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Erschienen in: Gynäkologische Endokrinologie 3/2008

01.09.2008 | Leitthema

Corpus-luteum-Insuffizienz

Definition und Bedeutung

verfasst von: PD Dr. A. Schultze-Mosgau, S. von Otte, M. Thill, K. Diedrich, G. Griesinger

Erschienen in: Gynäkologische Endokrinologie | Ausgabe 3/2008

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Zusammenfassung

Obwohl die Diagnose eines Lutealphasendefekts (LPD) überzeugend im Forschungsrahmen beschrieben wurde, bleibt er eine kontroverse klinische Entität. In der klinischen Praxis wurde der Versuch unternommen, die Diagnose des LPD mit verschiedenen Methoden zu sichern – BBT-Kurven, Progesteronmessungen und Endometriumbiopsien als direkte und indirekte Methoden. Diese Methoden sind allesamt retrospektiv, die Interpretation der endometrialen Histologie – selbst mit den kürzlich vorgeschlagenen molekularen Markern – ist nicht befriedigend. Deshalb existiert keine verlässliche Methode für die Diagnose eines LPD. Wird ein LPD gefunden, sind viele Ärzte geneigt, diesen als Ursache der Infertilität oder wiederholter Aborte anzusehen, obwohl es keinen überzeugenden wissenschaftlichen Beweis gibt, diese Assoziationen zu unterstützen. Tritt der LPD konsekutiv oder sporadisch auf? Diese Frage verkompliziert die Diskussionen über die Diagnosestellung und Behandlung des LPD. Für das Management eines LPD ist keine spezifische Therapie vorgesehen.
Literatur
1.
Zurück zum Zitat Adashi EY (1990) The potential relevance of cytokines to ovarian physiology: the emerging role of resident ovarian cells of the white blood cell series. Endocr Rev 11: 454–464PubMed Adashi EY (1990) The potential relevance of cytokines to ovarian physiology: the emerging role of resident ovarian cells of the white blood cell series. Endocr Rev 11: 454–464PubMed
2.
Zurück zum Zitat Annos T, Thompson IE, Taymor ML (1980) Luteal phase deficiency and infertility: difficulties encountered in diagnosis and treatment. Obstet Gynecol 55: 705–710PubMed Annos T, Thompson IE, Taymor ML (1980) Luteal phase deficiency and infertility: difficulties encountered in diagnosis and treatment. Obstet Gynecol 55: 705–710PubMed
3.
Zurück zum Zitat Ayabe T, Tsutsumi O, Momoeda M et al. (1994) Impaired follicular growth and abnormal luteinizing hormone surge in luteal phase defect. Fertil Steril 61: 652–656PubMed Ayabe T, Tsutsumi O, Momoeda M et al. (1994) Impaired follicular growth and abnormal luteinizing hormone surge in luteal phase defect. Fertil Steril 61: 652–656PubMed
4.
Zurück zum Zitat Balasch J, Vanrell JA (1987) Corpus luteum insufficiency and fertility: a matter of controversy. Hum Reprod 2: 557–567PubMed Balasch J, Vanrell JA (1987) Corpus luteum insufficiency and fertility: a matter of controversy. Hum Reprod 2: 557–567PubMed
5.
Zurück zum Zitat Balasch J, Vanrell JA, Creus M et al. (1985) The endometrial biopsy for diagnosis of luteal phase deficiency. Fertil Steril 44: 699–701PubMed Balasch J, Vanrell JA, Creus M et al. (1985) The endometrial biopsy for diagnosis of luteal phase deficiency. Fertil Steril 44: 699–701PubMed
6.
Zurück zum Zitat Blacker CM, Ginsburg KA, Leach RE et al. (1997) Unexplained infertility: evaluation of the luteal phase; results of the National Center for Infertility Research at Michigan. Fertil Steril 67: 437–442PubMedCrossRef Blacker CM, Ginsburg KA, Leach RE et al. (1997) Unexplained infertility: evaluation of the luteal phase; results of the National Center for Infertility Research at Michigan. Fertil Steril 67: 437–442PubMedCrossRef
7.
