.

This is a temporary (provisional) organ that is formed in the ovary from the follicle (the precursor of the egg) in the 2nd phase of the cycle (from 13-15 days) and remains until the onset of menstruation in the absence of conception. corpus luteum plays a major role in maintaining pregnancy by producing progesterone. This means that if the formation of this organ or any of its pathologies is disturbed, the reproductive system suffers. A woman cannot bear a fetus due to an abortion on early dates. One of best practices assessment of the condition of the corpus luteum is ultrasound.

Indications

Ultrasound examination of the corpus luteum is assigned to the patient in several cases:

Indication	Purpose of the study
Selection of adequate hormonal contraception	Define: Presence/absence of ovulation; Presence / absence of the corpus luteum, the timing of its formation; Exclude possible pathologies yellow body.
Delayed menstruation	Reliably determine the signs of pregnancy (the presence of a corpus luteum after the end of the 2nd phase, altered uterine mucosa, and so on) or their absence.
At uterine bleeding associated with the menstrual cycle (menorrhagia)	Exclude a violation of the structure of the corpus luteum or other pathology of the ovaries.
Suspicion of a corpus luteum cyst	Confirm/deny clinical diagnosis. If there is a cyst, determine the need for treatment.

How to define menorrhagia? This condition manifests itself in women in several ways:

• An increase in the amount of separated blood during menstruation - hypermenorrhea;
• Significant increase in duration menstrual bleeding- polymenorrhea;
• Irregularity of menstruation or its irregular rhythm.

As a rule, these options are combined with each other, which makes it possible to detect menorrhagia when collecting complaints.

Isolated ultrasonography the corpus luteum is not performed - during the procedure, the entire structure of the ovaries is examined. As a rule, such an ultrasound is combined with doplerometry (the study of the state of blood flow).

Preparing for an ultrasound

For better visualization, it is necessary to eliminate possible obstacles in the path of the ultrasonic signal. For this purpose, 2 days before the procedure, the patient is recommended to exclude certain products from a diet containing a large amount of fiber, which reduces the amount of gases in the intestinal cavity. These include:

• Any vegetables and fruits, as well as juices and other dishes prepared from them;
• Corn, millet, oatmeal, pearl barley;
• Rye bread.

You should also know that immediately before the diagnosis bladder patient needs to be filled. It will serve as a "landmark" in the study of the ovaries. This means the following:

• a few hours before the procedure, the patient is prescribed a plentiful drink;
• You should not empty your bladder until the end of the ultrasound.

Such an ultrasound examination of the corpus luteum takes 10-20 minutes. After it is carried out, the girl removes the remains of the gel from the surface of the skin and is allowed to urinate.

Normal ultrasound picture

The corpus luteum on ultrasound looks like a homogeneous structure, without cavities, with clear, even boundaries. Its presence should be determined after 12-16 days menstrual cycle. When pregnancy occurs, it persists until the placenta is formed. If conception did not occur, it means that it is destroyed at the end of the second phase or during the onset of menstruation.

The pathologies of this temporary organ will manifest themselves in 2 main options:

• Violation of its formation - in this case, the corpus luteum is absent in the corresponding phase of the cycle;
• Volumetric formations (most often cysts or tumors), in which the contours and uniformity of the organ change.

Other changes in the corpus luteum on ultrasound are extremely rare.

Volumetric formations

In 5% of patients with any menstrual irregularity, this is diagnosed volumetric education in the form of a cyst. It is formed from a burst follicle located in the ovary. Such a process does not pose a danger to the health of the girl and often disappears by itself, overgrown connective tissue. The threat may be a complication of the cyst - bleeding, which can be quite intense and aggravate the course of the disease.

In this case, the corpus luteum on ultrasound may look like this:

• Against the background of the corpus luteum, " bright spot» — hypoechoic formation in the form of a cavity. It can be in the form of a single undivided formation or have a fine-mesh structure, due to connective tissue partitions;
• Against the background of the "bright spot" areas can be determined increased density(hyperechoic), which are clots of clotted blood;
• With severe bleeding, the “bright spot” may be completely absent. Instead, education can be located round shape with clear boundaries of increased density (hyperechoic). This is a cyst that is completely filled with clotted blood. It is easy to confuse it with a benign tumor. Differential diagnosis CT scan or biopsy.

