What is a Luteal Phase?
A good starting point would be explaining what the Luteal Phase actually is in a woman’s cycle. The luteal phase begins during the second half of a menstrual cycle normally (not always) lasting around 12-14 days after ovulation. The corpus luteum, where “luteal phase “ is named after, is formed right after ovulation and is responsible for producing progesterone. During the luteal phase, production of hormone secretions such as progesterone and estrogen, begin to increase helping to prepare uterine lining for a possible fertilized egg. If there is no presence of a fertilized egg or the hormones levels are not optimal, then the menstrual cycle begins.
Luteal Phase Defect
A Luteal Phase Defect or LPD (because all things related to fertility lingo seems to have an acronym), is where there is an abnormality in the endometrial development. There is some debate surrounding luteal phase defect and its existence. When a suspected luteal phase defect occurs, the secretion of progesterone by the ovary is below normal or the endometrium isn’t responding to the normal stimulation of progesterone. A luteal phase defect are associated with both infertility and early miscarriage.
Most providers will diagnose luteal phase defect through conducting two, out-of-phase biopsies usually 2 days prior to the suspected start of menstruation.
There are three methods of therapy commonly used linked to treat LPD. However, your doctor will be the one best to decide which treatment option is right for you. There are three methods of therapy commonly used linked to treat LPD. However, your doctor will be the one best to decide which treatment option is right for you.
- clomiphene citrate or human menopausal gonadotropins (hMG) to stimulate follicular growth
- supplemental hCG to improve corpus luteum secretion of progesterone
- additional progesterone after ovulation given by injection, orally or by vaginal suppositories or gel is often used.
Do I have Luteal Phase Defect?
Start by asking yourself these questions: (Please note this is not a substitution for a medical diagnosis.)
- Is your luteal phase less than 12 days long?
- Do you have vaginal spotting before you get your menstrual bleed?
- Have you noticed a slow or low rise on your basal body temperature chart following ovulation?
- Have you had a vaginal ultrasound just prior to ovulation to document an adequately thick endometrium (a normal range is 6-10mm)?
- Has the doctor taken a blood test to evaluate progesterone levels mid-way between ovulation and your menstrual cycle? (A level of less than 10 nanograms may indicate a problem.)
- If you have had an endometrial biopsy, was it done after day 21 in your cycle?
- If the endometrial biopsy showed a “lag” and you are being treated for a luteal phase defect, will another biopsy be done in the future to evaluate results?
- If you have been on clomiphine, has the doctor evaluated your luteal phase? Clomiphene can sometimes thin the endometrial lining of the uterus.
- Some new tests to evaluate the uterine lining during the luteal phase include Doppler ultrasound and the evaluation of the integrins in the endometrial tissue. Talk with your doctor about these tests.
To find a fertility specialist, visit RESOLVE’s professional services directory.