Patient's question:
Not having a menstrual period, took progesterone for three days and it came. After a month, it didn't come again. Onset of symptoms: Results of laboratory tests:Doctor's answer:
What are the factors or causes of luteal phase defect? Research has found that the following factors or causes can lead to luteal phase defect in women:1. Insufficient secretion of FSH during the follicular phase, with low levels of FSH and estradiol in follicular fluid.
2. Inadequate LH peak during ovulation.
3. Insufficient secretion of LH during the luteal phase or insufficient pulsatile secretion of LH.
4. Abnormal steroid hormone receptors in endometrial cells, leading to low responsiveness to hormones secreted by the corpus luteum. Even if the luteal function is normal, the endometrium may develop improperly.
How is luteal phase defect diagnosed?
1. Basal body temperature is the simplest and most commonly used method to evaluate luteal function. The progesterone secreted by the corpus luteum acts on the hypothalamic temperature center to form a high-temperature phase. The progesterone concentration required to raise body temperature is above 2.5 g/ml. The difference between the high-temperature phase and the low-temperature phase should be more than 0.3°C. If the high-temperature phase lasts less than 10 days, the high-temperature phase rises slowly, or there is a dip in the middle of the high-temperature phase, it may indicate luteal dysfunction.
2. Serum progesterone concentration. The measurement of serum progesterone concentration is an important indicator for judging luteal function. A concentration above 5 g/ml indicates ovulation, and a concentration above 10 g/ml during the mid-luteal phase indicates normal luteal function. A concentration below 10 g/ml can diagnose luteal phase defect.
3. Endometrial tissue. The collection time for endometrial tissue is often recommended during the mid-luteal phase, specifically on the 7th day of the high-temperature phase, which coincides with the time of blastocyst implantation. Some also suggest collecting tissue during the late luteal phase, on the 11th to 13th day of the high-temperature phase. During the mid-luteal phase, the focus is on observing changes in glandular epithelium, while during the late luteal phase, the focus is on stromal cells. If the endometrial tissue appearance differs from the basal body temperature by more than 2 days, it can diagnose luteal phase defect.
If a woman experiences luteal phase defect, she should promptly seek scientific and effective examination and treatment at a relevant gynecological hospital to prevent the condition from worsening and affecting her health.