Incomplete luteal function infertility

　　The possible causes of incomplete luteal function infertility include abnormal endocrine regulation, abnormal autocrine-paracrine regulation of the ovary and luteum, and decreased endometrial responsiveness. The possible pathogenesis may include insufficient gonadotropin during the follicular phase, granulosa cell defect, insufficient estrogen stimulation of the endometrium, abnormal LH peak during the luteal phase, accelerated luteal regression, endometriosis, per卵巢 tissue inflammation, ovarian fibrosis, and unruptured follicle syndrome, all of which can lead to incomplete luteal function.

　　Incomplete luteal function leads to insufficient progesterone secretion, resulting in a basal body temperature that is lower than normal in the later stage, which affects fertility. Even if pregnant, there is a risk of miscarriage, and even repeated pregnancies and miscarriages. This disease is more common in women with irregular lifestyles and malnutrition.

　　The symptoms of incomplete luteal function infertility are as follows:
　　1. Menstrual disorders The period is shortened, but the amount of menstrual blood is more than normal, and the frequency of menstrual occurrence is also more.
　　2. Habitual abortion Insufficient progesterone levels make it difficult to retain the fetus, and it is easy to have a miscarriage.
　　3. Infertility Incomplete luteal function will reduce the secretion of progesterone in women's bodies, and the endometrium not falling off on time will make it difficult to conceive.

　　The etiology of incomplete luteal function infertility is unknown, and the prevention of the disease mainly focuses on health care in daily life.

　　1. Pay attention to dietary issues
　　In terms of diet, do not eat cold, spicy and other刺激性 food, drink more water, and keep the bowels smooth. Before the period, eat more fruits and vegetables, and do not eat scallions, garlic, and other foods. If there is excessive menstrual blood, avoid eating brown sugar.

　　2. Pay attention to clothing
　　In terms of clothing, it is best to wear cotton underwear that is soft and breathable, and change them frequently. After washing, the underwear should be dried in the sun.

　　3. Maintain mental joy
　　Mental health is also very important. Women must adjust their mental state well, ensure a pleasant mood, avoid mental stimulation, and do not have excessive emotional fluctuations. If there are phenomena such as abdominal distension, lumbar pain, breast tenderness, mild diarrhea, fatigue, drowsiness, emotional instability, irritability, or depression during the period, do not be overly anxious, as this is a normal phenomenon.

　　In addition to clinical manifestations and physical examination, auxiliary examinations are also necessary for the diagnosis of incomplete luteal function infertility. Common clinical examinations are as follows:
　　1. Basal body temperature measurement: commonly manifests as a slow rise in body temperature, short duration of high temperature, or low and fluctuating high temperature phase.
　　2. Hormone testing: mainly including six sexual hormones.
　　3. Ultrasound examination and ovulation monitoring: Pay attention to the presence of pelvic tumors, and ovary monitoring can show poor follicle development or luteinization.
　　4. Endometrial examination: used when suspected of endometrial lesions.
　　5. Husband's semen examination.

　　Patients with incomplete luteal function infertility should pay attention to their diet. Women should not eat cold, sour and spicy刺激性 food, drink more water, and keep the bowels smooth. Those with blood heat should eat more fresh fruits and vegetables before the period, such as grapes, duck plums, apples, bananas, etc. They should avoid eating刺激性 food that moves fire, such as scallions, garlic, chives, ginger, etc. In addition, those with excessive menstrual blood should avoid eating brown sugar.

　　The traditional Chinese medicine treatment for incomplete luteal function infertility should start from the whole body, replenish kidney essence, regulate menstrual blood, and take tonifying kidney Qi, benefiting essence and blood, consolidating the original essence, and regulating the Chong and Ren meridians as the main method. According to the different stages of the menstrual cycle, stage-by-stage regulation of the Yin and Yang balance in the kidney should be carried out, and endocrine disorders should be adjusted by adjusting the body's function and improving the body's own regulatory ability. The sequential administration of traditional Chinese medicine is commonly used in clinical practice to treat incomplete luteal function infertility.

　　1. Follicular phase:The late menstrual period is the period of follicle development, which is the first key period of the sequential therapy. According to the Yin-Yang differentiation, it belongs to the Yin stage, and the basal body temperature is in the low phase. Kidney Yin is the material basis of reproductive function. At this stage, it is necessary to focus on nourishing the kidney Yin, regulating the spleen and kidney, nourishing Yin blood, so that the true Yin and Yang in the kidney are full, which can promote the full development and maturation of the follicle, promote the arrival of the 'true mechanism', that is, help the repair and hyperplasia of the endometrium and help the development of the follicle. Clinically, the modification of Guizhi Wan and Erzhi Wan is commonly used. Although nourishing Yin and blood is important during this period, it is more important to supplement essence and assist Yang. On the basis of nourishing Yin blood, a small amount of gentle Yang-assisting medicine is added to assist the growth of Yin essence (follicle), such as She Chong Zi (Cnidium Monnier), Tu Si Zi (Cuscuta), Zi He Che (Placenta), etc.

　　2. Pre-menstrual period:That is, the luteal phase. After ovulation, the basal body temperature enters the high phase, during which the Yang increases and the Yin decreases, the Qi and blood in the Chong and Ren Channels are full, the Yang Qi gradually increases, and the Liver Qi is prone to disturb the Channels, often accompanied by symptoms such as breast tenderness, chest stuffiness, and irritability. Incomplete luteal function is mainly related to kidney Yang deficiency. The Yang begins to increase before the menstrual period, and the increase of Yang starts under the transformation of heavy Yin, so the increase of Yang to a heavy level must have a solid Yin foundation. Kidney Yang deficiency is actually a deficiency of Yang Water, and the deficiency of Yang Water will also affect the deficiency of Qi and blood to a certain extent, thus affecting the transporting and transforming function of the spleen and stomach, leading to the pathological changes of both spleen and kidney deficiency. Therefore, this period focuses on warming the kidneys and spleen to assist Yang, supplemented by soothing the Liver and regulating Qi, promoting the development of the corpus luteum, and facilitating the development of the ovum, with the prescription modification of Yulingzhu. The medicinal materials include Lu Jiao Pian (Deer Antler Plate), Tu Si Zi (Cuscuta), Rou Cong Rong (Cistanche), Ba Ji Tian (Morinda Officinalis), Yin Yang Huo (Epimedium), Gou Qi Zi (Chinese Wolfberry), Bai Zhu (Atractylodes), Fu Ling (Poria), Chen Pi (Tangerine Peel), etc. However, it must be noted that when warming the kidney and spleen Yang, it is necessary to add Yin-nourishing ingredients to complement the fire in the water and seek Yang in the Yin.

　　When treating this condition clinically, it is necessary to consider the different physical conditions of patients and the mixed syndrome types, combine the four diagnostic methods, and flexibly differentiate and treat. It is necessary to take medicine regularly according to the menstrual cycle, starting from the late menstrual period and continuing for 3 menstrual cycles.