| Chatper oneLuteinized unruptured follicle syndrome (LUFS) is a special type of anovulatory menstruation. It affects 5-10% women in reproductive age. Its performance is ovarian anovulation, though the follicle cells become luteinized, and thus cause infertility. The diagnosis is based on absence of ovulation holes on ovarian surface 4-7days after ovulation with laparoscopic or B ultrasonic show that follicles continue to grow bigger two days after LH peak appeared. The specific mechanism of LUFS is still unknown. It is probably caused by endocrine abnormalities and mechanical stimulation. The former is perhaps related with abnormality in hormone control of ovarian cycle or various factors in ovary. Gonadotropin especially LH, play an important role in ovulation which boost the dominant follicle mature in the end and its function. LUFS occurred irregularly. Because of its unpredictability, when it is diagnosed the follicle cells had already became luteinized. Therefore the treatment for the patients can't achieve the desired effect. How to interfere this process to prevent and treat it effectively is a challenges in reproductive endocrine.Objective: To investigate pathogenesis, prevention and timely treatment of LUFS, we detected the serum sex hormone, follicular phase/Menstrual cycle, treatment cycle,PCOand so on.Methods: The clinical data of 107 LUFS in natural cycle were collected as experimental group, whereas those of 93 normal ovulated women as control. Serum sex hormone in menstrual period and LUFS-day/ ovulation day by chemiluminescence, the time of follicular phase was observed by B-ultrasond. And record the number of follicles and the treatment cycle to analyze pathogenesis of LUFS, its prevention and treatment strategies.Result: 1 Mean LH in the LUFS group was significantly lower than that in the normal group on LUFS day. P in LUFS group was significantly higher than in normal group. There is no significant difference in the level of E2 between two groups on LUFS day. 2 Follicular phase in the LUFS group was significantly longer than that in the normal group. 3 The mean diameter of follicular on the LUFS day has increased 4.96mm when compare with the day before. 4 The number of PCO patients in LUFS group was significantly much more than that in the normal group.Conclusion: The occurrence of LUFS was associated with low LH level in natural cycle. Follicular phase of LUFS in natural cycle was relatively extended, so luteal phase in LUFS may be shorter than normal group. PCO in LUFS group was signifieantly more than in normal group.Chatper twoIGF is a single-chain polypeptide with molecular weight as about 7000 and its structure is similar to the insulin precursor. Many researches showed that IGF-1 and IGF-2 was produced by granulosa cells and theca cell through local autocrine and paracrine manners. The two factors independent or cooperative with gonadotropin choose excellent follicle, regulate the development of follicle, ovulation and the follicular atresia. Animal studies showed that IGF-1 in follicular fluid of LUFS group was significantly lower than that in the normal ovulation. The correlation between IGF-1 and LUFS was only reported in animals, because the LUFS's follicular fluid was very difficult to collect. So there are no direct studies on relationship between IGF-1 and LUFS in human being.Objective: To investigate the association between IGF-1 level in follicular fluid and LUFS.Methods: ELISA was used to detect IGF-1 in follicular fluid in the experimental group (9 LUFS patients) and control group(10 IVF-ET ).Comparisons were conducted in content of IGF-1 between LUFS patients and control group.Results: IGF-1 in follicular fluid in the LUFS group was significantly lower than in the control group.Conclusion: IGF-1 level may play an important role in ovulation. The low level IGF-1 in follicular fluid may lead to LUFS. This study had provided experimental evidence for the further confirmation of the relationship between IGF-1 and LUFS. |
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