The persistence of the mature corpus luteum is a cycle of two phases with a good folliculin and a luteal prolonged up to 20-25 days. The second stage is accompanied by excessive production of progesterone. Each time, the corpus luteum, reaching its heyday, passes through persistence. In the endometrium, a prolonged secretory stage is noticed, it grows until bleeding occurs. It resembles a menstrual period, but the endometrium is stratified into separate zones, where edema, red blood cell diapedesis and minor foci of necrosis are found. An integral part of persistence of the corpus luteum is atresia. It represents a decrease in follicle size.
Pathology is expressed by menstrual bleeding lasting 4-6 weeks. Basal temperature does not stop for a long period, its inherent premenstrual decrease is not traced. The level of progesterone secretion is quite high, there is no typical premenstrual decline in progestogens. A huge amount delays the formation of a new follicle, the restoration of the endometrium is slowed down. During the study of scraping of the uterine mucosa, decidual transformations are often detected. The disease gives rise to a suspicion of conception or termination of pregnancy early.
The second phase is normal
Closer to the middle of the monthly cycle, a dominant follicle forms. During ovulation, the egg leaves its place of residence, and luteinization occurs on this site. In simple terms, the follicle is considered the base for the corpus luteum and a natural continuation of the reproductive process. Hormonal cells close it inside, which are present in the cavity after the arrival of ovulation. Directly from these cellular structures, a luteal body is formed, which passes through 3 periods:
- formation;
- functioning;
- regression.
Possible pathologies
Standard functioning is needed to hold pregnancy. When there is no conception, the lack of the corpus luteum is expressed by shortening the duration of the monthly cycle. However, if the lady managed to conceive, then the degree of progesterone in the blood of the future mother is very important for the fetal egg. Testosterone is required to regularly and in the necessary proportions ensure pregnancy retention and the development of the unborn baby. In addition to multifunctional insufficiency, the following varieties of the pathology of persistence of the corpus luteum in the left ovary are likely:
- preservation of the luteal body if there is no pregnancy;
- luteal atheroma.
Each case is a position of the ovary in which endocrine function is violated and the female body is not provided with the necessary reproductive hormones, which is very important for saving the fetal egg after fertilization and the embryo after menstruation is delayed.
The signs of each type of pathology mark the course of menstruation. Girls with multifunctional insufficiency do not have pain, and the main criterion is difficulties with the onset of pregnancy.
Functional impairment
A lack of progesterone affects the possibility of conception and the duration of the monthly cycle. Signs will largely depend on whether the pregnancy has arrived or is absent. In the first case, the main criterion is the delay of menstruation. The girl does 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 pregravid preparation stage, it is possible to predict this pathology option in advance and help to save the vital activity of the ovum in time.
Pregnancy May Not Come
In this case, a low level of progesterone can be a factor for shortening the cycle and the occurrence of hormonal imbalance. If the testosterone of the luteal phase is in a regular deficiency, then the following diseases may appear:
- uterine fibroids;
- advanced endometriosis;
- untreated endometrial hyperplasia;
- polyp of the uterus or cervical canal;
- ovarian cysts.
How to recognize
With a lack of a luteal body, the following symptoms appear:
- a woman cannot become pregnant;
- miscarriages in the early stages;
- persistent malfunctions in the menstrual cycle.
With the persistence of the corpus luteum in the right ovary, pain does not occur, menstruation is normal, but there are difficulties with conceiving and carrying a future 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 the follicle arose, when ovulation occurred and what are the volumes of the corpus luteum. Such an examination will evaluate 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 an aspirate or biopsy. Histology will demonstrate that the endometrium is not ready for embryo retention. In this case, the optimal type of cure is the drug "Dufaston" according to the scheme proposed by the doctor.
Luteal body preservation
If the girl has a delay and a test with two bands - this is good, but there may be a situation when he 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. Nothing hurts, the test does not show, there is no fetal egg in the uterus on ultrasound, and the endometrium does not stop increasing. It is possible to wait for the following symptoms:
- lengthening of a monthly cycle;
- uterine bleeding.
An unpleasant feature of this situation is the lack of normal functioning in the ovary: the dominant follicle does not form, which is made a factor of infertility. On ultrasound, the doctor will identify in the ovary a formation that is a preserved corpus luteum. If you give an assessment of the condition of the endometrium, the result of histology will demonstrate excessive restructuring of the uterine mucosa.
Against the background of persistence, the drug "Dufaston" should not be used: the doctor will prescribe special therapy to resume the hormonal function of the ovary. Probably, in the future it will be necessary to again assess the condition of the endometrium using histology.
Luteal body cyst
In most cases, fluid may accumulate from within the cystic cavity where the follicle was located. In this case, a cyst of the luteal body appears with a pathology of hormonal function: in the lady’s blood, the level of progesterone will decrease. An unpleasant complication is also not uncommon. This is a rupture of a cyst of the corpus luteum. With it, the lower abdomen will hurt and there will be a violation of the monthly cycle.
On ultrasound, the doctor will notice a cystic formation, the hormone progesterone will be lowered, the test for ovulation will be positive, and menstruation will arrive ahead of time. Therapy involves taking pills, the doctor will prescribe the drug "Dufaston" or "Utrozhestan" to strengthen the second phase and the possibility of the desired conception.
If a break occurs, surgery may be necessary: excessive pain and internal bleeding will not give the doctor a choice.
During the period of surgical intervention, it is necessary to suture the wound on the organ and take a biopsy analysis. The histology result will demonstrate what type of cyst was. After that, an ultrasound scan will be needed for monitoring.
How to regulate the hormone?
The first criterion for pathology is a hormone less than normal. To resume the second phase, the doctor will prescribe the drug "Dufaston" according to the proposed scheme. Therapy can be time-consuming. For the purpose of optimal control, it will be necessary to perform:
- Ultrasound
- ovulation test;
- blood testosterone test.
The drug "Dufaston" is used at the stage of preparation for conception or when the first criterion for pregnancy arose - a delay in the menstrual cycle. The lady needs to do an analysis and, having seen that there is a pregnancy, start using the Dufaston medication in the dose indicated by the doctor. This is especially important when there are facts of miscarriage already in the past or if, after the procedure, the histological result showed the absence of a luteal body.
If there is any kind of pathology of the corpus luteum, then it is impossible to delay the diagnosis and cure. It is preferable to complete everything necessary for the purpose of pregnancy.
Seeing the coveted 2-lane test, the woman will be delighted, but this fact becomes the start of a long journey with obstacles. It is more correct to take pills for the intended purpose than not to reach the final goal.
Treatment of ovarian corpus luteum persistence
Having established a similar pathology, they prescribe a course of therapy where hormones are introduced. It is necessary to use those pharmaceutical substances that are able to inhibit the work of estrogen. As a rule, they are necessary from 5 to 9 days of the cycle for many months.
Injections are very common. For example, it is progesterone, pregin or other drugs. Injections are performed 9 days before the date when menstruation is most likely to occur, the course continues from 5 up to 7 days.
Additional methods
In addition to drug treatment, they also use:
- massage;
- laser therapy;
- ultrasound;
- the use of electrical stimulation.
Treatment must be carried out under the supervision of a doctor so that he has the ability to control the excretion of hormones. It is possible to find out about it from studies of functional diagnostics.
The cure of the disease begins with the operation of curettage of the mucosa. When it is localized in the left ovary and produces a hormone, the conclusion is made - the persistence of the corpus luteum. In simpler words, the tone of the uterus is reduced, the uterine cover is separated. For this reason, plentiful periods begin and last a long time. It is necessary to check in this case the condition of the ovary.