Lutealphaseninsuffizienz

Schwächelt der Gelbkörper wirklich?

Luteal insufficiency

All about weakness of the ovary?

Zusammenfassung

Die Corpus-luteum-Insuffizienz ist eine heterogene endokrine Störung, die durch eine verkürzte Lutealphase (<12 Tage), erniedrigte Progesteronwerte in der 2. Zyklushälfte bzw. eine inadäquate endometriale Differenzierung definiert ist. Die Prävalenz der lutealen Insuffizienz bei unselektierten Sterilitätspatienten wird auf 13,5% geschätzt. Zur Diagnose wird heute die 2- bis 3-malige Bestimmung von Progesteron in der Mitte der Lutealphase als ausreichend erachtet. Die Therapie erfolgt ursachenabhängig: Eine zugrunde liegende Hyperprolaktinämie oder Schilddrüsenfunktionsstörung sollte primär ausgeglichen werden. Liegt eine inadäquate Follikulogenese mit ungewöhnlich kurzen oder langen Follikelreifungsphasen der lutealen Insuffizienz zugrunde, kann eine Clomifenstimulation als Therapie der ersten Wahl erfolgen. Aber auch die luteale Progesteronsupplementation erfährt derzeit eine Renaissance.

Abstract

Corpus luteum insufficiency belongs to the heterogeneous endocrine disorders characterized by shortened luteal phases (<12 days), decreased progestogen levels in the second half of the menstrual cycle as well as inadequate endometrial differentiation. The prevalence is up to 13.5% in patients with infertility disorders. Replicated low progestogen levels in the luteal phase of the menstrual cycle are mandatory for diagnosis. However, in cases of hyperprolactinaemia or thyroid disorders treatment should focus on adjustment of endocrine dysfunction. Luteal insufficiency due to disturbed follicular genesis with shortened or elongated follicular growing periods can be treated with clomiphene. Recent studies also indicate a benefit of progestogen supplementation in the luteal phase.

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Toth, B., Rösner, S., Thöne, C. et al. Lutealphaseninsuffizienz. Gynäkologische Endokrinologie 8, 105–111 (2010). https://doi.org/10.1007/s10304-009-0341-6

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Schlüsselwörter

  • Corpus luteum
  • Progesteron
  • Lutealphase
  • Lutealphaseninsuffizienz
  • Luteale Insuffizienz

Keywords

  • Corpus luteum
  • Progestogen
  • Luteal phase
  • Luteal phase insufficiency
  • Luteal insufficiency