Changes within the ovaries occur throughout the menstrual cycle. The first two phases - follicular and ovulatory, last about fourteen days from the start of the cycle. During this time, the dominant follicle matures. The period after ovulation and before the onset of menstrual bleeding is called the luteal or, they say, secretory phase.
Where does the third phase begin?
If there was ovulation in the current cycle, then immediately after the ripe follicle ruptures. The body begins to produce the corpus luteum, which actively produces female hormones: progesterone, estrogen and the male hormone androgen. It acquires a yellow color due to the presence of lipids and luteins in its structure. In case of pregnancy, the corpus luteum will be responsible for the production of progesterone until the placenta is ripened and formed.
The walls of the bursting follicle turn into luteal cells surrounded by capillaries. In the future, they will be responsible for the nutrition of the gland. If during the luteal phase the fertilized egg is safely fixed in the uterine cavity, then the corpus luteum will act as a source for the intake of the hormones estradiol and androgen necessary for the development of the embryo. These two important “defenders” are responsible for the safety of pregnancy, reduce the contractile function of the uterus, and start the mammary gland for subsequent lactation.
The corpus luteum ceases to work if fertilization has not occurred, and then bleeding occurs and a new menstrual cycle begins.
Secretory phase length
For each woman, the duration of the menstrual cycle and the number of days of the luteal phase are different, moreover, they can vary in duration from cycle to cycle. The average value established in medical practice is 12 to 16 days. These data may be more when pregnancy occurs or in the case of the formation of a corpus luteum cyst.
For a planning woman, the sufficient duration of the last phase of the cycle is of great importance. If less than 10 days have passed from the onset of ovulation, then we are talking about the failure of the luteal phase. The death of the corpus luteum in this case occurs due to the low level of progesterone. If it is not enough in the body, then you can not talk about the onset and normal course of pregnancy.
Causes of hypofunction of the corpus luteum
As a rule, they learn about this after long unsuccessful attempts to get pregnant. A woman undergoes an examination, during which it turns out that her body can not keep and help the development of the embryo because there is not enough produced progesterone. Having found out that the luteal phase is one of the important periods of the menstrual cycle, the duration of which depends on the normal functioning of hormones, a woman can take timely measures to choose a therapy.
The influence of the anovulatory period on the duration of the luteal phase is not excluded. It is believed that if there is no ovulation, then the hormone progesterone to maintain the normal duration of the third phase will come from nowhere. The thickness of the endometrium in this case will be less than 5 - 10 mm, and the corpus luteum will be insufficiently formed.
There is also the possibility of excessive production of estrogen, which prevents the production of progesterone. At the same time, the corpus luteum will have normal sizes and will be fully formed, and the thickness of the endometrium will be opposite, more than 12 mm.
What affects the luteal phase deficiency
In addition to the malfunction of hormones, there are other reasons that affect the duration of the secretory phase. Hypofunction of the corpus luteum may develop due to chronic illness or overwork. Other reasons include:
- Surgery - curettage, abortion.
- Myomas, endometriosis, polyps, malignant neoplasms and adhesions in the pelvic organs.
- Polycystic, hypertrophy or exhaustion of the ovaries, other diseases.
- Excessive exercise.
- Diseases of the endocrine system.
- Increased prolactin levels in the body.
- Age over 35 years.
External factors can also affect the total number of days of the cycle and the luteal phase in this case becomes less. For example, a woman in the current cycle, its length was not 28 days, but 22-24. Stress, climate change, overwork, sleep disturbance, strict diet (starvation is not ruled out) and other factors can affect premature menstruation.
Treatment methods
It’s one thing to diagnose insufficiency of the third phase of the cycle in time, it’s another to correctly determine the causes of the onset and the treatment regimen. The final decision on treatment methods is selected by a qualified attending physician after a series of laboratory tests and ultrasound diagnostics. If the problem is with the hormonal system, then most likely the complex of treatment will consist of taking hormonal drugs, eliminating the causes of the failure in the body. In the presence of an inflammatory process, you can not do without taking antibiotics.
The consequences of disregard for the cycle, which is caused by the failure of the luteal phase, can lead to problems with bearing a pregnancy, possible infertility.
