Persistence of a mature corpus luteum - a cycle of two phases with a good folliculin phase and a long luteal phase up to 20-25 days. The second stage is accompanied by excessive production of progesterone. Each time, the corpus luteum, having reached its heyday, goes through persistence. In the endometrium, a long secretory stage is noticed, it grows up to the occurrence of bleeding. It resembles menstruation, but at the same time, the endometrium is stratified in separate zones, edema, diapedesis of erythrocytes and minor foci of necrosis are found there. Inherent in the persistence of the corpus luteum is atresia. It represents a reduction in the size of the follicle.
Pathology is expressed by menstrual-like bleeding lasting 4-6 weeks. The basal temperature does not stop for a long period, its characteristic premenstrual decrease is not traced. The level of secretion of progesterone is quite high, there is no typical premenstrual decline in gestagens. A huge amount delays the formation of a new follicle, the restoration of the endometrium is slowed down. Inwhile studying the scraping of the uterine mucosa, decidual transformations are often detected. The disease gives rise to a suspicion of conception or early termination of pregnancy.
Second phase normal
Toward the middle of the monthly cycle, the dominant follicle is formed. During the period of ovulation, the egg leaves its place of residence, and in this area the luteinization procedure begins. Simply put, the follicle is considered the base for the corpus luteum and a natural continuation of the reproductive process. From the inside, it is closed by hormonal cells that are present in the cavity after the arrival of ovulation. The luteal body is formed directly from these cell structures, which goes through 3 periods:
- formation;
- operation;
- regression.
Possible pathologies
Standard functioning is needed to keep the pregnancy going. When there is no conception, then the lack of a corpus luteum is expressed by a shortening of the duration of the monthly cycle. However, if the lady managed to conceive, then the degree of progesterone in the blood of the expectant mother is very important for the fetal egg. Testosterone is required to regularly and in the required proportions to ensure the retention of pregnancy and the development of the unborn baby. In addition to multifunctional insufficiency, the following varieties of the pathology of the persistence of the corpus luteum in the left ovary are likely:
- preservation of the luteal body if there is no pregnancy;
- luteal atheroma.
Everyonecase - this is the position of the ovary, in which the endocrine function is disturbed and there is no supply of the female body with the necessary reproductive hormones, which is very important for saving the ovum after fertilization and the embryo after the delay of menstruation.
Signs of each type of pathology leave a mark on the course of menstruation. In girls with multifunctional insufficiency, nothing hurts, and the main criterion is the difficulty with the onset of pregnancy.
Functional deficiency
Lack of progesterone affects the chances of conception and the duration of the monthly cycle. Signs will largely depend on whether pregnancy has come or not. In the first case, the main criterion is the delay in menstruation. The girl takes the test and, seeing a favorable result, is content with the impending conception.
However, directly during this period, the activity of the corpus luteum is very significant: when there is no corresponding amount of progesterone, then the drug "Dufaston" should be used. At the stage of pregravid preparation, it is possible to predict this variant of the pathology in advance and help save the vital activity of the fetal egg in time.
Pregnancy may not come
In this case, low progesterone levels can be a factor in shortening the cycle and causing hormonal imbalance. If luteal phase testosterone is regularly deficient, then subsequent diseases may appear:
- uterine fibroids;
- launchedendometriosis;
- untreated endometrial hyperplasia;
- polyp of the uterus or cervical canal;
- ovarian cysts.
How to recognize?
When there is a shortage of the luteal body, the following symptoms appear:
- women can't get pregnant;
- early miscarriages;
- constant failures in the menstrual cycle.
When the corpus luteum persists in the right ovary, there is no pain, menstruation is normal, but there are difficulties with conceiving and bearing the unborn baby in the early stages. The best type of diagnosis is ultrasound.
Using this method, it is possible to assess the stages of folliculogenesis: how did the follicle arise, when did ovulation occur and what are the volumes of the corpus luteum. Such an examination will assess the density of the endometrium, then it is possible to talk about progesterone deficiency.
In some cases, there is a need to assess the condition of the endometrium with the assistance of aspirate or biopsy. Histology will demonstrate the unpreparedness of the endometrium to hold the embryo. In this case, the optimal type of cure is the drug "Dufaston" according to the scheme proposed by the doctor.
