‘It is a syndrome defined as a failure of Ovulation to occur’

Emobileclinic Trending Issue: Luteinizing unrupture follicle syndrome.

Luteinizing unrupture follicle (LUF) syndrome is defined as a failure of ovulation which, despite the absence of follicular rupture and release of the oocytes the unruptured follicle undergoes luteinization under the action of luteinizing hormone. This form of anovulation is considered a subtle cause of female infertility.

LUF is seen in 10% of menstrual cycles of normal fertile women. A higher incidence has been reported in infertile women. The occurrence of LUF has been linked to many conditions such as unexplained infertility, endometriosis, pelvic adhesions and the use of NSAIDs. LUF has been demonstrated in both spontaneous and stimulated cycles.

Diagnosis of the syndrome can be made by laparoscopic inspection of the ovaries and by the assay of 17 B-oestradiol and progesterone in peritoneal fluid between day 14 & 20 of the cycle. However, ultrasonography has been demonstrated to be the method of choice for diagnosis of LUF.
The precise mechanism by which the ovulatory follicle fails to rupture is unclear. It has been postulated that LUF is a consequence of chronic follicular inflammatory-like reaction involving inhibition of synthesis of prostaglandins. Others postulated that the aberrant prolactin release and luteal phase defect might be contributory factors in the pathophysiology of this syndrome.

More recently, there is a suggestion that a primary granulosa cell defect might be the responsible mechanism for this syndrome.

Studies have also shown that the incidence and recurrence rates of LUF syndrome are increased significantly in consecutive cycles stimulated with clomiphene citrate and possible implication of clomiphene citrate in the aetiology of the syndrome exists. Other option in infertility treatment is therefore recommended in such cases.

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