Zurück zum Zitat Castelbaum AJ, Wheeler J, Coutifaris CB et al. (1994) Timing of the endometrial biopsy may be critical for the accurate diagnosis of luteal phase deficiency. Fertil Steril 61: 443–447PubMed Castelbaum AJ, Wheeler J, Coutifaris CB et al. (1994) Timing of the endometrial biopsy may be critical for the accurate diagnosis of luteal phase deficiency. Fertil Steril 61: 443–447PubMed
8.
Zurück zum Zitat Chatterton RT Jr, Haan JN, Jenco JM, Cheesman KL (1982) Radioimmunoassay of pregnanediol concentrations in early morning urine specimens for assessment of luteal function in women. Fertil Steril 37: 361–366PubMed Chatterton RT Jr, Haan JN, Jenco JM, Cheesman KL (1982) Radioimmunoassay of pregnanediol concentrations in early morning urine specimens for assessment of luteal function in women. Fertil Steril 37: 361–366PubMed
9.
Zurück zum Zitat Check JH, Goldberg BB, Kurtz A et al. (1984) Pelvic sonography to help determine the appropriate therapy for luteal phase defects. Int J Fertil 29: 156–158PubMed Check JH, Goldberg BB, Kurtz A et al. (1984) Pelvic sonography to help determine the appropriate therapy for luteal phase defects. Int J Fertil 29: 156–158PubMed
10.
Zurück zum Zitat Cook CL, Rao CV, Yussman MA (1983) Plasma gonadotropin and sex steroid hormone levels during early, midfollicular, and midluteal phases of women with luteal phase defects. Fertil Steril 40: 45–48PubMed Cook CL, Rao CV, Yussman MA (1983) Plasma gonadotropin and sex steroid hormone levels during early, midfollicular, and midluteal phases of women with luteal phase defects. Fertil Steril 40: 45–48PubMed
11.
Zurück zum Zitat Creus M, Ordi J, Fábregues F et al. (2003) The effect of different hormone therapies on integrin expression and pinopode formation in the human endometrium: a controlled study. Hum Reprod 18: 683–693PubMedCrossRef Creus M, Ordi J, Fábregues F et al. (2003) The effect of different hormone therapies on integrin expression and pinopode formation in the human endometrium: a controlled study. Hum Reprod 18: 683–693PubMedCrossRef
12.
Zurück zum Zitat Cumming DC, Honoré LH, Scott JZ, Williams KP (1985) The late luteal phase in infertile women: comparison of simultaneous endometrial biopsy and progesterone levels. Fertil Steril 43: 715–719PubMed Cumming DC, Honoré LH, Scott JZ, Williams KP (1985) The late luteal phase in infertile women: comparison of simultaneous endometrial biopsy and progesterone levels. Fertil Steril 43: 715–719PubMed
13.
Zurück zum Zitat Dalton CF, Laird SM, Estdale SE et al. (1998) Endometrial protein PP14 and CA-125 in recurrent miscarriage patients; correlation with pregnancy outcome. Hum Reprod 13: 3197–3202PubMedCrossRef Dalton CF, Laird SM, Estdale SE et al. (1998) Endometrial protein PP14 and CA-125 in recurrent miscarriage patients; correlation with pregnancy outcome. Hum Reprod 13: 3197–3202PubMedCrossRef
14.
Zurück zum Zitat Davis OK, Berkeley AS, Naus GJ et al. (1989) The incidence of luteal phase defect in normal, fertile women, determined by serial endometrial biopsies. Fertil Steril 51: 582–586PubMed Davis OK, Berkeley AS, Naus GJ et al. (1989) The incidence of luteal phase defect in normal, fertile women, determined by serial endometrial biopsies. Fertil Steril 51: 582–586PubMed
15.
Zurück zum Zitat del Pozo E, Wyss H, Tollis G et al. (1979) Prolactin and deficient luteal function. Obstet Gynecol 53: 282–286 del Pozo E, Wyss H, Tollis G et al. (1979) Prolactin and deficient luteal function. Obstet Gynecol 53: 282–286
16.
Zurück zum Zitat Downs KA, Gibson M (1983) Basal body temperature graph and the luteal phase defect. Fertil Steril 40: 466–468PubMed Downs KA, Gibson M (1983) Basal body temperature graph and the luteal phase defect. Fertil Steril 40: 466–468PubMed
17.
Zurück zum Zitat Filicori M, Butler JP, Crowley WF Jr (1984) Neuroendocrine regulation of the corpus luteum in the human. Evidence for pulsatile progesterone secretion. J Clin Invest 73: 1638–1647PubMedCrossRef Filicori M, Butler JP, Crowley WF Jr (1984) Neuroendocrine regulation of the corpus luteum in the human. Evidence for pulsatile progesterone secretion. J Clin Invest 73: 1638–1647PubMedCrossRef
18.
Zurück zum Zitat Geisthövel F, Skubsch U, Zabel G et al. (1983) Ultrasonographic and hormonal studies in physiologic and insufficient menstrual cycles. Fertil Steril 39: 277–283PubMed Geisthövel F, Skubsch U, Zabel G et al. (1983) Ultrasonographic and hormonal studies in physiologic and insufficient menstrual cycles. Fertil Steril 39: 277–283PubMed
19.
Zurück zum Zitat Gibson M, Badger GJ, Byrn F et al. (1991) Error in histologic dating of secretory endometrium: variance component analysis. Fertil Steril 56: 242–247PubMed Gibson M, Badger GJ, Byrn F et al. (1991) Error in histologic dating of secretory endometrium: variance component analysis. Fertil Steril 56: 242–247PubMed
20.
Zurück zum Zitat Ginsburg KA (1992) Luteal phase defect. Etiology, diagnosis, and management. Endocrinol Metab Clin North Am 21: 85–104PubMed Ginsburg KA (1992) Luteal phase defect. Etiology, diagnosis, and management. Endocrinol Metab Clin North Am 21: 85–104PubMed
21.
Zurück zum Zitat Hansel W, Dowd JP (1986) Hammond memorial lecture. New concepts of the control of corpus luteum function. J Reprod Fertil 78: 755–768PubMedCrossRef Hansel W, Dowd JP (1986) Hammond memorial lecture. New concepts of the control of corpus luteum function. J Reprod Fertil 78: 755–768PubMedCrossRef
22.
Zurück zum Zitat Hinney B, Henze C, Kuhn W, Wuttke W (1996) The corpus luteum insufficiency: a multifactorial disease. J Clin Endocrinol Metab 81: 565–570PubMedCrossRef Hinney B, Henze C, Kuhn W, Wuttke W (1996) The corpus luteum insufficiency: a multifactorial disease. J Clin Endocrinol Metab 81: 565–570PubMedCrossRef
23.
Zurück zum Zitat Hinney B, Henze C, Wuttke W (1995) Regulation of luteal function by luteinizing hormone and prolactin at different times of the luteal phase. Eur J Endocrinol 133: 701–717PubMed Hinney B, Henze C, Wuttke W (1995) Regulation of luteal function by luteinizing hormone and prolactin at different times of the luteal phase. Eur J Endocrinol 133: 701–717PubMed
24.
Zurück zum Zitat Insler V (1992) Corpus luteum defects. Curr Opin Obstet Gynecol 4: 203–211PubMed Insler V (1992) Corpus luteum defects. Curr Opin Obstet Gynecol 4: 203–211PubMed
25.
Zurück zum Zitat Ishimaru T, Mahmud N, Kawano M, Yamabe T (1992) Sporadic appearance of luteal-phase defect in prospective assessment. Horm Res (Suppl 1) 37: 32–36 Ishimaru T, Mahmud N, Kawano M, Yamabe T (1992) Sporadic appearance of luteal-phase defect in prospective assessment. Horm Res (Suppl 1) 37: 32–36
26.
Zurück zum Zitat Jones GES (1949) Some newer aspects of the management of infertility. JAMA 141: 1123 Jones GES (1949) Some newer aspects of the management of infertility. JAMA 141: 1123
27.
Zurück zum Zitat Jones GS, Madrigal-Castro V (1970) Hormonal findings in association with abnormal corpus luteum function in the human: the luteal phase defect. Fertil Steril 21: 1–13PubMed Jones GS, Madrigal-Castro V (1970) Hormonal findings in association with abnormal corpus luteum function in the human: the luteal phase defect. Fertil Steril 21: 1–13PubMed
28.
Zurück zum Zitat Jordan J, Craig K, Clifton DK, Soules MR (1994) Luteal phase defect: the sensitivity and specificity of diagnostic methods in common clinical use. Fertil Steril 62: 54–62PubMed Jordan J, Craig K, Clifton DK, Soules MR (1994) Luteal phase defect: the sensitivity and specificity of diagnostic methods in common clinical use. Fertil Steril 62: 54–62PubMed
29.
Zurück zum Zitat Knobil E (1980) The neuroendocrine control of the menstrual cycle. Recent Prog Horm Res 36: 53–88PubMed Knobil E (1980) The neuroendocrine control of the menstrual cycle. Recent Prog Horm Res 36: 53–88PubMed
30.
Zurück zum Zitat Kusuda M, Nakamura G, Matsukuma K, Kurano A (1983) Corpus luteum insufficiency as a cause of nidatory failure. Acta Obstet Gynecol Scand 62: 199–205PubMedCrossRef Kusuda M, Nakamura G, Matsukuma K, Kurano A (1983) Corpus luteum insufficiency as a cause of nidatory failure. Acta Obstet Gynecol Scand 62: 199–205PubMedCrossRef
31.
Zurück zum Zitat Landgren BM, Undén AL, Diczfalusy E (1980) Hormonal profile of the cycle in 68 normally menstruating women. Acta Endocrinol (Copenh) 94: 89–98 Landgren BM, Undén AL, Diczfalusy E (1980) Hormonal profile of the cycle in 68 normally menstruating women. Acta Endocrinol (Copenh) 94: 89–98
32.
Zurück zum Zitat Lenton EA, Landgren BM, Sexton L (1984) Normal variation in the length of the luteal phase of the menstrual cycle: identification of the short luteal phase. Br J Obstet Gynaecol 91: 685–689PubMed Lenton EA, Landgren BM, Sexton L (1984) Normal variation in the length of the luteal phase of the menstrual cycle: identification of the short luteal phase. Br J Obstet Gynaecol 91: 685–689PubMed
33.
Zurück zum Zitat Lessey BA, Castelbaum AJ, Sawin SW, Sun J (1995) Integrins as markers of uterine receptivity in women with primary unexplained infertility. Fertil Steril 63: 535–542PubMed Lessey BA, Castelbaum AJ, Sawin SW, Sun J (1995) Integrins as markers of uterine receptivity in women with primary unexplained infertility. Fertil Steril 63: 535–542PubMed
34.
Zurück zum Zitat Lessey BA, Ilesanmi AO, Lessey MA et al. (1996) Luminal and glandular endometrial epithelium express integrins differentially throughout the menstrual cycle: implications for implantation, contraception, and infertility. Am J Reprod Immunol 35: 195–204PubMed Lessey BA, Ilesanmi AO, Lessey MA et al. (1996) Luminal and glandular endometrial epithelium express integrins differentially throughout the menstrual cycle: implications for implantation, contraception, and infertility. Am J Reprod Immunol 35: 195–204PubMed
35.
Zurück zum Zitat Lessey BA, Yeh I, Castelbaum AJ et al. (1996) Endometrial progesterone receptors and markers of uterine receptivity in the window of implantation. Fertil Steril 65: 477–483PubMed Lessey BA, Yeh I, Castelbaum AJ et al. (1996) Endometrial progesterone receptors and markers of uterine receptivity in the window of implantation. Fertil Steril 65: 477–483PubMed
36.