The treatment plan is determined after additional diagnostics(determination of hormonal status, dopplerography) final diagnosis. It is optimal to evaluate the corpus luteum on ultrasound in dynamics (in the 1st and 2nd phases of the cycle), to increase the reliability of the procedure.

Ultrasound examination of the corpus luteum is one of the components of the ultrasound of the ovaries, which must be studied in case of violation of the reproductive function in a woman. The most common pathologies include a violation of the formation of this provisional organ or its volumetric formations. The tactics of treatment is determined individually in each case and can be represented by both hormonal therapy and surgical intervention.

This is a temporary gland in the ovary of a woman, formed at the site of the follicle from which the mature egg came out. And they called it that because it is filled with liquid yellow color containing hormones. Without the corpus luteum, pregnancy and normal childbearing are impossible.

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How does the corpus luteum appear

Regularly, every month in one of the woman's ovaries childbearing age the egg matures. It develops in the follicle during the first half of the menstrual cycle. After maturation, the follicle bursts, and the egg is released into the abdominal cavity. This process is called ovulation.

While the egg moves through the fallopian tube, a corpus luteum forms at the site of the ruptured follicle, which produces estrogen and progesterone. The latter is especially important - after all, it is he who prepares the woman's body for conception and pregnancy.

In the second half of the menstrual cycle, the corpus luteum actively produces progesterone, which promotes pregnancy. If fertilization does not happen, then the corpus luteum atrophies, the level of progesterone drops sharply and menstruation begins. And in the ovary, the process of maturation of the next follicle is initiated.

Functions of the corpus luteum

Under influence progesterone(it is also called the hormone of pregnancy) the endometrium of the uterus grows and swells, preparing for the implantation of a fertilized egg - the zygote. The fallopian tubes contract slowly, pushing the zygote forward, the cervix dilating to allow the passage of a large female germ cell.

But progesterone, on the contrary, relaxes the muscles of the uterus, preventing it from contracting. Under the action of the hormones of the corpus luteum, the glands of the uterus first secrete a mucous secretion that increases the permeability of spermatozoa, and later another, which contributes to the introduction of the zygote into the uterine wall. The uterus itself is preparing for active expansion.

Progesterone inhibits the maturation of the following follicles and prepares nervous system women to bear a child. In a woman's breasts, alveoli begin to develop - glands that produce milk.

The functioning of the corpus luteum itself is controlled by hCG(human chorionic gonadotropin), produced by the membrane of the embryo. Thus, if fertilization does not occur, the corpus luteum does not receive an "order" to grow further and degrades.

If conception has occurred, then the corpus luteum will develop and produce hormones until the placenta is fully formed, up to about -16 weeks of pregnancy. Then children's place will take over the production of progesterone and estrogen, and the corpus luteum is reduced. However, in some women, it persists until the very birth.

At ectopic pregnancy the corpus luteum grows slowly. This is due to the fact that in the embryo attached to wrong place(tube wall, ovary, abdominal cavity...) there is no opportunity to develop normally. The chorion (sheath) does not grow properly, so hCG is released in insufficient quantities.

What are the violations in the development of the corpus luteum

The main deviations in the normal formation of the corpus luteum are:

functional insufficiency;
- cyst.

Both diagnoses are made after comprehensive examinations, which include ultrasound, blood tests for progesterone and hCG levels, gynecological examination, study of the basal temperature chart. A woman is not at risk from ultrasound during pregnancy this moment ultrasound is the most informative and absolutely safe method fetal research. It can be carried out as many times as necessary and at any stage of pregnancy.

A corpus luteum cyst is considered a benign disease and rarely requires treatment. But the insufficiency or absence of the corpus luteum is better to detect as early as possible, because this pathology threatens to terminate the pregnancy in the early stages or further development placental insufficiency.

