Corpus Luteum Defect and Recurrent Miscarriage
Luteal phase defect, also known as corpus luteum defect, results in low levels of progesterone. So, what is the function of progesterone and why does a lack of it cause miscarriages?
The progesterone is also termed as “pregnancy hormones” as it plays a crucial role in maintaining a pregnancy. Having sufficient progesterone levels is very important in the first three months as it supports implantation and maintains a hospitable environment for the embryo to develop. Hence, low progesterone levels will lead to first trimester miscarriage, and eventually recurrent miscarriage if the condition is left untreated.
Antai hospital ensures that a patient with corpus luteum defect can maintain a healthy pregnancy by supplementing an accurate amount of progesterone a patient need.
Complications of Corpus Luteum Defect – Reproductive Immunity Disorder
Low progesterone level caused by corpus luteum defect makes it highly possible for a first trimester miscarriage to occur.
Usually, clearing of the womb is required after a miscarriage to ensure no attachments remain inside the uterus and there is a high possibility for patients to form anti-fetal antibodies (reproductive immunity disorder) in the process which will cause miscarriages in subsequent pregnancies as the antibodies attack the fetus.
Dr Chen Fenglin, Antai hospital’s director found that having a reproductive immunity disorder is a very real problem that accounts for 70 percent of unexplained recurrent early miscarriages. However, it is often overlooked by gynaecologists.
Causes of Corpus Luteum Defect
First, we need to understand the process behind the formation of Corpus Luteum:
- We have ovarian follicles in our ovaries which houses egg cells.
- During ovulation, the ovarian follicle ruptures and releases a mature egg that is ready for fertilization.
- Following the release of the mature egg, the corpus luteum will start to form during the luteal phase of our menstrual period (1 day after ovulation).
- The corpus luteum produces relatively high levels of progesterone.
To have normal corpus luteum formation, it requires the body to ovulate normally and release mature egg.
Hence, medical conditions that can disrupt the process of corpus luteum formation involves the inability to release mature eggs. Examples of such conditions include:
- Low Ovarian Function. With low ovarian function, the eggs will be released before maturing.
- Polycystic Ovary Syndrome (PCOS). People with PCOS have abnormal hormone levels that disrupts the follicles from growing and release matured eggs. The immature eggs in the follicles affect the formation of corpus luteum and production of progesterone.
- Endometriosis. If the endometrial tissues grow in the ovaries, it may interfere with ovulation, thus affecting the release of mature eggs. Endometriosis can also form scar tissues in the ovaries or the fallopian tube which will affect the quality of eggs and inhibit its maturation.
Medical History
Patients with low ovarian function, polycystic ovary syndrome, or endometriosis are at risk of having corpus luteum defect and should check for their progesterone level.
Due to low progesterone level, patients with corpus luteum defect might also suffer from recurrent miscarriage or infertility.
Symptoms of Corpus Luteum Defect
The symptoms are not a one size fits all there are several conditions that can led to corpus luteum defect and each condition has its own symptoms.
Here are some of the more common symptoms of corpus luteum defect for each condition mentioned above:
- Menopausal symptoms. This is more applicable to people with low ovarian function, or primary ovarian insufficiency. The symptoms include experiencing hot flashes, night sweats, and mood swings.
- Menstrual abnormalities. This is more applicable for people with endometriosis. The symptoms include extreme period pain that worsens with each month. The pain starts as the period is approaching and intensifies after the bleeding starts. Patients might also suffer from oligomenorrhea where they have infrequent menstrual periods.
- Obesity, Acne and Coarse Body Hair. This is more applicable for people with PCOS.
Diagnosis of Corpus Luteum Defect
The most effective method of diagnosis is through blood tests. Imaging studies can only reveal that you might have a health condition linked to corpus luteum defect (e.g., endometriosis, PCOS, etc.), but it does not confirm that you have corpus luteum defect.
The following are the relevant blood tests:
- Follicle-stimulating hormone (FSH). Patients with corpus luteum defect will have elevated levels of FSH.
- Estrogen. Patients with corpus luteum defects will have low levels of estrogen.
- Progesterone. Patients with corpus luteum defect will have low levels of progesterone.
Treatment
The most troubling problem with corpus luteum defect is the inability to produce sufficient progesterone to maintain a pregnancy. Hence, the most suitable treatment method is to supplement the level of progesterone.
If you only realise you have low level of progesterone after pregnancy and is at a risk of miscarriage, the progesterone should be supplemented immediately. If you realise that you have low level of progesterone before pregnancy, the progesterone will be supplemented after you ovulate. Of course, it is much safer to start the treatment before pregnancy to prevent a threatened miscarriage.
Progesterone can be supplemented through:
- Pills
- Injections
- Suppositories.
Antai hospital supplements progesterone through injections as it has the quickest absorption rate, and it is the most accurate way to ensure that the desired level of progesterone is administered into the body.
Antai hospital will measure your level of progesterone and prescribe an amount of progesterone supplement according to how much your body is lacking. The progesterone injection should be done daily, and the amount administered will gradually decrease until the third month of pregnancy. Usually by the third month of pregnancy, the placenta would have been fully developed and take charge of maintaining the pregnancy instead of the progesterone. Hence, treatment to increase the level of progesterone is no longer required after the third month of pregnancy.
Antai hospital treats luteal phase defects with a contractual full refund policy for unsuccessful treatment. Click Here to find out more.