15 answers

Luteal Phase Defect Pregnancy

I’m wondering if anyone has anything helpful to tell/share with me about luteal phase defects. I’ve been trying to get pregnant for a while, and had a miscarriage along the way. I had an ultra sound at 9 ½ weeks for that pregnancy, but it dated the fetus at 7 ½ weeks, and another week later the fetus died. The date was strange to me, because it showed me getting pregnant so late in my cycle, and then I read about luteal phase defects. I just went to the doctor yesterday to talk about fertility treatments, because I’m officially infertile long enough to be eligible, and I’m also 38 years old, so it’s gonna get worse quickly. Anyway, I was on day 40 of my cycle, with no period, and I’d taken 2 pregnancy tests, on days 34 and 36 (early detection ones), and they were negative. Now I took another one on day 41 and it’s positive. So it’s looking like I conceived pretty late in my cycle, and I’m a little nervous about it. The thing is, when I asked my doctor about the possibility of having a luteal phase defect (based on my other pregnancy and my cycle monitoring), she was skeptical about the existence of them, or that whether or not it means anything. But, there are things in mainstream literature like NIH and WebMD, so I’m not sure why she’s skeptical. (A luteal phase defect is when you ovulate late in your cycle after your endometrial lining is starting to degrade, and you'd have your period soon after you ovulate instead of 10-14 days after you ovulate.)

Did anyone else conceive late in their cycle (like day 30?), and what, if any, issues were there and how were they handled? Does anyone know anything about the defect that would be helpful? I have a call in to her, but I’m not sure my doctor is going to do anything supportive. Does anyone know anything about using progesterone cream during the first trimester without a doctor's order?

Thanks.

What can I do next?

So What Happened?™

Thanks everyone for your responses. I did not change doctors, but told her I was using the progesterone cream. She was non-committal and said it shouldn't hurt anything. Things have been going fine. The first ultrasound to give me a due date confirmed that I'd conceived around day 30 of my cycle. We did a couple of others to confirm the baby was growing fine. I'm now 12 weeks pregnant, and just had the one for genetic screening and it came back excellent, with my risk factors the same as a 20 yr olds (since I'm 38 that was great news).

More Answers

We are dealing with infertility issues right now as well. I would suggest reading the book Taking Charge of your Fertility. It has a wealth of information including information about short luteal phases. Before I read the book and understood what was going on, I would go 2 months without a cycle and then my doctor would put my on Provera to start a new cycle. Now I am charting my temps, something I learned from the book. Currently, I am at day 40 of my cycle and just ovulated and I know this based on my temps. In the past I would already have taken meds to initiate a new cycle and missed that ovulation. So now I know to wait and watch. I would highly suggest reading the book then chart your cycles like crazy and then present that info to your doctor. If they aren't willing to listen to you then transfer care to someone who will. Good luck with this, hopefully both of us will have good news soon!

2 moms found this helpful

I ovulate extremely late in my cycle (just a couple of days beforehand, on average). I'm also suuuuuuuuuper fertile...and have to be very careful not to get pregnant. Go figure.

In any event. Whether it's related to the late ovulation or not....I don't know.

What I do know... after multiple miscarriages and my son, is that I grow really really large placentas. They are so large, that they tend to rip away, causing placental abruptions. My son was 10lbs at birth...the placenta was twenty something. The average size is 3-6 lbs.

It would make sense that the increased placenta size is related to the late ovulation (since women who get pregnant ON their period, actually regrow that lining on the quick) and I suppose that quick regrowth of the endometrial lining COULD affect the growth of the placenta. Or it may just be me and weird physiology.

Anyhow, those are just semi-educated guesses.

For the birth of my son I was paranoid, so put myself of "chair rest". The time before, I had literally been walking and felt something rip and give way...so with my son I became the fat pregnant chick everyone sneered at, but I had my little boy. :) :) :) The other miscarriages had all been fairly early on (prior to 3 months) and I was very very very active...which is what it was (eventually) assigned as to the cause. The one prior to my son though, was at 5mo and nearly killed me. So with my son I was paranoid.