Hypofunction of the corpus luteum during pregnancy

Insufficiency of the function of the corpus luteum during pregnancy - very serious breach. It leads to the impossibility of becoming pregnant, to spontaneous abortions, to a threat to the life of the fetus if the placenta has formed with deviations from the norm.

An incomplete cycle of the corpus luteum phase is one of the causes of infertility. If the corpus luteum develops for less than ten days and dies, then the amount of progesterone produced by it is simply not enough to prepare the mother's body for pregnancy. The zygote may not have time to penetrate the wall of the uterus during this time. Or the uterus will reject it as a foreign organism if the hormonal background is formed incorrectly.

Insufficiency of the corpus luteum during pregnancy is a reason for emergency medical intervention. Functional insufficiency of the corpus luteum means that it produces less hormones, primarily progesterone, than is necessary for normal development pregnancy. Progesterone deficiency can significantly affect the formation of the placenta and the nutrition of the fetus. But more often than not, low level pregnancy hormone leads to miscarriage in the first or second trimester.

Lack of corpus luteum during pregnancy

Sometimes the corpus luteum is not visualized at all on ultrasound, although the fact of pregnancy has been established. As a rule, this indicates a very small corpus luteum during pregnancy and requires immediate hormonal correction. Normal sizes corpus luteum 1–3 cm. If it is smaller, then less hormones enter the mother's body. This means that the life of the unborn child is in real danger.

Treatment for functional insufficiency or absence of the corpus luteum

Treatment of the disease is carried out with hormonal preparations, as a rule, containing progesterone. There are a lot of such drugs, but only one can determine which one is right for you. professional doctor after the various analyzes and surveys.

At hormone therapy It is not only the dosage that matters, but also the timing of the medication. If the insufficiency of the corpus luteum is the cause of infertility, then the doctor will prescribe an appointment hormonal drugs after ovulation. You need to know the exact time of ovulation, because progesterone suppresses it.

If you have already had miscarriages and there is a suspicion of corpus luteum hypofunction, then at the first signs of pregnancy, you should consult a doctor. If the diagnosis is confirmed, correction will be required hormonal background to keep the pregnancy. It will take a long time to be treated, until the placenta is fully formed. Naturally, treatment should be accompanied by constant monitoring of the level of hormones in the blood.

Sometimes the corpus luteum develops incorrectly. The walls of the follicle, from which the mature egg came out, begin to thicken and stretch, and internal cavity filled with serous fluid. A tumor-like formation is formed - a cyst of the corpus luteum. However, you should not panic - a corpus luteum cyst never degenerates into a malignant formation.

Causes of a corpus luteum cyst can be:

• disorders in the functioning of the lymphatic and circulatory system ovaries;
• infectious diseases genital organs;
• taking hormonal drugs;
• harmful conditions labor, bad habits;
• stress;
• extreme diets.

In most cases, the cyst does not interfere with the development of pregnancy and does not require medical intervention, because it is a modified corpus luteum and secretes sex hormones in sufficient quantities. Usually, after two or three months, it begins to dissolve by itself and disappears completely.

The size of the cyst usually does not exceed 6-9 cm, it rarely causes concern to the pregnant woman. But the doctor will still observe her, and the woman will recommend moderate physical exercise and careful sex so as not to cause the cyst to rupture or torsion of its leg.

Diagnosis of a corpus luteum cyst is carried out using ultrasound, gynecological examination, hormonal analysis, laparoscopy. A woman can feel drawing pains in the lower abdomen or side. If the pain is always localized in one side, then this may be a symptom of an ovarian cyst. Another symptom is menstrual irregularities, bleeding outside of critical days.

The corpus luteum cyst can be eliminated by itself, so usually it is not touched, but only observed. If there is no hope for spontaneous atrophy, then the cyst is removed using laparoscopy.

Rupture of a cyst- most serious complication this disease. He is accompanied acute pain, bleeding and requires surgical intervention. A ruptured unhealed cyst can lead to the development acute infection internal organs.

Torsion of the cyst leg also requires surgical treatment, because squeezing the tissues leads to their necrosis.

