Luteal phase defect, now what? - Mothering Forums
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#1 of 24 Old 12-03-2004, 08:50 PM - Thread Starter
 
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Hi all,
After about six months, I have figured out for sure (with the help of a fertility monitor) that I have a luteal phase defect with my luteal phase lasting about 9 days. I feel like I should go the natural route first, with b6 supplementation and progesterone cream,but part of me wants to just run out and get the blood tests, ultrasounds that check the follicle, and the endometrial biopsy. I have a 2.5 year old and I can't stand to go to another playgroup where someone asks "When are you going to have another?" I am so blessed to have one already, and for those of you experiencing infertility with your first try, my heart goes out to you since this is one of the hardest things I have had to go through and it has only been a short time in comparison to most. I am just tired of feeling so down and anxious.
My question is, can my OB (I normally go to a midwife, but don't know what her scope of practice is for fertility issues) do things like endometrial biopsies and ultrasounds that check the follicle, etc.. things of that nature that try to get to the root of the cause for short luteal phases?
I didn't know if I should just wait it out and see what happens before making an appt. with an RE (since they probably won't see me until it has been a year) or call an OB.
Thanks in advance,
Elle
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#2 of 24 Old 12-04-2004, 11:39 AM
 
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Quote:
Originally Posted by tilly2321
My question is, can my OB (I normally go to a midwife, but don't know what her scope of practice is for fertility issues) do things like endometrial biopsies and ultrasounds that check the follicle, etc.. things of that nature that try to get to the root of the cause for short luteal phases?
Your OB can give you progesterone supplements that you can start taking at 3dpo and you normally won't start your period until after you stop them. You'd take them, test at 14/15dpo and then if negative, stop the supps and you'll start. If you do get pregnant, you'll need to continue them through the 1st tri.

My LP is also 9-10 days....we've been TTC#2 for more than 8 years.
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#3 of 24 Old 02-11-2005, 12:04 AM
 
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Wow...tilly, I can't beleive it, I could have written your post myself! I was just researching 'short luteal phase' and googled it and guess what, this MDC thread came up!

I had a m/c at 12 weeks (blighted ovum) in Nov., and since then I've been charting and it looks like I have a short luteal phase...now I'm wondering what to do about it. I, too, was wondering what steps to take next- I have always seen midwives, don't know if they handle fertility issues or not, or do I have to find a fertility doctor now? I guess first I will see what kind of natural remedies are available before going that route.

It is so disappointing b/c my first pregancy and birth was the easiest ever- I was so blessed, but ever since then I have had nothing but problems with nursing, my cycles, then the m/c, and now possibly a luteal phase defect. I just don't want to go down that road of tons of doctor visits, prescriptions, blood tests, ultrasounds, biopsies, and whatever else is involved.

And like you, I have a 2 yr old, and I get asked almost daily when the next one is on the way...I am getting so tired of giving a fake smile and making some kind of light comment. Why don't people realize that it's a personal thing??
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#4 of 24 Old 11-14-2005, 12:01 AM
 
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Anyone have updates? The same exact thing happened to me. I finally did get pregnant again when my first one was 26 mos. This was two years ago. I have two boys now and I'm going through it again. I follow the advice in "Fertility Cycles and Nutrition" by Marilyn Shannon. This is a very insightful book. I figure even if I don't get pregnant again, I'll be healthier. Has anyone tried progesterone cream??
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#5 of 24 Old 11-15-2005, 02:36 PM
 
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I also have a short LP. It's 3 days, sometimes a whole 4. I started taking extra B6 3 months ago and it did nothing, I started Vitex 2 months ago and so far nothing, I went to my midwife and she has me on natural progestrone cream for CD 12 until AF or BFP(then I would switch to suppositories) I think the vitex and the prosestrone are not mixing so I'm coming of the vitex slowly. My MW said it can be 3 months before we see a difference from the cream so I'll give it until the end of January and see where we are at and go from there.

