Luteal Phase Defect And Fertility
Luteal Phase Defect (LPD) is a commonly misunderstood condition that frequently affects fertility. In order to understand what a luteal phase defect is, it is important to know what the luteal phase of a woman's menstrual cycle is and what happens when it is functioning properly.
What Is Luteal Phase Defect?
The luteal phase refers to the amount of time during the menstrual cycle between ovulation and the onset of the next menstrual period. For most women that period of time is 10 to 14 days. If the luteal phase is less than 10 days or longer than 14 days, it is possible a woman has a luteal phase defect.
During a normal cycle a woman's body creates a hormone called follicle stimulating hormone (FSH). This hormone is responsible for the forming of a mature egg-containing follicle in one of the ovaries. The follicle bursts and becomes the corpus luteum which then secretes the hormone progesterone. It is the elevation of progesterone that causes the endometrium (uterine lining) to thicken, giving the fertilized egg a place to embed and grow. When there is a luteal phase of less than 10 days, there is insufficient progesterone to sustain a pregnancy.
A normal menstrual cycle can be disrupted in one of several different places. Some causes are poor follicle production, premature expiration of the corpus luteum and the failure of the uterine lining to respond to normal levels of progesterone. These may occur separately or two or more may overlap and cause disruption to the normal cycle.
Home Testing And Diagnostic Testing
The InterNational Council on Infertility Information Dissemination, Inc., (INCIID) in Arlington, Virginia says that women who practice fertility charting-recording their basal body temperature on a daily basis-will often notice that the elevated temperature characteristic of this phase does not stay high for the average 12 days of the luteal phase. It has also been noted that many women who monitor the time of ovulation find their next cycle begins sooner than the normal 12 to 14 day span.
A serum progesterone test, a simple blood test which checks levels of progesterone in the body, will be performed if there is any suspicion that there is a possible diagnosis of LPD. If the results show less than normal levels of progesterone it indicates production during the luteal phase is inadequate. Another diagnostic option is an ultrasound of the uterus to see the condition of the lining and this is usually done mid-cycle. Yet another way to diagnose LPD is by endometrial biopsy which is done several days prior to the next expected menses. The tissue sample from the uterus is obtained and a pathologist will examine it to see if it can be categorized as being on a specific day. If there is a discrepancy of a few days, then it is considered out of phase.
Once You Know, The Rest Is Not So Difficult
The good news is that once this defect is detected, it is very responsive to the correct treatment, which is often taking a progesterone supplement during the luteal phase as long as the follicle development is normal. Along with progesterone, some medical professionals use ovarian stimulation protocols like Clomid to ensure follicles are present. Careful monitoring ensures the protocol is successful.
The real key to the success of treatment lies in finding the exact cause of luteal phase defect.