Understanding Luteal Phase Defect

There are many causes of infertility; however, one that commonly goes unnoticed is luteal phase defect (LPD). This ovulatory dysfunction is caused by a disruption in the luteal phase of the menstrual cycle, which prevents the uterus from developing the proper environment to grow a fetus. This condition rarely exhibits significant symptoms. Dr. Sonja B. Kristiansen and her team at the Houston Fertility Center in Houston, TX, can perform critical testing to determine whether LPD is the cause of your fertility difficulties and help you restore proper function.

What is the Luteal Phase?

Before discussing luteal phase defect, it is important to define the luteal phase. The menstrual cycle consists of two stages: the follicular phase occurs first, and the luteal phase happens after that. The follicular phase is crucial for the growth and development of the egg. Once the egg has matured, the follicle housing the egg releases it from the ovary.

Graphic of a woman's uterus
Luteal phase defect does not produce any discernible symptoms and often goes undiagnosed. 

The luteal phase begins immediately following ovulation. When the egg is released, the follicle converts into the corpus luteum, a gland that is accountable for the secretion of progesterone. This hormone is especially important for preparing the uterine lining for a potential fertilized egg.

What is a Luteal Phase Defect?

A luteal phase defect is characterized by abnormal development of the endometrium. This can be caused by a number of reasons. If the level of progesterone during the luteal phase is either too low or not present for an adequate length of time, it can result in complications. No matter what causes a luteal phase defect, it occurs when the endometrium fails to respond to the stimulation of progesterone.

Women diagnosed with luteal phase defect are most commonly treated with progesterone supplements.

What Causes Luteal Phase Defect?

There are several factors that can contribute to the development of luteal phase defect. This condition can be the result of:

What Are The Symptoms?

Luteal phase defect does not always present symptoms. Therefore, it can be difficult to diagnose. However, there are a few symptoms that may, in some cases, indicate a luteal phase defect. These include:

  • Unexplainable difficulty conceiving
  • Premenstrual spotting
  • Short menstrual cycles, lasting less than 26 days
  • Repeat early miscarriage
  • Premenstrual syndrome (PMS)

Diagnosing Luteal Phase Defect

An endometrial biopsy is generally the only way to to determine whether you have luteal phase defect. Approximately 24 to 48 hours before the next menstrual cycle is anticipated, a small sample of the endometrial tissue is harvested, analyzed, and dated. If there is a difference of three or more days between the date of biopsy and the actual beginning of your cycle, the endometrial lining will be labeled “out of phase.” Those diagnosed with luteal phase defect will have two “out of phase” biopsy results.

Treatment for Luteal Phase Defect

Women diagnosed with luteal phase defect are most commonly treated with progesterone supplements. In many cases, extra progesterone can prevent loss of pregnancy when administered three days after ovulation. Timing is incredibly important, however, as beginning supplemental progesterone too early can increase the risk of a tubal pregnancy. Therefore, it is crucial that you document your ovulation accurately.

Schedule a Consultation

If you have experienced difficulty becoming pregnant and you are not sure why, you may benefit from a visit with Dr. Kristiansen. She can help you determine the cause of your infertility and recommend any necessary treatments. To schedule a consultation, contact us online.

Dr. Sonja Kristiansen

Houston Fertility Center

Dr. Sonja Kristiansen is the founder and Medical Director of Houston Fertility Center. She is a board-certified Reproductive Endocrinologist Infertility (REI) specialist who is proud to help hopeful parents fulfill their dreams of having children. Our center is affiliated with the:

  • American College of Obstetricians and Gynecologists
  • American Society for Reproductive Medicine
  • Texas Medical Association

We provide convenient care for patients from greater Houston and visitors from out of town. For more information about our services, contact our office online or call (713) 225-5375 today.

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