Luteal Phase Defect (LPD)
Definition - What does Luteal Phase Defect (LPD) mean?
Luteal phase defect (LPD) is a disrupted menstrual cycle that prevents the body from fully growing the uterine lining. LPD can occur when the ovaries do not release enough progesterone, or the uterine lining does not respond to the hormone. Without a fully developed uterine lining, it can be difficult to become or remain pregnant.
LPD may also be called luteal phase deficency.
FertilitySmarts explains Luteal Phase Defect (LPD)
A woman’s menstrual cycle can be broken into two phases: the follicular phase and the luteal phase. Each phase is approximately 12-14 days long, depending on the specific length of an individual’s cycle.
The follicular phase is the first half of the cycle, beginning on the first day of the menstrual period and ending just before ovulation begins. During this phase, the ovaries release a series of hormones:
- Estrogen, which promotes follicle development in the ovaries.
- Follicle-stimulating hormone (FSH), which promotes the maturation of the an egg within the follicle.
Menstruation takes place at the onset of the follicular phase. Once the uterine lining has fully shed, estrogen is released from the ovaries. The increased estrogen levels assist in initiating the regrowth of the lining.
The second phase, the luteal phase, begins when lutenizing hormone (LH), is released. This is known as the LH surge, and it occurs 12-24 hours prior to ovulation. The LH surge causes the follicle to rupture, releasing the egg into the ovary, where it proceeds towards the fallopian tube in search of fertilization.
Once ovulation occurs, ovaries have begin releasing high doses of the hormone progesterone, which finalizes the uterus lining growth. When finished, the uterine lining should be thick and rich, prepared for implantation and nourishment of the embryo.
However, when LPD occurs, the shortened cycle prevents the uterine lining from becoming fully developed. This can occur due to a lack of progesterone production or a failure of the uterine lining to respond to the hormone dispersal.
An underdeveloped uterine lining can have negative ramifications to both conception and pregnancy, including:
- Implantation failure
- Recurrent implantation failure
- Recurrent pregnancy loss
- Unexplained infertility
Signs of LPD include:
- Abnormally short menstrual cycles (less then 28 days between cycles)
- Low levels of progesterone
- Abnormal basal body temperatures following ovulation
- Spotting in between periods
Other symptoms and problems commonly associated with LPD include:
- Anorexia or extremely low body weight
- Extreme over exercising
- Thyroid disorder
- Polycystic ovary syndrome
In order to diagnose LPD the following procedures may be performed:
- Pelvic ultrasounds, to measure the thickness of the uterine lining
- Endometrial biopsy, to test the endometrial lining
- Hormone testing
- Fertility charting
Available treatment options include supplementation of progesterone. There are three ways to provide this:
- Ovarian induction, through ovarian stimulation medication
- hCG hormone injections
- Progesterone injections following ovulation
Additional treatment recommendations include lifestyle changes, including a diet rich in progesterone supportive foods, supplements, and progesterone cream.