Luteinized unruptured follicle syndrome (LUFS)

Conventional Medicine,

Luteinized unruptured follicle syndrome (LUFS): Failure of the follicle to release an egg even though it has reached maturity. Commonly seen when an LH surge is not followed by ovulation. LUFS can be confirmed with ultrasound. In the case of LUFS, progesterone level cannot tell since with LUFS the body goes through all of the steps of ovulating follicle just doesn't' rupture.

1.1 Understanding of the normal ovulation mechanisms
     Normal ovulation is completed within the ovaries. It is under hypothalamus - pituitary - ovarian gonadal axis regulation; through a variety of proteases and cytokines involved. Mature follicles secrete estradiol (E2) to promote the release of hypothalamic GnRH, and then cause the release of pituitary gonadotropins, LH / FSH peaks, making the rapid increase in follicular fluid, pressure, promote follicle wall stretch forming; promote the preovulatory LH peak luteinization, produce a small amount of progesterone (P); LH, FSH and P with effective coordination, activates plasmin activity in follicular fluid, follicular fluid pressure and combined with the follicle wall stretch. The latent collagenase is then activated and it appears that leukotrienes and prostaglandins as well as plasmin may be involved in this process. The active collagenase causes a digestion of the collagen in the follicle wall. Plasmin as well as possibly other proteolytic enzymes such as proteoglycanases may cause a further dissociation of the follicular wall. These processes of digestion of collagen and dissociation of the collagen fibers result in an opening in the follicular wall with the formation of the stigma and rupture. While the weakening of the follicular wall takes place throughout the entire wall, rupture remains for the most part a localized process at the apex of the follicle. This localization of the rupture may be explained on the basis of mechanical factors operating when the follicle wall thins and weakens

Things influence on the LH peak are Polycystic ovary syndrome (PCOS), Hyperprolactinemia (HPRL), Hypothyroidism. Others like Inflammatory mechanisms hinder ovum. Chocolate cyst disease side inflammatory mass, caused by endometriosis, pelvic surgeries can stimulate the body's inflammatory response mechanism, leading to fibroblast proliferation and collagen deposition, so that the normal anatomical position changes within the pelvic cavity, ovary and surrounding tissue adhesion.

Another is ovarian blood supply shortage.
Emotional impact: infertile women often anxiety, depression, nervous, sensitive, these feelings can cause blood reduction, increased PRL levels, leading to neuroendocrine disorders, reduction of dopamine secretion of Gn affect ovarian function, followed by the development of LUFS