The ovulation cycle occurs in two phases.

The first day of your last period starts the follicular phase, where a follicle in one of your ovaries prepares to release an egg. Ovulation is when an egg is released from the ovary into the Fallopian tube.

The latter part of your cycle is called the luteal phase, which takes place after ovulation. The luteal phase typically lasts from 11 to 17 days. During this time, your body prepares for the possibility of a pregnancy.

The follicle in your ovary that contained the egg before ovulation changes into the corpus luteum. The primary function of the corpus luteum is to release the hormone progesterone.

Progesterone stimulates growth or thickening of the lining of your uterus. This prepares the uterus for the implantation of a fertilized egg or embryo.

The luteal phase is important in the reproductive cycle. Some women may have a short luteal phase, also known as a luteal phase defect (LPD). As a result, it gets harder to become pregnant.

A short luteal phase is one that lasts 8 days or less. The hormone progesterone is essential to implantation and a successful pregnancy. Because of this, a short luteal phase may contribute to infertility.

When a short luteal phase occurs, the body doesn’t secrete enough progesterone, so the uterine lining doesn’t properly develop. This makes it difficult for a fertilized egg to implant in the uterus.

If you do become pregnant after ovulation, a short luteal phase may result in an early miscarriage. To sustain a healthy pregnancy, the uterine lining must be thick enough for an embryo to attach itself and develop into a baby.

A short luteal phase can also be due to the failure of the corpus luteum.

If the corpus luteum doesn’t secrete enough progesterone, your uterine lining may shed before a fertilized egg implants. This can cause an earlier menstrual cycle.

LPD can also be caused by certain conditions, such as:

If you have a short luteal phase, you may not realize there’s a problem. In fact, you might not suspect fertility issues until you’re unable to conceive.

If you’re having difficulty getting pregnant, your doctor can investigate further to see if you have LPD. Symptoms may include:

If you can’t get pregnant, figuring out the underlying cause is the first step to improving your odds of conception. Talk to your doctor about infertility.

They can conduct a variety of tests to determine whether infertility is caused by a short luteal phase or another condition. You’ll likely have blood tests to check your levels of the following hormones:

In addition, your doctor may recommend an endometrial biopsy.

During the biopsy, a small sample of your uterine lining is collected and examined under a microscope. Your doctor can check the thickness of the lining.

They may also order a pelvic ultrasound to examine the thickness of your uterine lining. A pelvic ultrasound is an imaging test that uses sound waves to generate pictures of organs in your pelvic area, including your:

  • ovaries
  • uterus
  • cervix
  • fallopian tubes

Once your doctor identifies the underlying cause of your LPD, pregnancy may be possible. In many cases, treating the cause is key to improving fertility.

For example, if a short luteal phase results from extreme exercise or stress, decreasing your activity level and learning stress management can cause the return of a normal luteal phase.

Techniques to improve stress levels include:

Your doctor may also recommend supplemental human chorionic gonadotropin (hCG), which is a pregnancy hormone. Taking this supplement can help your body secrete a higher level of the hormone progesterone.

Your doctor may also recommend taking additional progesterone supplements after ovulation. This helps your uterine lining grow to a point where it can support the implantation of a fertilized egg.

Other methods to increase your chance of getting pregnant include medications, such as clomiphene citrate, which stimulates your ovaries to produce more follicles and release more eggs.

Not all treatments work for every woman, so you’ll have to work closely with your doctor to find the most effective medication or supplement.

There are some controversies regarding LPD, with some specialists questioning its role in infertility and even whether it actually exists.

Let’s look at this further.

There’s no consensus on how to diagnose LPD

The endometrial biopsy has long been used as a diagnostic tool for LPD. However, past studies have indicated that the biopsy results are poorly correlated with fertility.

Other tools for LPD diagnosis include measuring progesterone levels and monitoring basal body temperature (BBT).

However, neither of these methods has been proven reliable due to the variability of criteria and differences between individuals.

There’s no clear evidence that LPD causes infertility

In 2012, the American Society of Reproductive Medicine released a statement regarding LPD and infertility. In this statement, they said that there’s currently not enough research evidence to support that LPD by itself causes infertility.

One 2017 study found that an isolated cycle with a short luteal phase was quite common, while recurrent cycles with a short luteal phase were rare. It concluded that a short luteal phase may affect short-term, but not necessarily long-term, fertility.

A 2018 study in women undergoing in vitro fertilization (IVF) looked at luteal phase length and birth rate. They found that there was no difference in the birth rate in women with short, average, or long luteal phases.

There’s limited evidence on the efficacy of LPD treatments

The American Society of Reproductive Medicine discussed the various LPD treatments in 2012. They stated that there’s currently no treatment that’s been consistently shown to improve pregnancy outcomes in women with natural cycles.

A 2015 Cochrane review assessed supplementation with hCG or progesterone in assisted reproduction.

It found that although these treatments may lead to more births than a placebo or no treatment, the overall evidence for their efficacy was inconclusive.

Clomiphene citrate is also sometimes used to treat LPD. However, there are currently limited studies on its efficacy.

Being unable to get pregnant or experiencing a miscarriage can be frustrating and discouraging, but help is available.

It’s important that you don’t ignore fertility suspicions.

The sooner you seek help from a doctor to diagnose the underlying cause, the sooner you can receive treatment and help increase your chance to have a healthy pregnancy.

Q:

How can you tell if you’re experiencing a short luteal phase and need to seek treatment?

— Anonymous patient

A:

It’s difficult to know if you’re experiencing a shortened luteal phase as you may not have any signs or symptoms. If you’re trying to get pregnant and having difficulty, or you’re experiencing miscarriages, you should talk to your doctor to see if it’s appropriate to be tested for causes of infertility. This may include testing for a luteal phase defect.

Katie Mena, MD

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.