Luteal Phase Defect

Sounds Like LSD!  What Is It?

Luteal Phase Defect - LPD - can greatly affect fertility. Just what is luteal phase defect? To determine that answer, we must first address what the luteal phase is. Luteal phase refers to the time in the menstrual cycle between ovulation and the beginning of the next menses. For most women, that period of time is 10 to 14 days. If the luteal phase is less than 10 days or greater than 14 days, then there is a real possibility for luteal phase defect or LPD.

The International Council on Infertility Information Dissemination, Inc. (INCIID) in Arlington, Va., describes LPD as a commonly misunderstood condition that frequently affects fertility.

What Happens in the Body to Cause LPD

During the course of a normal cycle, your body will create a follicle stimulating hormone (FSH) which causes the formation of a mature, egg-containing follicle in one of the ovaries. When the follicle bursts into what is called the "corpus luteum", it secretes the hormone progesterone which, in turn causes the uterine lining to thicken in preparation for the embryo, providing a place for it to attach. If the luteal phase is less than 10 days, then there is not enough progesterone produced to sustain a pregnancy.

The normal menstrual cycle can be interrupted by several difference occurrences such as poor follicle production, premature death of the burst follicle and the failure of the uterine lining to respond properly to normal levels of progesterone. All of these can overlap each other or they can be independent of one another.

Diagnosing Luteal Phase Defect

LPD can be diagnosed through the measurement of basal body temperature using a daily basis fertility chart. Women with LPD will notice that their basal body temperature does not stay elevated for the normal 12 days of the luteal phase of the cycle. Also, their next cycle will begin sooner than the normal 12 to 14 day time span. Testing of the progesterone levels will reveal a hormone problem and then the doctor may suggest a fertility drug to see if the progesterone levels increase.

Serum Pregesterone Test

If there is a suspicion of LPD, a serum progesterone test can be performed which will check the levels of progesterone in the body. Done about seven days after ovulation, this blood test will reveal if there is adequate progesterone being produced during the luteal phase. An ultrasound may be performed in order to view the uterine lining and may further support the diagnosis.

Endometrial Biopsy as a Means of Diagnosing LPD

An endometrial biopsy is another way to diagnose LPD and is usually done several days prior to the expected start of the next menstrual period. A small sample of uterine tissue is removed and tested to see if it is developed enough to sustain a pregnancy. If the lining is not the correct density for the period of the cycle, ovulation-induction medications may be prescribed. The good news is that once the condition is diagnosed, it is very responsive to treatments.

Treatment Options

There are different treatment options available such as progesterone supplementation as well as ovarian stimulation to push the ovaries into better hormone production. Often Clomid is used to trick the body into thinking it doesn't have enough estrogen.

The testing, treatment and cycles can be lengthy for some women, but finding the exact cause of the disorder is the key to effective treatment.

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