Luteal Phase Defect: Diagnosis and Treatment

Luteal phase defect (LPD) is a common condition that may affect fertility. However, it is usually very responsive to fertility treatment. If you discovered LPD on your own through fertility charting, it’s important to see your physician to receive treatment.

With LPD, two things can cause the endometrial lining of the uterus not to accept an egg: Either the ovaries are not secreting enough progesterone or the endometrium doesn’t correctly respond to normal levels of progesterone. To get the correct treatment, your physician must first determine what’s causing the LPD.

Diagnosis of Luteal Phase Defect

An endometrial biopsy is used to determine if the lining of the uterus is adequately prepared to sustain a pregnancy. This test is usually done a day or two before the next menstrual cycle is expected. During the test, a small sample of the endometrial lining is removed and then evaluated to see if it’s typical of a certain cycle day. The technician dates the sample, and if there’s a discrepancy of more than two days between that date and your cycle, the lining is considered “out of phase.” To be positively diagnosed with LPD, you must have two “out of phase” biopsy results.

A serum progesterone test is another diagnostic test. This simple blood test is done seven days after ovulation to see if your body is producing enough progesterone.

Treatment of Luteal Phase Defect

If the endometrial biopsy was “in phase” but your progesterone level is low, you’ll be given progesterone supplements to increase the level of this hormone. Progesterone may be taken orally, by vaginal suppository or vaginal gel, or by injection.

If your progesterone level was normal but the endometrial biopsy was “out of phase,” you’ll be given a fertility drug such as Clomid (clomiphene citrate) to stimulate the ovaries. This medicine is taken orally and stimulates the growth of the follicle to increase your chance of producing a higher quality egg.