You’ve been getting your period for years, but you’re probably not familiar with the different phases of menstruation, and how discrepancies in hormone levels during the process could impact your fertility. Here’s what you need to know about Luteal Phase Deficiency (LPD).
The luteal phase refers to the time in a normal menstrual cycle that begins after ovulation (when a mature egg is released) and continues until the start of your next menstrual period. The average luteal phase lasts for 14 days, but can range from 10 to 16 days.
During the luteal phase, the corpus luteum — which is created from cells that remain after the egg is released — secretes the hormone progesterone which is needed to maintain an early pregnancy. This rise in progesterone causes the endometrial lining of the uterus to thicken, and makes it receptive to implantation of the embryo.
What Is Luteal Phase Deficiency?
Luteal Phase Deficiency (LPD), also called Luteal Phase Defect, has been described as an insufficient level of progesterone production. A “short luteal phase” is described as one that lasts fewer than 10 days. However, there is a lot of debate in the field of reproductive medicine regarding the validity and treatment of this diagnosis.
What Causes LPD?
A few potential causes of LPD include:
- Abnormalities in other hormones, such as gonadotropin-releasing hormone, follicle stimulating hormone and luteinizing hormone, may cause deficiencies in estrogen and progesterone production.
- Thyroid and prolactin disorders.
- A recent childbirth.
- A history of a kidney transplant.
How Does LPD Affect My Fertility?
LPD and a lack of progesterone have been suggested to be associated with infertility and early pregnancy loss. Why? When progesterone levels drop, the endometrial lining of the uterus will break down, which may trigger menstrual bleeding and cause an early miscarriage. Without the proper levels of progesterone and a positive uterine response, the lining will not be thick enough for the embryo to attach to it.
If I Suspect I Have LPD, What Are My Treatment Options?
No treatment for LPD has been shown to improve pregnancy outcomes in natural cycles. In a medicated or stimulated cycle, luteal support with progesterone or hCG may improve pregnancy outcomes.
Dr. Taraneh Gharib Nazem is Senior Fellow in Reproductive Endocrinology and Infertility at the Icahn School of Medicine at Mount Sinai/Reproductive Medicine Associates of New York. She is a board-certified Obstetrician Gynecologist. Dr. Nazem completed her residency in Obstetrics and Gynecology at the New York University School of Medicine, where she was elected administrative chief resident and graduated with the Robert F. Porges Honor Resident Award, for outstanding performance.