Luteal Phase Defect

August 5, 2009

Counting The Right Number Of Days

Many things can affect a woman's fertility. The way her uterus is situated, whether she has PCOS or endometriosis, or perhaps some genetic problems, can all affect her ability to conceive. Among the issues that affect a woman's fertility is one called luteal phase defect, or LPD.

The luteal phase of a woman's menstrual cycle is that span of time between ovulation and the onset of the next menstruation. Most women have a luteal phase of 10-14 days. Luteal phase defect is a luteal phase that is either less than 10 days or more than 14 days in length.

What Is A Normal Luteal Phase?

In a normal menstrual cycle, a woman's body creates follicle-stimulating hormone (FSH). This hormone is responsible for the formation of a mature, egg-containing follicle in one of the ovaries. The follicle bursts and becomes the corpus luteum, which releases the hormone progesterone. It is the elevated level of progesterone that encourages the uterine lining to thicken, giving the fertilized egg a place to attach. If the luteal phase is less than 10 days, there is not sufficient time for the lining to thicken adequately to hold the embryo and the pregnancy cannot be sustained.

A normal menstrual cycle can be interrupted in a number of different places. Some causes for interruption include poor follicle production, early death of the corpus luteum and the failure of the uterine lining to respond to the normal levels of progesterone. These problems can arise separately or they can overlap, causing disruption to the normal cycle.

How Is LPD Diagnosed?

Diagnosis of luteal phase defect can be made using monitoring and recording of basal body temperature every morning. When a woman has LPD, she will notice that the elevated basal body temperature does not stay up for the average 12 days during the luteal phase. She will also notice that her next cycle begins sooner than the normal 12-14 day time span.

A call to the doctor should result in a serum progesterone test to check the progesterone levels in the body. If the levels are very low, the doctor may recommend a fertility drug, such as Clomid, to help increase the progesterone levels. If it is successful, then a second course may be recommended. An ultrasound may be performed to view the lining of the uterus. This is done mid-cycle and is non-invasive. It is helpful in getting a correct diagnosis.

Another way of diagnosing LPD is by performing an endometrial biopsy, which is usually done several days before the date of the next menstrual period. This helps to determine if the uterus is developed sufficiently enough to sustain a pregnancy. A small sample of the uterine lining is sent for tests to determine density and to see if it can be categorized as typical for a specific cycle day. If there is a discrepancy of more than a few days, LPD may be diagnosed and ovulation-induction medications prescribed.

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