How is
luteal phase defect diagnosed?
Your doctor
may recommend that you keep track of your temperature
upon waking with a bbt
chart. Progesterone causes a rise in temperature
that is visible on a bbt chart during the second half of your
cycle. Normally, you will see temperatures rise after ovulation
and stay up for about 12-14 days before menstruation. You
can tell how long your luteal phase is by looking at your
bbt chart. If your luteal phase is shorter than ten days you
may have a luteal phase defect. Some doctors may be concerned
if your luteal phase is shorter than twelve days.
Endometrial
biopsies are another way that luteal phase defect is diagnosed.
Endometrial biopsies are usually done late in your menstrual
cycle around 11 or 12 days after ovulation. An endometrial
biopsy is a scraping of part of the endometrium (the lining
of your uterus). Your doctor will use an instrument to take
a sample of the lining of your uterus. He will send this sample
off to a lab to be evaluated. The lab will take a look at
the sample under a microscope and determine what stage of
development the tissue is. If the tissue is not developed
as much as it should be for where you are in your cycle you
may be diagnosed as having a luteal phase defect.
Since
progesterone production is the big concern with luteal phase
defect, some doctors will check your blood progesterone level
to diagnose luteal phase defect. This is done by checking
your progesterone levels at different stages of your menstrual
cycle. If your progesterone level is low, you may be diagnosed
with having a luteal phase defect. There are some drawbacks
to checking blood progesterone levels. The level of progesterone
in your blood fluctuates from hour to hour throughout the
day. You may appear to have a normal blood progesterone level
at one point in the day but have a lower level if your blood
was drawn at a different time of day. Also, blood
progesterone levels vary for normal pregnancies
making it difficult to establish what level is inadequate
to sustain pregnancy.
Treatment
of luteal phase defect
There
are a few ways that luteal phase defect is treated. Some doctors
simply prescribe progesterone suppositories to increase the
level of progesterone in your bloodstream. How effective progesterone
treatment is has not been determined. Progesterone therapy
is generally started a few days after ovulation and continued
until the placenta begins to take over progesterone production
around the twelfth week of pregnancy. Not all doctors are
comfortable with progesterone supplements. Progesterone’s
safety has not been established. Although there is no evidence
of birth defects caused by progesterone supplementation, there
really is no long term data on its use either. We are just
not sure that there will not be repercussions from using progesterone
or even if it is effective.
Fertility
drugs like Clomid
are sometimes used to treat luteal phase defect. If follicle
development is poor during the first half of a woman’s
cycle, the resulting egg and corpus luteum may be poor. Clomid
is used to stimulate a woman’s follicles to ovulate.
If treatment is successful, the corpus luteum will be healthier
and subsequently, progesterone production will be better.
HCG injections
are yet another treatment for luteal phase defect. HCG
is normally produced during pregnancy and helps maintain the
corpus luteum. HCG injections help to stimulate the corpus
luteum and increases progesterone levels during the luteal
phase.
