Many women try to get pregnant for years, and when they can’t, a long and exhausting marathon of tests begins. However, a problem that receives very little attention is LUF. Do you know what it means? LUF (luteinized unruptured follicle syndrome)1 can be a silent issue that greatly hinders those trying to conceive. But how do you know if you have this syndrome?
Let’s first understand LUF better. The ovaries start working when a woman menstruates. The body tells the brain that menstruation has occurred, and the brain in turn stimulates the pituitary gland to produce FSH2. FSH then communicates with the ovaries, initiating the process of egg maturation. The eggs begin to grow, and estrogen comes into play to support this growth as well as the endometrium. At the end of follicular growth, LH is released and then triggers the release of the egg, or eggs, if more than one reaches the appropriate stage for fertilization. In women with LUF, the problem occurs precisely at this moment — the follicle does not rupture.
Even without rupturing, the process of luteinization of the “corpus luteum” begins. The corpus luteum should only form after the egg is released, but women with LUF experience all the symptoms of post-ovulation except for ovulation itself, and without ovulation, pregnancy cannot occur. The cells that were to become the egg begin to stimulate progesterone secretion, so hormone levels after the fertile window appear absolutely normal to doctors. There is no specific cause identified for this lack of rupture. It’s speculated that LH deficiency or a tougher membrane surrounding the egg could be involved, but no exact cause for LUF is known.
How to Diagnose and Treat LUF?
The problem arises when a couple wants to get pregnant and by various methods it’s clear their health is fine. Pregnancy does not happen and hormone levels are all within the normal range. So how do you detect LUF? Only through ultrasound.
Through ultrasound, unruptured and also secretory follicles can be visualized, but to diagnose the syndrome, the woman needs to repeat the test in other cycles for confirmation. If confirmed, LUF does have treatment, so don’t worry. All you need is cycle monitoring with serial ultrasound. It’s known that the follicle has ruptured when the size of the follicular cyst decreases drastically; we can say it ‘shrivels.’
It is not necessary to induce ovulation; simply monitoring the follicle’s growth — and then when it reaches the ideal size, medication can be given to help it rupture. Some doctors recommend going directly to insemination or IVF, but there are reports of women with LUF who became pregnant with this simple procedure using Ovidrel or Choriomon. However, professionals experienced with this issue say that the most effective way to achieve pregnancy more quickly is ICSI or IVF.
LUF is a form of anovulation, but it’s more difficult to diagnose because the menstrual cycle is normal, with no delays and with all the signs of ovulation. The mucus secreted during the fertile period appears, and even all the ovulation pains can be present. But the most important detail of this period does not occur: ovulation itself. Have you been trying to get pregnant for a long time and nothing happens? Then ask your doctor for all the hormone and ultrasound tests. Normally, a healthy and fertile couple will conceive within a year. If pregnancy doesn’t happen within this timeframe, it’s suggested the couple undergo more detailed tests and a deeper investigation.
See also: Anovulatory Cycle – What It Is and What Are the Symptoms
Photo: Adrian Wiggins