Thus, main danger associated with the corpus luteum during pregnancy is its lack of functionality. But you should not be upset - the level of development modern medicine helps women endure healthy child even with corpus luteum insufficiency. Just in this case, in order to maintain the pregnancy, you may need to take hormonal drugs. And only a doctor can choose their dosage - trust him.

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Insufficiency of the corpus luteum in women is now quite common. Many women have problems with their menstrual cycle or with the ability to carry a fetus. Of course, problems with menstruation are rarely paid attention to, with, according to statistics, only 4 out of 10 women turn to a specialist. Many ignore the problem or use various recipes traditional medicine and advice from family and friends.

What is a disease?

Very rarely folk therapy gives the desired result, usually the patient only loses important time for treatment. Therefore, the sooner you see a doctor, the best effect will be from treatment.

A common problem that causes cycle disorder and infertility is corpus luteum insufficiency. Dangerous insufficiency of the corpus luteum during pregnancy, as there is a very high risk miscarriage.

Yellow body - specific endocrine gland, which is activated only during menstruation and persists at the beginning of pregnancy until the moment of delivery. With insufficiency of the corpus luteum, it is observed that affects the female body and pregnancy.

The most common causes of NLF are various hormonal disorder and problems: hyperprolactinemia and hyperandrogenism, low amounts of FSH and LH in the first phase of the cycle, hyper- and hypothyroidism. Other possible reasons- strong infectious process in the uterine appendages, biochemically caused pathological changes in the corpus luteum, as well as chronic diseases of cardio-vascular system, kidney and liver. They can also cause autoimmune processes (rheumatism, systemic lupus erythematosus, Hashimoto's disease, amyloidosis, and others).

Causes of the development of corpus luteum insufficiency

The reasons may be as follows:

1. Genetic abnormalities and damage, especially on the X chromosome. It is asymptomatic, but harms the reproductive system of a woman, causes a deficiency of almost all hormones.
2. Ovarian disease, whether it is a cyst, polycystic, ovarian cancer - everything can cause insufficiency.
3. Various pathologies of the pituitary gland, damage as a result of trauma, genetic dysplasia pituitary gland or even oncological processes.

Symptoms of corpus luteum insufficiency are quite different. Sometimes it appears only in violation of menstruation, but it can also develop a strong pain syndrome during menstruation. Such a diagnosis during pregnancy is very dangerous. For the first diagnosis during pregnancy, an ultrasound can be performed, with which you can only determine. The amount of hormones produced can really be known only with the help of an analysis for the amount of progesterone, for this it is necessary to donate blood from a vein.

If a woman has a permanent violation of the cycle, miscarriage, then the diagnostic method is a biopsy of the endometrium on the 26th day of the menstrual cycle. Morphologists examine tissues for the presence of oncological processes, correspondence to the day and period of the menstrual cycle.

Correct test results in the luteal phase of the cycle determine the level of the hormone progesterone in the serum more than 5 ng / ml. If the sum of the amount of progesterone determined three times at different periods of the menstrual cycle is more than 16 ng / ml, then there can be no changes in the corpus luteum.

There may be corpus luteum dysplasia without a lack of hormones. This is a variation of the norm, since it does not affect the female hormonal system and the opportunity to have children. There is no need to start treatment, since in such cases it can only harm a woman, cause hormonal imbalance and bring huge harm reproductive system.

Treatment Methods

Treatment for corpus luteum deficiency is fairly easy. There are several treatment options. If the disease began as a result of another problem in the female genital area, then the first problem is treated and, as a result, the condition of the corpus luteum is stabilized. Use such a drug as Utrozhestan - natural progesterone in capsules of 200 mg. If the deficiency is caused genetic mutation, use vaginal suppositories with progesterone to improve hormonal state women and increase the chance of bearing a fetus.

Very often, for diagnosis, the statement is used basal body temperature. The basal temperature method is morally and technologically outdated, it does not represent particular efficiency and accuracy. Sometimes this method shows as a violation a simple feature female body. For correct diagnosis You need to use ultrasound and analyzes for hormones.

