LPD & Endometriosis

Endometriosis is a condition that can, among other things, rob a woman of her fertility. It is true that many women with milder cases of endometriosis are able to conceive and carry a pregnancy to term. However, between 30 to 50 percent of women with endometriosis are infertile. One of the effects of endometriosis on fertility appears in the form of luteal phase defect.

What Is The Luteal Phase Of The Menstrual Cycle?

The luteal phase of the menstrual cycle is that period of time between ovulation and the onset of the next menstrual period. Usually, the period of time between them is 10 to 14 days. If the time lapse is shorter than 10 days or longer than 14 days, the likelihood of luteal phase defect is high.

During the course of a normal menstrual cycle, a woman's body secretes a hormone called follicle stimulating hormone, or FSH, which causes the formation of a mature follicle in one of the ovaries. The follicle contains an egg and when the follicle bursts it morphs into the corpus luteum and secretes progesterone. Progesterone is the hormone that causes the lining of the uterus, the endometrium, to thicken in preparation for housing the fertilized egg. When the luteal phase of the cycle is less than 10 days, the endometrium is insufficient to allow an egg to implant and the result is a missed conception. The phase must be over 10 days in order to conceive and conception happens to be the most difficult part of the pregnancy process for women with endometriosis.

How Endometriosis Affects Ovulation

A woman with anything more than a very mild case of endometriosis can have a very difficult time conceiving and often resorts to assisted reproductive therapy in order to have a baby. A woman who is able to conceive often will find that the endometriosis goes into remission during the pregnancy. On the other hand, endometriosis causes infertility by negatively affecting ovulation through luteal phase defect. Since the menstrual cycle is very affected by endometriosis, the egg is often not released at the appropriate time during the cycle. The unpredictability of menstruation often means that the endometrium is not prepared to allow the egg to nest and the pregnancy cannot be sustained. A fertilized egg will spontaneously abort since the pregnancy is not viable-and all of this happens without the woman ever realizing she is pregnant.

Endometrial Implants And Their Effects

The cause of endometriosis is unknown. It may be genetic, or it may be the result of an ineffective immune system. When endometrial implants grow in the fallopian tubes, they become blocked and the egg cannot travel to the uterus. In some cases, implantation of the endrometrium on the ovaries prevents the release of an egg (anovulaton), or can cause a luteal phase defect which interferes with implantation of the egg in the uterus. Luteinized unruptured follicle is another result of endometriosis. This happens when there are severe pelvic adhesions that encase the ovaries and, regardless of normal hormonal LH (luteinizing hormone) surges, the egg is not released.

Sometimes LPD can be corrected in a woman with endometriosis when the condition is exposed and regular basal body temperature charts are maintained to indicate when the eggs are being released. Otherwise, hormonal intervention or surgery can be of use in aiding in conception and pregnancy.

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