How to track on a chart
Every woman planning to conceive a child thinks about the need to establish the beginning of the secretory phase. Many methods and tests were invented and tested to help her. The most obvious and simplest method is to determine the luteal phase according to the schedule of the basal temperature, which is filled throughout the entire menstrual cycle. The woman transfers the data from the thermometer to a graph that can be drawn on a simple piece of paper in a cage or notes in a special mobile application. This should be done daily, at the same time.
Lowering and increasing basal temperature may indicate the onset of ovulation, implantation of the ovum, the duration of all phases of the cycle, the onset of pregnancy, or the onset of menstrual bleeding.
Calendar method
The old way to control your period according to the usual calendar. Previously, mothers taught their daughters to mark the start and end dates of menstruation on a pocket calendar. Then, the number of days between cycles was calculated. This made it possible to control the onset of critical days. Now, many have switched to mobile applications, which have the function of automatically determining the second phase (ovulation) and the date of the next menstruation.
During planning, the calendar method allows you to quickly calculate the onset of ovulation and thereby determine when the third phase of the cycle begins. It happens that the onset of ovulation in a woman could occur on the 21st day of the cycle (late ovulation) or on the 5th day (early). A lot here depends on the characteristics of the female body and the duration of the menstrual cycle.
Obvious signs of the third phase
Visually, a woman can determine the onset of the third phase by vaginal discharge. They become more abundant as the body prepares for the onset of a meeting of a fertilized egg. In some cases, swelling of the mammary glands is noted.
According to the results of the tests, doctors establish the level of progesterone. At the beginning of the luteal phase, 7 - 57 nmol / L is considered the norm. With the onset of ovulation, its maximum value is noted, if pregnancy has not occurred and menstruation is expected, then its numbers fall.
Painful sensations
In some cases, a woman may notice minor pains in the lower abdomen, which indicate the approach of menstrual bleeding, as well as a decrease in the level of progesterone in the body. It is worth paying attention to such unpleasant symptoms, since normally a woman should not experience any discomfort before the onset of a new cycle.
If a woman does not know that this is the luteal phase, what day comes, what significance does she play in the process of pregnancy planning, she may miss important deviations in the work of her body.
The probability of conception in the third phase of the cycle
There is no doubt that there is a connection between all phases of the cycle, and their integral role in the normal functioning of the entire female body is also noted. Particular importance is given to the probability of conception in a given period of the menstrual cycle.
First you need to find out several important points: when the luteal phase begins, what day of the cycle serves as the starting point for the secretory phase. If a number of questions were answered above, then ultrasound monitoring and special tests to determine ovulation will help to calculate the exact day. It is her onset that serves as the beginning for the countdown of the third phase of the menstrual cycle. For women in whom it is late, the probability of conception at the end of the cycle can be increased by stimulating the production of hormones that maintain pregnancy.
IVF and secretory phase support
During the maintenance of the IVF protocol, hormonal support is extremely important, especially in the luteal phase, since this period is responsible for the successful start of pregnancy. Due to the fact that the female body receives a fertilized egg from the outside, it is extremely important to prepare the endometrium for successful implantation. This is impossible without stimulation and support of the secretory phase.
To determine the need for the appointment of a particular drug, it is important to take tests to determine the insufficiency of the production of pregnancy hormones. This is done so that the chosen method is justified and does not rely solely on generally accepted practices. Since each woman is a unique organism, the work of which cannot be brought under any standards and patterns.
As a rule, drugs like "Utrozhestan", "Dufaston", intramuscular injections of progesterone and chorionic gonadotropin, which are responsible for the safety and development of pregnancy, are prescribed. Their many years of use and a positive result have established themselves as one of the most reliable and trustworthy.
We must be prepared for the fact that IVF involves a huge load in the form of hormones taken and most likely the question arises - is it possible to reduce their number or replace the treatment regimen on my own? The answer here will be unequivocal and negative. To maintain a successful protocol, you must adhere to all the doctor's prescriptions. It is especially important to support the body at the end of the cycle in order to prevent the likelihood of a miscarriage.