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#6 of 24 Old 12-04-2005, 09:54 PM
 
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I would find a dr (OB or family physician) who will do some post-ovul hormone testing. OTC prog cream may not be strong enough if your levels are really low. IMO, there is no sense waiting to supplement with natural prog since a prog deficiency has other neg healthy effects (such as increased cancer risk). But just using OTC may not solve the problem.
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#7 of 24 Old 12-28-2005, 05:11 AM
 
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Marilyn Shannon's book is awesome.

Great info, easy to read, nutritionally & medically sound. If you haven't already, I would highly reccomend picking it up.

I used progesterone suppositories for LP defect (9-10 days). I also used them during both IVF cycles. They were messy & itchy. Much easier to take than PIO shots though.

Good luck!
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#8 of 24 Old 12-28-2005, 05:32 AM
 
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If you would like to try herble things first then I highly recommend using Vitex aka chaste tree extract this herb helps progesterone production. Personally I used it from the time of Ovulation until AF or + pg test it can safely be taken while pg in the first months so it will not hurt the baby and may even help support the pg if u do have low progesterone. With ds I took it up till 4 days after my first + then I got my blood work done that showed extremly low progesterone so I then went on progesterone pill suppliments till 12weeks.

There r many great herbs out there to help support and regulate your cycle. A book that tells them that I love is Wise woman herble by susan weed.

 
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#9 of 24 Old 12-28-2005, 11:15 PM
 
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I second getting post ovul hormone testing. It's totally non-invasive and it's possible that you will need more than OTC prog to correct the issue. Why waste time and $ when it may not solve the problem? OTC prog creams are less than 50 mg/day even if you take an unusually large dose. My SIL had a normal 14 day luteal phase but prog levels were only 20% of normal. She had to take 3000mg/day of prog to get her levels BARELY BARELY within the normal range. The only way to realistically take that high a dose is with prescription prog.
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#10 of 24 Old 12-28-2005, 11:29 PM
 
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Hello,
Just poking my nose in because I had LPD infertility. We had tried for 2 years to have our first child--I tried everything, including herbs, teas, and then moved on to progesterone suppositories. I tried with just progesterone suppositories alone for about 6 months, and finally my doctor told me he wanted to try me on Clomid days 5-9, and then progesterone suppositories after ovulation. The Clomid helps to support the luteal phase and helps you to ovulate later--with a longer luteal phase. After one month of that treatment I was finally pregnant with our first child. I was really reluctant to try Clomid, but at that point I was very desperate to be pregnant. That child is now 11.

I used the same protocol to get pregnant with our daughter, Samantha. I tried natural conception for a year before going back on the clomid/progesterone--so I guess that was the magic recipe for my particular body.

Sometimes Progesterone alone can work--I have heard it can really help to lengthen the luteal phase--so I would try that first.

Good luck,
Lisa
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#11 of 24 Old 01-14-2006, 02:26 PM
 
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Quote:
Originally Posted by abc7426
Anyone have updates? The same exact thing happened to me. I finally did get pregnant again when my first one was 26 mos. This was two years ago. I have two boys now and I'm going through it again. I follow the advice in "Fertility Cycles and Nutrition" by Marilyn Shannon. This is a very insightful book. I figure even if I don't get pregnant again, I'll be healthier. Has anyone tried progesterone cream??
:

The Marilyn Shannon book is great...proper nutrition solved my cycle issues (and they were innumerable) several years ago, before we conceived dd. It only took one cycle of proper eating (and I have to admit that I was stringent beyond belief, but it was soooooo worth the work) once I was educated! I could take several cycles for your body to regulate, but I have to tell you that I had undergone the doctors "fixes" for six years before I finally DEFAULTED to proper nutrition after doing some research myself. All the hormone therapy (quote, unquote) did for me was to make me wretchedly sick. Didn't fix the problems. Not that that isn't necessary for some women, but my advice would definately be to try the natural approach first. If nothing else you will certainly be healthier for the effort.

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#12 of 24 Old 01-14-2006, 03:31 PM
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The easiest way to go is this...

Ask for blood work - you should have some done on cd 3 to check baseline levels, also check your thyroid.

