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Alternative names Return to top
Inadequate luteal phaseDefinition Return to top
Luteal phase defect is when there is inadequate secretion or action of the hormone progesterone during the menstrual cycle. This results in a lag of more than two days in the development of the endometrium (the lining of the uterus, where an egg implants).
Causes, incidence, and risk factors Return to top
The concept of luteal phase defect is controversial, and its role in infertility is uncertain. It may affect about 3 to 4% of infertile women, and up to 5% in women with a history of recurrent, spontaneous abortions. However, luteal phase defect can be found in up to 30% of isolated cycles of normal women.
Risks factors include:
Symptoms Return to top
The main symptom is short or irregular menstrual cycles.Signs and tests Return to top
Traditionally, a biopsy of the endometrium is the standard for diagnosing luteal phase defect. However, measuring the progesterone level in blood serum is often used as a means of diagnosis instead of endometrial biopsy due to the pain, difficulties of precise menstrual cycle dating, and expense associated with endometrial biopsy.
A blood serum progesterone level of lower than 10ng/mL one week prior to the start of menstruation or 7 days after the LH (luteinizing hormone) surge is generally accepted as a diagnosis of luteal phase defect.
Treatment Return to top
Progesterone injections or gel (Crinone) are often used when luteal phase defect is suspected.
If there is evidence that low FSH (follicle stimulating hormone) is present with luteal phase defects, clomiphene citrate may also be used.
Expectations (prognosis) Return to top
Using progesterone therapy, success rates of approximately 50% have been reported, but good controlled clinical studies are lacking. The risk of using clomiphene citrate is its uncertain effectiveness and a 5% chance of multiple births (mostly twins).
Update Date: 6/3/2004 Updated by: Peter Chen, M.D., Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |