LUF syndrome (luteinised unruptured follicle syndrome) is a relatively rare condition that can significantly affect female fertility. Despite its lesser-known status, it plays a crucial role in some cases of unexplained infertility, making its understanding vital for those wishing to conceive.
Around the middle of the menstrual cycle, ovulation occurs — the process of releasing a mature egg from its follicle. This mature follicle, known as a Graafian follicle, ruptures to release the egg, which can then be fertilized. In LUF syndrome, the follicle undergoes luteinization, which means it begins to produce progesterone as if ovulation had occurred. However, the follicle does not rupture and the egg remains trapped inside. Thus, ovulation is ineffective despite the hormonal signs that indicate it has occurred.
CAUSES AND RISK FACTORS
The exact causes of LUF syndrome are not fully understood. However, several factors are believed to contribute to its occurrence:
- Certain medications, especially those used in the treatment of infertility, can increase the risk of LUF syndrome.
- Conditions such as endometriosis and polycystic ovary syndrome (PCOS) are associated with a higher risk of developing LUF.
- Psychological stress can affect hormonal balance and contribute to the syndrome.
SYMPTOMS AND DIAGNOSIS
LUF syndrome often goes undiagnosed because it does not present specific symptoms distinguishable from other fertility problems. Women with LUF usually have regular menstrual cycles and show signs of ovulation on hormone tests (including home tests). The key difference, however, is the absence of an egg in the fallopian tube at the time of presumed ovulation.
Diagnosing LUF syndrome can be challenging. It usually involves a combination of ultrasound monitoring of the ovaries and blood tests to check hormone levels. Suspicion is the retention of high FSH levels after ovulation. Ultrasound is used to track the development of the follicle and to determine if the follicle has ruptured. Sometimes laparoscopy, a minimally invasive surgical procedure, is used for a more definitive diagnosis, especially in cases where other diagnostic methods do not provide clear answers.
TREATMENT
Treatment of LUF syndrome can be complex and varies according to individual circumstances. One common approach involves the use of medications that stimulate ovulation, such as clomiphene citrate or gonadotropins. These drugs aim to stimulate the release of the egg from the follicle. In some cases, an injection (trigger shot) with human chorionic gonadotropin (hCG) is administered to accelerate the final maturation and rupture of the follicle.
For women who do not respond to medication, assisted reproductive technologies (ART), such as in vitro fertilization (IVF), may be recommended. IVF bypasses the need to rupture a follicle by retrieving the egg directly from the ovary.
LUF syndrome, although not widely known, is an important factor in some cases of infertility. Early diagnosis and appropriate intervention can improve the chances of conception, offering hope to many women struggling with infertility. As awareness grows, so does the potential for better outcomes for those struggling with the condition