Then 7 days past ovulation (NOT ON CD 21 unless you ovulated on cd 14 - make sure of this!!!) have them check your progesterone. This will tell you if your levels are in the right place, if you ovulated, etc.

http://www.fertilityplus.org/faq/hormonelevels.html

That will give you an idea of what you need tested...and what the levels should be - don't just let them tell you "oh, it's normal", actually get the numbers.

Your OB ay be able to do all this. But I highly suggest getting into the RE - they are specialists, and really know the route to take.

Now, they also usually have a bit of a wait to get into their office...so while that is happening, I would work on some natural things as well. Work on your diet, add some vitamins, add some OTC progesterone cream. Infertility treatment is alarmingly invasive (go check out some of the infertility blogs!) , often painful, and expensive, and usually NOT COVERED BY INSURANCE, and if you can fix it with some changes to your eating, or supplements, I would highly suggest pursuing that first. Especially if it hasn't been a year yet. That year does give you credibility in some doctor's eyes.

I would also suggest acupuncture, and chiropractic - both of which have been shown to help with LP defect, and fertility in general.

Good luck!

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#13 of 24 Old 01-17-2006, 10:29 PM
 
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What is RE, as mentioned in previous posts in this thread?

I'm TTC #2 (ds is now 2.9) and I think I have a LP of 10 days...I had a MC in October at 10 weeks, two weird AFs since then, and I'm now spotting 10 days after ovulating. Argh.
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#14 of 24 Old 01-18-2006, 03:48 PM
 
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Reproductive Endocronoligist
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#15 of 24 Old 01-26-2006, 09:59 PM
 
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Hi ladies!

I've just been doing some reading on LPD, as my average luteal phase over about 6 months now according to fertility friend is only 11 days, with a max of 12 days. Last month, after starting spotting, but not my normal period on the day it was expected, I had a (what turned out to be a false) positive test 5 days later, which a blood test later that day measured as equivocal/positive (12) and then two days later as negative (4).
In between the two tests my period really finally kicked in, but the midwife said it wasn't a miscarriage as if it was the level would have stayed closer to 12. I've been trying for a second child for 4 cycles now, and for three of them that were well times, had this sneaking feeling that I was pregnant, but never actually was, concluding with this whole mess the last time!

I know that some doctors say LPD at 10 or less and some say 12. The midwife tested by thyroid which was normal the day of the second preg. blood test, and she said she would test progesterone, which I realize now I never got a result on. So I have a couple questions for those who have a little more experience with this...

- Do you think this might be LPD?
- I read a couple places that B6 alone can do it, but I am already on day 18 of this cycle....is there any point in trying it now, or does it have to be the whole time. I just had a +OPK today, and I have NOT ovulated yet.
- Do those of you who took progesterone have any negative experiences with it that would disincline me from trying it just in case? Do you have to take it all the way through the first trimester, or are there any negative effects that would make it worth the risk to get off it after the pregnancy is established?

Thanks to anyone who has advice. I've been feeling like something just isn't right and this certainly would explain a LOT.

I'm so tired of all this ambiguity each month, so any guidance is SO appreciated!!!!!

Nicki
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#16 of 24 Old 02-02-2006, 05:44 PM
 
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I am in the same boat with a clear LPD diagnosis (symptoms: pre AF spotting for 5 days before each AF for 6 cycles in a row, delayed temp rise after O, and a characteristic drop the day after temp rises). I miscarried (blighted ovum) back in June and have tried for 6-7 cycles since, 5 of those supplemented with perscription Progesterone (200mg Prometrium) suppositories 2x per day. My RE is telling me Clomid is the next step. I have been reluctant but am becoming more open to the idea. I have tried all kinds of natural remedies, B-6 (have been taking it for 3 years), Vitex, stellar diet, lowered stress, acupuncture, you name it. I also have a friend who is 26 weeks pregant and had two miscarriages and was diagnosed with LPD. She was seen by a nationally-known fertility clinic and they said that Progesterone alone would not likely have prevented another miscarriage for her. They felt Clomid (or Femera) was clearly superior. I know this is the medical view and not the alternative view we hear on these boards as much. But as I approach 40, I think I am becoming more receptive to this idea. Though DH and are I are really scared of increased chance of twins (up to 10% chance vs. 3% naturally), especially fearful about what that would do to our precious DD.