He's brilliant (<grinning> okay okay, he's perfectly normal), healthy, & I'm well.

2 moms found this helpful

I've never heard of a luteal phase defect but every woman's body is different and some women have shorter luteal phases than others. In my case my luteal phase is 12 days so I ovulate later in my cycle than most women would. So it can be harder to determine when I've ovulated because my cycles are never the same length either.

I guess if Doctors wanted to put a name on something that they didn't have an answer for, like shorter or longer luteal phases, than maybe that is what they would call it. A Luteal Phase Defect because a "normal" luteal phase is supposed to be 14 days from what I understand.

I really don't have an answer for your question about using progesterone cream during the first trimester of a pregnancy either. I've never had any complications during pregnancy that lead to a miscarriage so I don't know what to say on that part.

1 mom found this helpful

Hi Colleen. I figured out that I was ovulating late in my cycle too but it was more like day 18 or 19 of a 28 day cycle. Having a short luteal phase is a BIG problem. I didn't figure it out until I started using an ovulation monitor since my cycles were pretty regular. I'm pretty sure I also did a blood test to check my progesterone levels which is pretty routine when going through fertility issues. My OB put me on progesterone suppositories right away and I got pregnant and stayed pregnant after the second month on the suppositories. I actually had identical twins, which was totally random and not because of anything I was doing fertility-wise. If your doctor is skeptical about the luteal phase thing, I would find another doctor. You don't have time to waste on this. If you do a progesterone cream without doctors orders, the important thing to keep in mind is not to start applying the cream until like 3 days after you ovulate. If you boost your progesterone too early after ovulation, you increase your risk of the egg implanting in the fallopian tubes which results in an ectopic pregnancy. The progesterone creates the right environment for the egg to implant in the uterus and it is what the ovaries naturally release when ovulation occurs. You don't need progesterone before ovulation, just a few days after ovulation. Hope that makes sense. I never had a miscarriage but I'm wondering if I might have had a few pregnancies that just didn't implant properly due to lack of progesterone. Hope this helps. good luck to you.

1 mom found this helpful

Hi Colleen,

I second the suggestion to read Taking Charge of Your Fertility (I wish I had read this when I was a teenager!) it really helped me understand my reproductive cycle better.

I would also suggest that you read a book called "The Infertility Cure" by Randine Lewis. I bought this for my sister-in-law and read it before I gave it to her (!) It comes from the perspective of Chinese Medicine which looks at the whole body rather than the specific symptoms. It gave me an appreciation for Chinese medicine and acupuncture and reaffirmed my belief that we should start with the least invasive treatments before trying more disruptive things. Too many fertility doctors just want to throw Clomid at women, not try to figure out what is wrong. Find a doc that you're comfortable with. You don't need any extra stress!

1 mom found this helpful

I have had 2 miscarriages in the past between my two kids. Not sure what it was caused from, but when I got pregnent with my son my Dr. started testing my progesterone levels and we found out that my levels were very low so he put me on progesterone pills for the first trimester and he is now a healthy happy 2 1/2 year old. When I got pregnent this time (17 weeks today!) I called the dr. as soon as I found out and went in and had blood tests and my progesterone levels were very low again and I was put pack on progesterone pills and so far all is going well.

I would ask your Dr. if she will order you to get blood work to test your progersterone levels and go from there. That way if they are low you can get on the meds you need.

Good Luck!

1 mom found this helpful

Colleen,

I have a luteal phase defect. My naturopath and I picked this up by monitoring my hormone levels throughout my cycle. I ovulate late in my cycle and typically there isn't enough time for implantation to occur. I'm 41 and pregnant. This time, I took oral progesterone from mid-cycle on. The plan had been to taper me off when my period should be due (~14 days after I started) but I turned out to be pregnant the first cycle we used the progesterone so my midwives kept me on it through 12 weeks. No miscarraige!

I encourage you to find another doctor to work with,
C.

1 mom found this helpful

I don't know if you'll think it's late, but I conceived on day 23 with both of my boys. That's later than normal. Both my boys are fine. Good luck with your research.

Best,

AMD

1 mom found this helpful

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