Patient's question:
I have always wanted to have children!!!!!! My period hasn't come for 70 days. After consulting with a doctor, I was given five shots of progesterone. A week later, my period arrived. Is this delay caused by luteal phase deficiency? Should I just wait and see, or take measures to further stabilize my menstrual cycle? Is Traditional Chinese Medicine better, or Western hormone medication?？？Thank you!!!!!!!Doctor's answer:
Luteal phase defect refers to menstrual disorders, early miscarriage, infertility, and other symptoms caused by insufficient progesterone secretion from the ovary's corpus luteum. The etiology of luteal phase defect is not yet fully clear. It may be due to an imbalance in the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), leading to poor follicular development and corpus luteum formation defects, resulting in insufficient progesterone secretion after ovulation. Endometriosis, increased prostaglandin release after miscarriage, and the improper use of clomiphene citrate and progesterone drugs can also affect luteal function. Additionally, hyperprolactinemia often coexists with luteal phase defect.The diagnosis of luteal phase defect can be based on basal body temperature, blood progesterone levels, and endometrial biopsy. Patients with this condition exhibit a biphasic basal body temperature pattern, but the rise and fall are slow, with an increase of less than 0.3°C and a duration of only 9-10 days, sometimes with an extended follicular phase. On the 8th day of the temperature rise, blood progesterone levels are below 10 ng/mL. Historically, endometrial biopsy on days 21-22 of the menstrual cycle, with an endometrial phase delayed by more than 2 days compared to normal, was used as a diagnostic criterion. However, it has been found that some clinically diagnosed patients with luteal phase defect actually have unruptured follicle syndrome upon laparoscopic examination. Therefore, the definitive diagnosis of this condition requires the combination of ultrasound and laparoscopic imaging.
The most common treatment for luteal phase defect is to supplement the body's progesterone deficiency. This is typically achieved through intramuscular injections of progesterone or oral administration of medroxyprogesterone acetate. Human chorionic gonadotropin (HCG) can also be used to promote luteal function.