My input and process for what its worth. Others who have LPD and have gone the Clomid route?
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#17 of 24 Old 02-02-2006, 07:48 PM
 
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Just wanted to add this very good description of LPD, I've read many and this is the best I've seen. It is at the INCIID site: http://www.inciid.org/printpage.php?...tility101&id=7
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#18 of 24 Old 02-07-2006, 06:48 PM
 
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Folks -

Hoping that you all can help with this one.

I just turned 42 years and am trying to conceive number two. My daughter is 21 months and we still love to breastfeed together -- about 4-5 times a day with no signs of weaning.

So here is the challenge: I have had my "AF" (period) now for 4 months and have been trying to conceive with no luck. Using the Toni Weschler charts and ovualtion tests I have determined that I have a regular 28 day cycle with 9 day luteal phase (ie: ovulation on day 17) -- so a classic luteal phase defect.

My OB is very sympathetic to my desire to continue breastfeeding and prescribed progesterone suppositories to take starting 48 hours after ovulation. He also thought 100 mg of B6 would be fine.

Has anyone else had any luck with this approach? I am open to other ideas as well, but concerned about the effect of herbs on my milk supply. Would appreciate any wisdom.

Thanks - Boo's Mom
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#19 of 24 Old 02-10-2006, 10:53 AM
 
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Hi Boo's Mom

I feel for you because we are in a similar situation. I too am breastfeeding my 13 month old son, and I started charting and it seems that ovulation is on day 17-18, period comes back on day 30, so there might be a problem. I am just starting to try to conceive # 3 but I think this time it might be more dfficult, because of that.

Now, I want to tell you about the website below, where they offer a progesterone cream which can be used by breastfeeding mothers. It is natural, but apparently lacks herbs that can cause problems for breastfeeding mothers. I might try it, probably. I don't know if you should choose this, over what your doctor told you. I probably would stick with the doctor's advice. But you asked for other imputs, so that is one. I guess reading about it won't hurt.
http://www.nutritionmadesimple.net/nutritionindex.shtml

Another thing is that breastfeeding is usually a time where fertility is decreased and charting is made very difficult, especially if there are night waking. I have Toni Wechlers 's book as well, love it, but my charts are not consistent, I do not get the necessary amount of sleep half the time, and often I cannot take my BBT at the same time. Cervical Mucus seems to have a slightly more consistent pattern, but often even after what I think is ovulation, it seems to come back, with different consistency. So, my point is, if you wake up at night to nurse, your charts might not be as reliable as you think, and it might be harder to be sure that you do have a luteal phase defect.

Lastly, in my case my OBGYN thinks that my possible fertility issues are caused by the breastfeeding itself. He recommended that I wean the baby, and said that until then he does not want to give me anything, because maybe I won't need it, because my fertility challenges might be simply due to breastfeeding itself. I felt badly, because I wanted to nurse the baby longer, but I also felt a little better, thinking that maybe then what I have is a normal reaction to breastfeeding, not a real problem after all. He even said that often the prolactine hormon produced during breastfeeding, decreases the progesterone, necessary for implantation and conservation of pregnancy. I did conceive my second child during breastfeeding,so initially I was surprised to hear that. But the more I read, the more I realize that I was one the fewer lucky ones, but a lot of women have to try a lot harder, to conceceive and carry a pregnancy to term while breastfeeding. And maybe this time, I will be one of them too. My doctor and I sometimes don't see eye to eye, but he is an excellent, excellent doctor and nice human being, and has done wonders, for both my pregnancies and deliveries, so I take his opinions seriously.

If you have time, please read the article below. It might give you some additional info.
http://www.kathydettwyler.org/detfert.html

So, I hope that I helped a little bit, and that you don't mind if I said some things that might not be your opinion. I did it because I have a similar experience, and I might have to make a choice, if I want to maximize my chances of having a third child. I am 31 years old, not twenty. So I don't want to play with my luck. I think that there is no right or wrong choice, only your priorities. Either way you (and I) have already given our children a lifetime extraordinary benefit, by lovingly nursing them so far.

