The last 12 to 14 days of your monthly menstrual cycle, the time period between ovulation and the time when you get your period, are called the luteal phase. Once you have tracked your ovulation symptoms to determine your most fertile time for successful conception, the luteal phase can become what is affectionately referred to as the two-week wait, or 2WW. The luteal phase is where the endometrium lining, or the lining of the uterus, is built up to receive the newly developing embryo for implantation.
But for women with a luteal phase defect (LPD), these two weeks can often end in early miscarriage or another period. Instead of a BFP (big fat positive), they instead see a CD1 (cycle day 1).
An LPD is characterized by an insufficient amount of progesterone production by the woman to build a sufficient endometrium lining for implantation or the inability of the endometrium lining to respond to progesterone properly. Unfortunately, most women with the condition may not even notice they have it until they are actively trying to conceive.
Women who are charting their menstrual cycles are likely to notice some of these common symptoms of LPD each month:
– Their basal body temperature (BBT) will spike on ovulation but will not stay elevated following ovulation
– Their period occurs much sooner than two weeks after ovulation
– Spotting between periods
– Light or frequent periods
Women with LPD may have difficulty getting pregnant, although the condition itself is not considered an infertility diagnosis. The reason for this is all women are likely to have changes in the luteal phase from time to time. But for women with the condition, implantation is more challenging and the risk of early miscarriage is more likely.
Doctors can diagnose LPD using a few different methods. The most common method is by using a pelvic ultrasound to determine the thickness of the endometrial lining. In some cases, a biopsy may be performed to look for the beta-3 integrin sticky protein that is found in the lining of the uterus and facilitates a better environment for implantation. In addition, they might perform any of the following blood tests to determine if there is a problem: follicle-stimulating hormone (FSH) level, luteinizing hormone (LH) level, a pregnancy test and/or a progesterone level.
For some women, particularly those who are not trying to conceive, an LPD requires no treatment. But for women who are actively trying to get pregnant, treatment options include:
– A cycle of Clomid (clomiphene citrate), a fertility drug that is able to stimulate the ovaries to produce more follicles that will develop into mature eggs for your menstrual cycle
– Use of human chorionic gonadotropin (hCG), which is useful in stimulating both progesterone production and ovulation
– A series of progesterone injections or other supplements (pills or suppositories) administered after ovulation to help the endometrial lining to develop more during the luteal phase
Luteal phase defects are one of many areas of awareness that is addressed by the annual event, National Infertility Awareness Week (NIAW). With this year’s theme, “Resolve to Know More,” National Infertility Awareness Week is April 20 to 26. NIAW is designed to help build the infertility community’s awareness of issues and challenges faced by infertile couples.
After ovulation symptoms have occurred and conception does not, many women may begin to suspect that they are having an issue with the luteal phase of their monthly cycle. Consult with your doctor if you notice any of the above symptoms so you can determine if a luteal phase defect might be standing in the way of your dreams of family. Working together, you and your doctor can come up with a treatment plan for luteal phase defect that removes all obstacles and makes your dreams of family a reality.
Sources:
“Luteal Phase Defect.” www.fertilityfactor.com. Web. 31 March 2014. <http://www.fertilityfactor.com/infertility_luteal_phase_defect>
Johnson, MD, Kimball. “Luteal Phase Defect.” WebMD. 10 Jan 2013: 1-2. Web. 20 Nov. 2013. http://www.webmd.com/infertility-and-reproduction/guide/luteal-phase-defect