This is what will make it possible to diagnose insufficiency of the corpus luteum in time and correctly cure the pathology. If therapy is started correctly and in a timely manner, then the prognosis will be favorable, possibly full recovery. If the disease is neglected and ignored, it can easily lead to complete infertility, violation of all sexual functions, loss of desire.

Traditional medicine recommends a lot of recipes against cycle disorders. For example, decoction bay leaf. But this recipe not only does not help with such problems, but can also cause great harm. For example, cause bleeding, adversely affect benign tumors, which is very dangerous in polycystic conditions.

There are many bad recipes. These are garlic decoctions, the use of belladonna (belladonna) and other variations on the theme of traditional medicine - all this is very dangerous! Herbs can cause great harm to the body, and important time will be lost. According to statistics, with a timely visit to a doctor, 90% of women with corpus luteum insufficiency achieve a positive outcome. And self-treatment almost never ends positively.

If the cause is oncology, then with timely treatment, there is a very high chance that the disease will be stopped or almost completely cured.

Therefore, the lack of a corpus luteum is not terrible diagnosis, at proper treatment it can be dealt with in a few weeks, and then nothing will interfere with the possibility of becoming pregnant and bearing a healthy child.

One of common causes these complaints is insufficiency of the corpus luteum of the ovary, and, as a result, insufficient production of progesterone in the second (luteal or secretory) phase of the monthly cycle. What is the corpus luteum of the ovary and what does the hormone it produces affect?

The corpus luteum is a non-permanent gland internal secretion, which appears only after ovulation, secretes progesterone and is necessary to maintain pregnancy.

During each menstrual cycle, a group of follicles grows - primary, (roughly speaking, "fluid-containing vesicles") in which eggs mature. At some point, the body (according to an unproven! mechanism) selects that follicle (secondary) that will become dominant and will develop further, attracting more and more hormones it needs for development and, thereby, suppressing the rest of the follicles. Having reached a certain size, under the influence hormonal changes during the cycle (decrease FSH levels- follicle-stimulating hormone of the pituitary gland, estrogen, an increase in the level of LH - luteinizing hormone), the egg is released through a small hole and its further "capture" fallopian tube. In place of the former follicle (tertiary), its wall is destroyed and vessels grow into it, which contribute to the synthesis of the hormones progesterone and estradiol, and the accumulation of lipids and the yellow pigment of lutein - the corpus luteum of the ovary is formed. It is also necessary to stipulate that the follicle, with a lack of hormones, may never burst and the egg will never come out of it - in place of this follicle, later, but a corpus luteum will also form.

What is its further fate and why is it needed? The main and main function of the corpus luteum is to create favorable conditions for implantation of a fertilized egg into the endometrium and preservation of pregnancy for at least 5 weeks (before the formation of the placenta). This is ensured by maintaining the level of progesterone for 12-16 days after ovulation has occurred, which are necessary for the endometrium to become “suitable” for implantation, and in case of fertilization, by its further production in the required amount. Also, it is necessary to mention that the corpus luteum, producing progesterone, suppresses the secretion of FSH by the pituitary gland, therefore, making it impossible for maturation, “exit” (ovulation) and the fertilization of another egg. In the event that fertilization does not occur, the LH level drops and the corpus luteum begins to die. In this regard, the amount of progesterone decreases, the amount of FSH increases again and the cycle starts again.

From the above, it follows that: the corpus luteum is formed only in the second phase of the cycle, it exists in order to secrete progesterone, which ensures the normal course of the cycle and contributes to the onset and maintenance of pregnancy during the first time. In the absence of pregnancy, it dies off and in its place is formed white body. Therefore, under the insufficiency of the corpus luteum is meant the synthesis of progesterone by it in insufficient quantities, which leads to the problems described above.

Causes of corpus luteum insufficiency

What are the causes leading to the pathology of the corpus luteum:

1. Genetic conditioned pathology - as a rule, this is possible with a change in the structure of the X chromosome (abberation).
2. Pathology of the ovaries - characterized by a decrease in the level of all hormones, both the ovary and the pituitary gland, according to the mechanism feedback. Among the main ones are:
polycystic ovary syndrome
Cystic degeneration of ovarian tissue
Oncology
Postoperative and post-medication (iatrogenic) ovarian failure
3. Pathology of the pituitary gland - may be due to:
Oncology
Injuries
genetic defects
In this case, there is insufficient production of hormones characteristic of a particular area of ​​the pituitary gland ( local lesion) or all hormones, indicating a total lesion (less often).
4. Pathology of other systems and organs. These include:
Liver failure
kidney failure
Hyperprolactinemia, hyperandrogenemia, etc.