Zurück zum Zitat Li TC, Rogers AW, Lenton EA et al. (1987) A comparison between two methods of chronological dating of human endometrial biopsies during the luteal phase, and their correlation with histologic dating. Fertil Steril 48: 928–932PubMed Li TC, Rogers AW, Lenton EA et al. (1987) A comparison between two methods of chronological dating of human endometrial biopsies during the luteal phase, and their correlation with histologic dating. Fertil Steril 48: 928–932PubMed
37.
Zurück zum Zitat McNeely MJ, Soules MR (1988) The diagnosis of luteal phase deficiency: a critical review. Fertil Steril 50: 1–15PubMed McNeely MJ, Soules MR (1988) The diagnosis of luteal phase deficiency: a critical review. Fertil Steril 50: 1–15PubMed
38.
Zurück zum Zitat Nakajima ST, Gibson M (1989) The effect of a meal on circulating steady-state progesterone levels. J Clin Endocrinol Metab 69: 917–919PubMed Nakajima ST, Gibson M (1989) The effect of a meal on circulating steady-state progesterone levels. J Clin Endocrinol Metab 69: 917–919PubMed
39.
Zurück zum Zitat Nikas G (1999) Pinopodes as markers of endometrial receptivity in clinical practice. Hum Reprod (Suppl 2) 14: 99–106 Nikas G (1999) Pinopodes as markers of endometrial receptivity in clinical practice. Hum Reprod (Suppl 2) 14: 99–106
40.
Zurück zum Zitat Noyes RW, Hamno JO (1953) Accuracy of endometrial dating, correlation of endometrial dating with basal body temperature and menses. Fertil Steril 4: 504–517PubMed Noyes RW, Hamno JO (1953) Accuracy of endometrial dating, correlation of endometrial dating with basal body temperature and menses. Fertil Steril 4: 504–517PubMed
41.
Zurück zum Zitat Noyes RW, Hertig AT, Rock J (1975) Dating the endometrial biopsy. Am J Obstet Gynecol 122: 262–263PubMed Noyes RW, Hertig AT, Rock J (1975) Dating the endometrial biopsy. Am J Obstet Gynecol 122: 262–263PubMed
42.
Zurück zum Zitat Ohara A, Mori T, Taii S et al. (1987) Functional differentiation in steroidogenesis of two types of luteal cells isolated from mature human corpora lutea of menstrual cycle. J Clin Endocrinol Metab 65: 1192–1200PubMed Ohara A, Mori T, Taii S et al. (1987) Functional differentiation in steroidogenesis of two types of luteal cells isolated from mature human corpora lutea of menstrual cycle. J Clin Endocrinol Metab 65: 1192–1200PubMed
43.
Zurück zum Zitat Olive DL (1991) The prevalence and epidemiology of luteal-phase deficiency in normal and infertile women. Clin Obstet Gynecol 34: 157–166PubMed Olive DL (1991) The prevalence and epidemiology of luteal-phase deficiency in normal and infertile women. Clin Obstet Gynecol 34: 157–166PubMed
44.
Zurück zum Zitat Sheehan KL, Casper RF, Yen SS (1982) Luteal phase defects induced by an agonist of luteinizing hormone-releasing factor: a model for fertility control. Science 215: 170–172PubMedCrossRef Sheehan KL, Casper RF, Yen SS (1982) Luteal phase defects induced by an agonist of luteinizing hormone-releasing factor: a model for fertility control. Science 215: 170–172PubMedCrossRef
45.
Zurück zum Zitat Smith SK, Lenton EA, Landgren BM, Cooke ID (1984) The short luteal phase and infertility. Br J Obstet Gynaecol 91: 1120–1122PubMed Smith SK, Lenton EA, Landgren BM, Cooke ID (1984) The short luteal phase and infertility. Br J Obstet Gynaecol 91: 1120–1122PubMed
46.
