Luteal Phase Defect (LPD), Page 2

How is LPD diagnosed?

Properly-timed endometrial biopsy is the most accurate method of determining if LPD exists. Such biopsies of the uterine lining (endometrium) are usually done as an office procedure and are mildly uncomfortable.

In addition, the following less invasive tests may help:

  • Serum progesterone - At 7 DPO (days past ovulation), serum progesterone levels less than 14 are inadequate for conception.
  • Estradiol - At midcycle
  • Follicle size - At midcycle, via ultrasound

Women who are concerned about the possibility of LPD are encouraged to use several cycles of BBT charting and other ovulation detection methods in an effort to enhance the diagnosis.

How real is this diagnosis?

Some physicians, even reproductive specialists, downplay the significance of LPD in their diagnosis and treatment decisions. It is generally thought that all women, fertile and subfertile, experience at least occasional cycles in which a short luteal phase is present. Also, many believe that when LPD is present in a cycle, it is the result of an egg that was compromised from the start (and hence, would have resulted in miscarriage or fetal anomaly if pregnancy occurred.)

With that in mind, if a woman believes that LPD is an issue in her fertility, she may need to be prepared to be a good self-advocate with her medical practitioners.

Does treatment for LPD exist?

Treating LPD is a matter of effecting the hormone levels in a timely manner, in hopes of bringing the menstrual and ovulatory cycles into sync with one another. Specifically the following may be used:

  • Clomiphene citrate or injectable fertility medications
  • Progesterone supplementation after ovulation
  • injections of hCG to stimulate the corpus luteum for more natural progesterone supplementation
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