Symptoms of corpus luteum insufficiency

The clinical picture of corpus luteum insufficiency can be traced from "one to the other". So, the first symptom is a violation of the menstrual cycle, due to the fact that there is no production enough progesterone and, as a result, on the one hand, proliferative changes in the endometrium do not occur, and on the other hand, the cycle lengthens and the mechanisms of the reverse response are violated.

In the event that, despite the foregoing, fertilization occurs, then problems may arise at the stage of implantation of a fertilized egg into the endometrium. First of all, this is due to the unpreparedness of the endometrial layer, its functional immaturity.

The next and probably the most acute problem, if implantation does occur, miscarriage (spontaneous abortion, miscarriage) becomes - the level of progesterone is too low in order to prevent spontaneous contraction of the uterus and the expulsion of the "alien" in fact gestational sac from her cavity.

Examination for corpus luteum insufficiency

What are diagnostic measures contributing to the detection of corpus luteum insufficiency:

1. Measuring the level of basal temperature is an outdated method, which is mainly of historical interest. Determining insufficiency using the basal temperature method is a gross mistake, if only because the temperature level can also be lowered with normal progesterone.
2. Determination of the level of progesterone in the blood serum - take on average on the 16-18th day of the cycle, at intervals of a day or two, for several months - this will eliminate the error and accurately determine the amount of progesterone in the period of interest. Norm:
Progesterone - 1.59 ± 0.3 nmol / l - follicular phase, 4.77 ± 0.8 nmol / l - ovulation, 29.6 ± 5.8 nmol / l - luteal phase.
3. Ultrasound examination - the size of the ovary, its echostructure, the presence or absence of follicles in it, their normal growth, the presence of a corpus luteum, its size. The study is best done in dynamics with one specialist.
4. When permanent violation cycle, miscarriage - endometrial biopsy on the 26th day of the cycle. Look at its correspondence to the day of the cycle, the nature of the tissue.

Treatment of progesterone deficiency

In the presence of established cause and finding out the causes begin with the treatment of the underlying disease. For symptomatic treatment corpus luteum insufficiency use progesterone-containing drugs. These include:

1. Utrozhestan - natural progesterone capsules - 1 (200 mg) capsule 2-3 times a day in the second half of the menstrual cycle.
2. Natural progesterone in ampoules - usually used in hospitals.
3. Duphaston - semi-synthetic progesterone. It is prescribed at a dose of 1 tablet 2 times a day from the 16th day of the menstrual cycle or immediately after ovulation (how to take it is selected for a specific patient, taking into account the length of the cycle and taking other drugs).

These are the main progesterone preparations that are used in the Russian Federation. In addition, there are: vaginal and rectal suppositories with progesterone (prescribed on the 25th day of the cycle), skin creams, etc.

Treatment is necessarily selected for each specific patient, since incorrect and irrational prescribing of drugs can lead to even greater complications and stop ovulation altogether.

It is imperative to monitor the treatment: do an ovulation test, watch the progesterone content in the blood, be observed on an ultrasound scan.

Gynecologist-endocrinologist Kupatadze D.D.

Insufficiency of the corpus luteum is a violation of the function of this hormonal organ formed for a short period, which is formed immediately after ovulation. The main reason for this phenomenon is called the lack of progesterone, which is produced in the second phase. menstrual cycle. To determine the causes of such problems, you should make an appointment with a gynecologist.

The corpus luteum begins to form after ovulation in the second phase of the menstrual cycle. After its formation, the development of vital important hormone- progesterone. If there is a deficiency of “pregnancy” hormones in the body, then the implantation of the fetal egg is much more difficult, which is why a woman cannot become pregnant for a long time. If fertilization does occur, then the embryo experiences a lack of nutrition, which can provoke an abortion.