Whatever road you choose, I wish you luck and success. Please keep me posted.

Val13
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#20 of 24 Old 02-26-2006, 03:05 AM
 
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Here's my experience with LPD. I was anovulatory, and then with clomid I began to ovulate but would start my period full force 7-8 days past ovulation. (my RE said I needed 11 days to get implantation successfully). I did not want to add in more pharmaceuticals, so I convinced my RE to let me do OTC progesterone creams and monitor my prog levels via bloodwork.

I got the Pro-Gest brand of Progesterone cream (the "best"), the individual little packets for maximum strength. I used five times the recommended dose, 3 times per day. The Pro-Gest was $35 per box of little packets, and I went through 2 and a half per month, so over $75 per month in progesterone cream. I rubbed it on my belly, breasts, and thighs. It stank and it made my skin rashy. In 3 months, my bloodwork showed zero change in progesterone level with the Pro-Gest cream.

I switched to progesterone perscription pills, which were only $30 without insurance kicking in (3 month's worth!). They brought my progesterone level up to normal, and I would not start my period till 3 days after stopping the progesterone pills. No side affects other than they make you feel pregnant every month. I have only great things to say about the RX pills and they were cheaper than the OCT cream, even with me having no infertility coverage.

Vitex and B6 combo did make my luteal phase one day longer, but it shortened my follicular phase by 2 days - the days the egg develops. On vitex/B6 I ovulated on CD8. That was too early for a well developed follicle. Just watch your chart carefully that the combo doesn't move your ovulation sooner because that cancels out the benefits of a longer luteal phase.
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#21 of 24 Old 04-09-2006, 05:27 PM
 
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Ack. I'm feeling really discouraged after everything I've read. My dd is 29 months and still a dedicated nurser. I'm not inclined to wean her. But now I'm wondering if I'm going to be able to sustain a pregnancy while breastfeeding.

I had a miscarriage (blighted ovum) in October and have been trying to get pregnant since, but my luteal phase has been about 7 days long for the past several cycles. I've started B-complex, EPO, essential fatty acids, and vitex. I plan to start using OTC prog cream this cycle. But I just have the feeling that I'm fighting a losing battle if breastfeeding is keeping my prolactin levels too high. Maybe I can get her to cut back on her nursing.

Does anyone know if a really long follicular phase can be related to LPD?

Also, when taking vitex for LPD, are you supposed to take it for the whole cycle, or just after ovulation (like with progesterone)?

Thanks for any help!
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#22 of 24 Old 05-30-2006, 03:40 PM
 
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I'm glad to hear I'm not the only one going through this and I hope some of you come back with updates to your stories.

My DD is 18 months old. I've been getting my cycles back for 4 months now and the O date is now later (around cd17-18) and my LP is down to 7-8 days. My DD still nurses about 6-8 times a day and I'm wondering if this means I need to wean her to try and bring back my cycles to a normal range again. I really don't want to wean, but not sure what to do. I feel like if I wean and it's not the BFing and my cycles are just altered for another reason, then I've lost that great BF relationship.

Also, I'm 36 and have endo. So, we were thinking of starting to TTC in the next few months (I want to lose some weight first).

Any advice? Would weaning make a difference? Should I get my hormone levels tested? Help.

J

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#23 of 24 Old 06-09-2006, 08:53 PM
 
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Does anyone know what they do if clomid doesn't correct your luteal phase? I have been on two months- up to 100mg and nothing. I am a kind of nervous about what will come next.
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#24 of 24 Old 07-26-2006, 06:04 PM
 
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Hi all~

I'm suspecting I have a LP defect (no offical diagnosis from a doc, but my LP was 9 days last month... usually 10-11 days, plus I had a m/c at 8 weeks back in April). I just thought I'd try to resurrect this thread to see if any of the original posters have seen any improvements with their regimens... now that a few months have passed!
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