Luteal Phase Defect

My journey begins in December of 2014 when I got baby fever and read that it could take a couple of months (!) to get pregnant after birth control pills. I ditched the pack and figured it was the perfect time to get started since DH (darling husband) and I were getting married early in 2015. We got married on Groundhogs Day in 2015, in a tiny ceremony at the courthouse with only our parents present, him wearing a suit that cost 5 times more than my dress. Unconventional, for sure, but somehow just perfect for us.

We began the phase I call “Active TTC” when my cycle started on March 31st, with charting, OPKs, CM, prenatal vitamins, all the bells and whistles. My cycles all seemed to be in order prior to this, 28 days almost every month. I had passed that hurdle! But checking my BBT gave me a clue that something was not quite what it seemed. I didn’t ovulate until day 19-21 of my cycle, compared to day 14, which is considered normal. Furthermore, my luteal phase (the time from ovulation until your period comes) was only 7-9 days long when it really should be 14. But still, we pushed on, making sure to have as much sex as we could fit in during the fertile window in hopes that maybe one time it would work.

It didn’t. I talked to my OB and then to a RE in August and September when I still hadn’t gotten pregnant, even though it hadn’t been quite the recommended year of trying that some RE offices (and insurance companies, I would soon find out) need you to have before receiving treatment. I had done some research on my own because my favorite piece of advice is “just google it”, and found something called luteal phase deficiency or luteal phase defect (LPD), which fit my symptoms perfectly. My OB did not seem convinced when I told her about my research, but finally agreed to do a progesterone draw to test for low luteal phase progesterone, an indicator of LPD. The results came in and it showed progesterone levels under 5, which means no ovulation. But I knew that wasn’t right, thanks to my handy dandy BBT chart, so we tried a second draw and came up with the same results. It was clear from the way she spoke to me that I could never convince her there was a problem other than anovulation, so we parted ways and I moved on to a reproductive endocrinologist (RE).

After blood tests, ultrasounds, and a semen analysis we had a diagnosis: “Ovulatory disfunction with a little luteal phase disorder”. So I was right (never question the scientist!), but how this affects my fertility is still unclear. The literature is pretty divided, since some people with LPD get pregnant with no problems, while other need assistance. Nothing makes you feel more invalidated than something like this article entitled “Current Clinical Irrelevance of Luteal Phase Deficiency”. Ouch. But that first month with the RE we tried progesterone suppositories in hopes of lengthening my luteal phase, which unfortunately didn’t work. After that, we took a couple of months trying like “normal” people with no luck.

So here we are now. It has been a full year now and we are ready to move on to Chapter Two, accept that we need assistance, and maybe, just maybe get a happy ending.


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