• Functional reasons

Main functional reasons deficiencies are:

1. genetic predisposition. Caused by changes in the structure of the X chromosome.
2. Malfunction of the ovaries. Manifested through a decrease in the production of all hormones. It may be due to such pathological changes in the ovaries as a cyst, the presence of tumor formations, cystic degeneration of ovarian tissues, ovarian failure in postoperative period recovery.
3. Pathological changes in the pituitary gland. Causes incorrect operation The pituitary gland is often traumatized, malignant tumor formations, and genetic changes.

• Organic causes of deficiency

If a woman has diseases of the reproductive organs or any other system of the body, the reproductive system may be disrupted and even a change in the structure of some of its organs. Diseases that provoke insufficiency of the corpus luteum phase include:

• the formation of adhesions and tissue adhesions in the uterine cavity;
• endometriosis. Growth of uterine tissue beyond its limits;
• adenomyosis. The process of ingrowth of the uterine membrane into its muscle layers;
• myoma. A benign formation located in muscle layers uterus. Can reach a significant size and prevent pregnancy;
• hyperplasia. The process by which ;
• the presence of polyps. Polyps are benign formations. They do not threaten the life of a woman, but can interfere with the work of the ovaries and other organs of the reproductive system;
• oncological diseases. The development of malignant neoplasms;
• the presence of diseases of other organs and systems. Problems with the kidneys and liver often provoke insufficiency.
• Individual reasons malfunction of the corpus luteum

Deficiency is not necessarily the result of any pathological changes in the body. Its development may be due to in the wrong way life and the following factors:

• drastic weight loss. Thoughtless application of any diets that limit the intake of useful and nutrients, negatively affects the work of the reproductive system;
• psychological factor. Work related to constant stress and unrest, conflicts and scandals at home cause ovarian failure;
• change of climate zone. If professional activity women are directly related to constant business trips and flights over long distances, this can prevent her from getting pregnant;
• reception narcotic substances and some drugs. Unfortunately, there are cases when the use of drugs led to malfunctions of the reproductive system;
• physical exercise. Reckless and excessive exercise or physical labor worsen general health women her well-being.

At healthy woman the corpus luteum phase lasts about 14 days. Minor deviations of 1-2 days are allowed, both larger and smaller. To determine the onset of this phase, most often they resort to basal temperature charting. Sometimes a woman uses special ovulation tests. When the luteal phase lasts only 10 days or less, then you should visit a gynecologist, as it is likely that the desired pregnancy does not occur due to insufficiency of the corpus luteum.

A woman should be attentive to her health and at the first sign of any illness, contact a gynecologist. Symptoms of corpus luteum insufficiency include:

• irregular periods;
• too short cycle;
• copious discharge for the entire period of menstruation;
• the presence of large clots in the blood;
• scanty discharge of blood during menstruation, which lasts only three days.

Luteal phase insufficiency may be suspected if a woman has had a miscarriage (especially two miscarriages in a row) in the first trimester of pregnancy. We can talk about a possible insufficiency of the corpus luteum if married couple unsuccessfully trying to conceive a child for a year, but pregnancy does not occur.

How is corpus luteum insufficiency diagnosed?

Many doctors use basal temperature charts to determine luteal phase disorders. This is a rather outdated method, which is absolutely not enough to confirm problems. More reliable is the determination of the level of progesterone in the blood serum. To do this, during several menstrual cycles, a woman takes tests on certain days.

An important step in the diagnosis is an ultrasound examination, which assesses the size of the ovaries, their echostructure, the presence of a corpus luteum and its size. If cases of miscarriage have occurred in the past, an endometrial biopsy is performed.

Making a diagnosis based only on the provided basal temperature data is rough medical error, since in some cases the temperature can be reduced at absolutely normal level progesterone. Therefore, a woman should turn to another specialist.

After confirming the diagnosis, treatment is prescribed, which includes taking progesterone-containing drugs. To avoid side effects, it is recommended to follow the instructions for medicines and do not exceed the dosage prescribed by your doctor.