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Luteal Phase Defect

What is luteal phase defect?

Luteal phase defect(LPD) is a condition marked by inadequate progesterone levels that are must for maintaining the usual secretory lining of the uterus (endometrium). Further, progesterone is essential for the implantation of the embryo and its growth.

What causes LPD?

To have a better understanding of LPD, let’s first know more about the menstrual cycle.

This cycle comprises of two phases:

  • Follicular phase: The stimulation of the follicle occurs with the release of oestrogen and maturation of the egg in it.
  • Luteal phase: The matured egg’s release marks the ovulation and beginning of the luteal phase. The follicle degenerates into corpus luteum that secretes progesterone.

The events must occur sequentially for the endometrium to develop properly. The key factors being the development of the lining of the uterus that’s driven by oestrogen. Then the right mix of oestrogen and progesterone create the suitable environment needed for an embryo’s implantation (in case the egg is fertilised).

Poor levels of progesterone during the luteal phase lead to LPD that prevent the proper development of the endometrium. When the production of progesterone is low, the luteal phase is shortened, and menstruation happens soon after ovulation (<10 days). During a normal luteal phase, the menstruation happens on an average of 14 days after ovulation.

The other causes that can lead to LPD include:

What are the symptoms of LPD?

  • The main symptom of LPD is that you will notice that your periods will get shorter.
  • Spotting will occur amidst periods
  • Fertility issues

How is LPD diagnosed?

Some tests can be done to see if LPD is the cause of your infertility. The tests can include:

  • Blood tests: To evaluate the levels of follicle-stimulating hormone, luteinizing hormone and progesterone.
  • Ultrasound: A pelvic ultrasound to determine the endometrial thickness can be done. Further, your cervix, uterus, fallopian tubes and ovaries can be examined.

What is the treatment for LPD?

Your doctor to treat LPD can prescribe medication that promotes the ovaries to produce a large number of eggs by stimulating the follicles and enhancing the progesterone secretion.

You can be prescribed progesterone and human chorionic gonadotropin (for stimulating progesterone) supplementation as well.

Next Steps

If you have been diagnosed with LPD, discuss the various treatment options available for treating it with your doctor.

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References

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  • Luteal Phase Defect: How It Impacts Fertility and How to Treat It. RESOLVE. http://www.resolve.org/about-infertility/medical-conditions/luteal-phase-defect-how-it-impacts-fertility-and-how-to-treat-it.html?. Accessed 3 Jan. 17.
  • Progesterone administration for luteal phase deficiency in human reproduction: an old or new issue? BioMedCentral. Journal of Ovarian Research. https://ovarianresearch.biomedcentral.com/articles/10.1186/s13048-015-0205-8. Accessed 3 Jan. 17.
  • Bukulmez O, & Arici A. Luteal phase defect: myth or reality. Obstet Gynecol Clin North Am. 2004 Dec;31(4):727-44, ix.
  • Understanding Ovulation. American Pregnancy Association. http://americanpregnancy.org/getting-pregnant/understanding-ovulation/. Accessed 3 Jan. 17.

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