Saadat Aliya, Shagufta Saeed, Mariam Malik, Fouzia Nazir, Huma Aziz, Saad Rana.
Endocrinology of patients with Luteinized Unruptured Follicle Syndrome.
Pak J Obstet Gynaecol Jan ;12(1,2):72-7.

The incidence of luteinized unruptured follicle (LUF) syndrome was evaluated in relation to the endocrine profile in women with fertility deprivation. A total of 253 women of 22-42 years of age attending the Women Clinic and Fertility Advisory Center for the diagnosis and management of fertility disorders were included in this study. Ultrasonographical scans were performed transvaginally at follicular, preovulatory and luteal phases of the cycle. A total of 5-7 blood samples / cycle were taken at the time of each scan for the measurements of serum LH, FSH, E2 (estradiol), P (progesterone) and PRL (prolactin). Of the 253 cycles studied, 13 (5%) patients had luteinized unruptured follicle syndrome. Follicular growth does not appear to be altered in these cycles, however after the LH peak, the follicle instead of rupturing demonstrates an accelerated growth pattern reaching a maximum diameter of 18-35 mm. Of the 13 patients, serum hormone profile of 3 (23%) patients was normal, whereas, 10 (77%) patients had subtle hormonal disturbances (subnormal hormone profile) during the menstural cycle. These subtle hormonal disturbances included inadequate mid-cycle gonadotropin surge, low follicular phase estradiol levels, insufficient levels of mid-luteal serum progesterone and slightly higher concentrations of serum prolactin. The results of the present study suggest that defect causing LUF may be in the ovarian tissue probably related to deficiency in enzymes involved in the ovum release and/or hormonal changes during the follicular phase. Verification of this hypothesis needs detailed analysis of plasma hormone profile during follicular phase in presumed LUF cycles.

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