Preservation of the luteal body
If a girl has a delay and a test with two bands is good, but there may be a situation when it is negative. The probable cause of this phenomenon is the persistence of the corpus luteum. In this case, the hormone progesterone does not stop forming, lengthening the second phase. Absolutely nothing hurts, the test does not show, on ultrasoundthere is no fertilized egg in the uterus, and the endometrium does not stop growing. Possibly wait for further signs:
- lengthening the monthly cycle;
- uterine bleeding.
An unpleasant feature of this situation is the lack of normal functioning in the ovary: the dominant follicle is not formed, which becomes a factor in infertility. On an ultrasound, the doctor will reveal a formation in the ovary, which is a preserved corpus luteum. If you evaluate the state of the endometrium, then the result of histology will demonstrate an excessive restructuring of the uterine mucosa.
Against the background of persistence, you should not use the drug "Dufaston": the doctor will prescribe a special therapy to restore the hormonal function of the ovary. Probably, in the future, it will be necessary to re-evaluate the condition of the endometrium using histology.
Luteal body cyst
In most cases, there may be an accumulation of fluid from inside the cystic cavity, located where the follicle was. In this case, a luteal body cyst appears with a pathology of hormonal function: in the blood of a lady, the level of progesterone will decrease. An unpleasant complication is also common. This is a ruptured cyst of the corpus luteum. With it, the lower abdomen will hurt and a violation of the monthly cycle will appear.
On an ultrasound, the doctor will notice a cystic formation, the hormone progesterone will be lowered, the ovulation test will be positive, and menstruation will arrive ahead of time. Therapy involves taking pills, the doctor will prescribe the drug "Duphaston" or "Utrozhestan" forstrengthening the second phase and the possibility of the desired conception.
If a rupture occurs, surgery may be needed: excessive pain and internal bleeding will not give the doctor a choice.
During the period of surgical intervention, it is necessary to sew up a wound on the organ and take an analysis for a biopsy. The histology result will demonstrate what type of cyst it was. After that, you will need an ultrasound for control.
How to regulate the hormone?
The first criterion for pathology is that the hormone is less than normal. To resume the second phase, the doctor will prescribe the Duphaston medication according to the proposed scheme. Therapy can be long in time. For optimal control it will be necessary to do:
- ultrasound;
- ovulation test;
- testosterone test in the blood.
The drug "Duphaston" is used at the stage of preparation for conception or when the first criterion of pregnancy arose - a delay in the menstrual cycle. The lady needs to do an analysis and, seeing that there is a pregnancy, start using the Duphaston medication at the dose shown by the doctor. This is especially important when there are already facts of miscarriage in the past or if after the procedure the histology result showed the absence of the luteal body.
If there is any kind of pathology of the corpus luteum, then it is impossible to delay the diagnosis and treatment. It is preferable to do everything necessary for the purpose of pregnancy.
Seeing the coveted test with 2 stripes, the woman will be delighted, but thisthe fact becomes the start of a long journey with obstacles. It is better to take pills for their intended purpose than to never reach the final goal.
Treatment of ovarian corpus luteum persistence
Having established such a pathology, a course of therapy is prescribed, where hormones are introduced. It is necessary to use those pharmaceutical substances that will be able to inhibit the work of estrogens. As a rule, they are needed from days 5 to 9 of the cycle for many months.
Very often do injections. For example, it is progesterone, pregin or other drugs. Injections are made 9 days before the date when menstruation is most likely to occur, the course continues from 5 to 7 days.
Additional methods
In addition to drug treatment, also used:
- massage;
- laser therapy;
- ultrasound;
- applying electrical stimulation.
Treatment must take place under the supervision of a doctor so that he can control the excretion of hormones. It is possible to find out about it from studies of functional diagnostics.
Cure of the disease begins with the operation of scraping the mucosa. When it is localized in the left ovary and produces a hormone, a conclusion is made - the persistence of the corpus luteum. In simpler words, the tone of the uterus is reduced, the separation of the uterine lining occurs. For this reason, abundant periods begin and last for a long time. In this case, it is also necessary to check the condition of the ovary.
