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Luteal Phase Defect
How LPD Affects Fertility By Gwen Morrison
"Treatments include adding progesterone by oral, injection or vaginal suppository routes," says Ricki Pollycove, M.D., of San Francisco, Calif. "We also use ovarian stimulation protocols to 'goose' the ovary into better hormone production. This is often done using Clomid (clomiphene citrate), a central-cycle center medication that tricks the body into thinking it does not have enough estrogen, hence an outpouring of more stimulation to the ovary to get going and gear up."
If, however, it is deemed that the follicle development is inadequate, as in Lambert, then patients may be given ovulatory stimulants such as Clomid, which help the follicle to mature. When the follicle matures appropriately, the chance of producing a higher quality egg increases. It also has the benefit of producing a more normal functioning corpus luteum.
There are some physicians who use injections of human chorionic gonadotropin (HCG) to stimulate the corpus luteum further. The one downfall of this method is that elevated HCG levels are a sign of pregnancy and using the injections will often cause false positive pregnancy results in women.
"Progesterone suppositories were prescribed at first, but did not get the results they wanted, so my doctor has since put me on 50 milligrams of Clomid," says *Jennifer Kennedy from San Diego, Calif. "This, along with progesterone suppositories four days after ovulation, seems to have worked in extending my cycle."
Kennedy describes her monthly routine as very daunting. "I go in on Day 3 for a sonogram to ensure everything is fine to start Clomid. Start Clomid on Days 5-9. I go in again on Day 12 to check that the Clomid has worked and that I have follicles. They then schedule me for an IUI. Then the following week, I go for a progesterone blood test. And then, I do another month of the same if I don't get pregnant."
Luteal Phase Defect is considered a fairly common disorder. Finding the exact cause of the disorder remains the key to obtaining the appropriate treatment.
*Name has been changed.
