‘With a luteal phase defect, the lining of the uterus does not grow properly each month’

Emobileclinic Trending Topic:Luteal Phase Defect

A luteal phase defect (LPD) is a disruption in a woman’s monthly menstrual cycle. It is also called an ‘inadequate luteal phase’ or abnormality in endometrial development. The luteal phase is end stage of the menstrual cycle. It occurs after ovulation and before menses starts.

The luteal phase is usually about 12-14 days long. During this phase, the lining of your uterus normally becomes thicker to prepare for a possible pregnancy. With a luteal phase defect, the lining of the uterus does not grow properly each month. This can make it difficult to become or remain pregnant, although there is a debate about whether this is a direct cause of infertility. During this time, the ovaries produce a hormone called progesterone, which enables the endometrium to grow. The developing baby attaches to thicker lining if pregnancy occurs and if does not occur the endometrium sheds and menses occurs.

semen quality pic

A LPD can occur if ovaries do not release enough progesterone or if the lining of the uterus does not properly respond to the progesterone. LPD has been linked to many health conditions including anorexia, endometriosis, extreme amount of exercise, hyperprolactinaemia, obesity, polycystic ovary syndrome and thyroid disease. Symptoms of LPD may include more frequent menses, miscarriages, difficulty getting pregnant and spotting between periods. It may be difficult to diagnose LPD as there is no single test that can diagnose it. Blood tests that can be helpful include FSH level, LH level, pregnancy test and progesterone level. Another method is to monitor the number of days between ovulation and menses. Some authority recommend a series of endometrial biopsies. This checks the lining of the uterus.




A small sample, of this lining is removed at a specific time of the month and examined under the microscope. Unfortunately, none of these methods have been proven to accurately predict infertility and have limited value in evaluating an infertile couple.

Management is usually via progesterone supplementation for luteal support and commonly provided during infertility treatment. There are 3 methods of therapy that have been utilized to treat LPD:




  • Controlled ovarian stimulation with clomiphene citrate or human menopausal gonadotropin (hMG) to produce more than 1 follicle and therefore more than 1 corpus luteum.

  • ¬†Supplemental hCG to increase corpus luteum secretion of progesterone.

  • ¬†Supplementation of progesterone after ovulation.

 

 

 

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