Zurück zum Zitat Soules MR, Clifton DK, Cohen NL et al. (1989) Luteal phase deficiency: abnormal gonadotropin and progesterone secretion patterns. J Clin Endocrinol Metab 69: 813–820PubMed Soules MR, Clifton DK, Cohen NL et al. (1989) Luteal phase deficiency: abnormal gonadotropin and progesterone secretion patterns. J Clin Endocrinol Metab 69: 813–820PubMed
47.
Zurück zum Zitat Soules MR, McLachlan RI, Ek M et al. (1989) Luteal phase deficiency: characterization of reproductive hormones over the menstrual cycle. J Clin Endocrinol Metab 69: 804–812PubMed Soules MR, McLachlan RI, Ek M et al. (1989) Luteal phase deficiency: characterization of reproductive hormones over the menstrual cycle. J Clin Endocrinol Metab 69: 804–812PubMed
48.
Zurück zum Zitat Stouffer RL, Hodgen GD, Ottobre AC, Christian CD (1984) Follicular fluid treatment during the follicular versus luteal phase of the menstrual cycle: effects on corpus luteum function. J Clin Endocrinol Metab 58: 1027–1033PubMedCrossRef Stouffer RL, Hodgen GD, Ottobre AC, Christian CD (1984) Follicular fluid treatment during the follicular versus luteal phase of the menstrual cycle: effects on corpus luteum function. J Clin Endocrinol Metab 58: 1027–1033PubMedCrossRef
49.
Zurück zum Zitat Wentz AC (1980) Endometrial biopsy in the evaluation of infertility. Fertil Steril 33: 121–124PubMed Wentz AC (1980) Endometrial biopsy in the evaluation of infertility. Fertil Steril 33: 121–124PubMed
50.
Zurück zum Zitat Wuttke W, Pitzel L, Seidlová-Wuttke D, Hinney B (2001) LH pulses and the corpus luteum: the luteal phase deficiency (LPD). Vitam Horm 63: 131–158PubMedCrossRef Wuttke W, Pitzel L, Seidlová-Wuttke D, Hinney B (2001) LH pulses and the corpus luteum: the luteal phase deficiency (LPD). Vitam Horm 63: 131–158PubMedCrossRef
51.
Zurück zum Zitat Wuttke W, Spiess S, Knoke I et al. (1998) Synergistic effects of prostaglandin F2alpha and tumor necrosis factor to induce luteolysis in the pig. Biol Reprod 58: 1310–1315PubMedCrossRef Wuttke W, Spiess S, Knoke I et al. (1998) Synergistic effects of prostaglandin F2alpha and tumor necrosis factor to induce luteolysis in the pig. Biol Reprod 58: 1310–1315PubMedCrossRef
52.
Zurück zum Zitat Wuttke W, Theiling K, Hinney B, Pitzel L (1998) Regulation of steroid production and its function within the corpus luteum. Steroids 63: 299–305PubMedCrossRef Wuttke W, Theiling K, Hinney B, Pitzel L (1998) Regulation of steroid production and its function within the corpus luteum. Steroids 63: 299–305PubMedCrossRef
53.
Zurück zum Zitat Xiao E, Xia-Zhang L, Ferin M (2002) Inadequate luteal function is the initial clinical cyclic defect in a 12-day stress model that includes a psychogenic component in the Rhesus monkey. J Clin Endocrinol Metab 87: 2232–2237PubMedCrossRef Xiao E, Xia-Zhang L, Ferin M (2002) Inadequate luteal function is the initial clinical cyclic defect in a 12-day stress model that includes a psychogenic component in the Rhesus monkey. J Clin Endocrinol Metab 87: 2232–2237PubMedCrossRef
Metadaten
Titel
Corpus-luteum-Insuffizienz
Definition und Bedeutung
verfasst von
PD Dr. A. Schultze-Mosgau
S. von Otte
M. Thill
K. Diedrich
G. Griesinger
Publikationsdatum
01.09.2008
Verlag
Springer-Verlag
Erschienen in
Gynäkologische Endokrinologie / Ausgabe 3/2008
Print ISSN: 1610-2894
Elektronische ISSN: 1610-2908
DOI
https://doi.org/10.1007/s10304-008-0278-1

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