diagnosis guide
If you’ve just received a medical diagnosis, or you’re concerned that something in your present or past health history might be jeopardizing your fertility, check here for quick info on common medical conditions and how they can affect conception and pregnancy.
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Luteal Phase Defect
What It Is
A condition in which the luteal phase of a woman’s monthly cycle—the time between ovulation and menstruation--chronically runs shorter than 10 days. This causes fertility problems, because the uterine lining cannot build up sufficiently for an embryo to implant.
Women with luteal phase defect (LPD) either do not produce enough progesterone to prepare the uterine lining for implantation or their wombs do not respond properly to progesterone stimulation. An underactive thyroid also can shorten the luteal phase by interfering with the body’s normal metabolism.
SymptomsBecause most women with LPD have regular periods and thus appear to have normal monthly cycles, the condition often goes undetected until they have difficulty getting pregnant.
How It's Diagnosed/Detected
Women trying to conceive who are charting their basal body temperature may notice that their temperature does not stay elevated as it normally should during the second half of their cycle. This is a clue that they are not producing sufficient progesterone, which keeps basal body temperature higher during the luteal phase. Women charting their cycles may also notice that their periods come sooner than the typical 14 days after ovulation.
The most accurate way of diagnosing LPD is by an endometrial biopsy, usually performed several days before a woman expects her period. A pathologist will check the sample to see if the uterine lining is as developed as it should be on the day of the cycle when it was taken. When there is a discrepancy of more than a few days, the woman is considered to be “out of phase.” Further tests can determine whether the cause is lack of progesterone or a poor response to progesterone by the uterine lining.
How It Affects Fertility (And Pregnancy)Women with LPD cannot sustain a pregnancy because the uterine lining is not thick enough to allow an embryo to attach. The lining breaks down, bringing on menstruation and causing an early miscarriage.
Treatment
Treating LPD is fairly straightforward. The doctor will likely prescribe progesterone supplements or sometimes a drug such as Clomid to reset a woman’s cycle.
Fertility Prognosis
Luckily, fertility problems quickly cease with proper treatment.
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