Inadequate Luteal Phase? Anyone?

Inadequate Luteal Phase? Anyone?

Postby Thistle » Mon Feb 25, 2008 1:37 am

Also referred to as a luteal phase defect; I read about it on the internet and found that there's actually quite a bit of literature out there about it, but no definite numbers regarding its role in multiple pregnancy loss; however, it does appear to be one possible contributing factor in women who have subsequent, multiple, early m/c's. (That'd be me...) It results in low levels of progesterone because the short luteal phase does not allow for enough time for the endometrial lining to build up before the corpus luteum dies and stops producing the progesterone.

Or something like that.

Does anyone have an official diagnosis of this, or know more about it personally?
Me: 35 and holding; DH: 30
Keegan (DS), age 11; Ainslee (DD), age 3; Ash (DS), almost 2
M/C: '95, '04, twice in '07, and now '08. BLEH.
It's a GIRL! Due Dec. 22, 2008
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Postby janie.c » Thu Feb 28, 2008 9:04 am

I have it unfortunately, and it has caused me to lose 7 babies so far (last one was a few days ago).

I normally ovulate about 2 days after my period has ended, so I have hardly any lining at all, and very frequent irregular periods. My hcg's are pathetically low and hardly rise before they suddenly fall and............... well you know the rest.

My doctors are not even slightly bothered about it, they just say to keep trying and one day I might get lucky, well I am 33 now so my days of getting lucky are running out without help. One doctor even said there was no such thing as a luteal phase defect!

So I guess I keep on trying, knowing that I will continue to lose the babies, or give up............... right now I am just praying for a miracle and preparing myself for more losses, the docs say 7 isn't a lot of m/c's and if I have a few more they might look into it. (Good old UK NHS)
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Postby Thistle » Thu Feb 28, 2008 9:34 am

Okay, HOLDupasecondthere... After SEVEN miscarriages, your doctors are saying "don't worry, keep trying?!?!" Under ANY circumstances, that's not acceptable!! But knowing that you have an *actual* condition that is widely considered to be a contributing factor to early pregnancy loss makes it even MORE unacceptable. Most doctors (well, in the US, anyway) will start looking into causes after three consecutive losses, whether they think there's a physiological reason for it or not. And from everything I've read, you are not powerless in the face of this defect. Your doctors should be giving you progesterone from the get-go, before you even get pregnant. The problem is not ONLY the lack of lining, but the lack of progesterone, because the corpus luteum dies prematurely and allows whatever lining is actually there to shed before it should. Have none of your doctors ever suggested progesterone therapy, or even estrogen therapy, to even out your cycles a bit???

I am so irritated at the medical profession just now!! :() After seven consecutive losses, SOMEone needs to take a closer look at your situation, whether they believe it's due to LPD or not.

Keep us updated, and do some doctor shopping! I'll be thinking of you.

~Thiss.
Me: 35 and holding; DH: 30
Keegan (DS), age 11; Ainslee (DD), age 3; Ash (DS), almost 2
M/C: '95, '04, twice in '07, and now '08. BLEH.
It's a GIRL! Due Dec. 22, 2008
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Postby janie.c » Thu Feb 28, 2008 10:17 am

I did politely broach the subject with my specialist (even the word makes me laugh, but that is what they call themselves) and was told very firmly that they don't 'believe' in progesterone issues, and don't bother testing for it as there is no 'proof' it is even a factor in re currant m/c's, infact they think progesterone issues are all a bit airy fairy and I am being silly.

Now, being on the NHS and them being the only 'specialist' in my area, I either do what they say or have no one. My partners medical cover does not accommodate these issues as far as going private and our savings won't go far, so it is the NHS or nothing.

Also they say that as I always lose babies at 3 months or under it is not like I am 'really pregnant' so they don't see what the fuss it about, and as I can get pregnant I should count myself lucky.................



We have what is called a 'postcode lottery' in the UK regarding medical issues and help assigned, my postcode isn't one with the lucky numbers alas.
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Postby Thistle » Thu Feb 28, 2008 10:31 am

You know, Janie... My WHOLE LIFE, I have wanted to move to the UK. I have always felt that that was my true home, where I belong, where I felt I should be. I have made numerous efforts to make it a reality, but for primarily financial reasons (and the difficulties of becoming a British citizen, it is more of an ordeal than I ever anticipated), have never been able to accomplish that goal.

HOWEVER... After reading about your public health system (not only from you, but from others as well), I am becoming quickly disenchanted! That is... just... COMPLETELY freaking WALLEYED!!! NO ONE has the right to tell a Mum that she is "not really pregnant" at ANY juncture in her pregnancy! And I have heard of doctors who don't believe in progesterone issues. What I would like to know is, where have THEY been sitting their useless arses when all of the most recent studies were done and the numbers showed that hundreds of thousands of women who never COULD carry a baby past the tenth week or so finally had successful pregnancies after starting progesterone therapy, hmmmm???

Come on over here to the US; we'll make you a citizen and put you on Medicaid. You will get full coverage (so long as you promise to remain unemployed and practically indigent), and will be allowed to see any doctor who accepts Medicaid insurance. At least that way, your luck won't be based on your post code...

Oh, Lord. There just isn't ANY good way to make healthcare both affordable AND well-managed, is there?

I am so sorry. You have been put through some ridiculous, heartbreaking crud, and for what? So the doctors can hurry up and get to the next patient? IT'S NOT FAIR!!!!!

I am going to look into smuggling you some contraband progesterone suppositories...
Me: 35 and holding; DH: 30
Keegan (DS), age 11; Ainslee (DD), age 3; Ash (DS), almost 2
M/C: '95, '04, twice in '07, and now '08. BLEH.
It's a GIRL! Due Dec. 22, 2008
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Postby janie.c » Thu Feb 28, 2008 10:53 am

The UK does have it's good points, unfortunately my experiences of the NHS have made me wish I lived anywhere else but here, it's almost like they are trying to deal with our current overcrowding problems by stopping people from breeding!

I told my doc about everything I had read up on progesterone therapy, and asked if I could at least try it to see if it did anything, or even if she could humour me and check my levels when they did my hcg's, so I could show her what I mean................. she said that she ws the doctor, and she knew my body better than I did, and they don't waste their time worrying about insignificant things like progesterone levels when their is no proof whatsoever etc etc.

So basically a short luteal phase doesn't exist, progesterone is completely irrelevant and there is no such thing as too many m/c's, ooh and I have 2 whole years before they will stop helping me (I am still waiting for them to start tho haha) according to my wonderful specialist. I am thinking she got her qualifications off the back of a Kellogg's box!

The UK doesn't even have decent weather, and the roads are pants for going out on the motorbike................. so I can't recommend it as a place to live :(
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Postby Thistle » Thu Feb 28, 2008 12:12 pm

*snort!*

Your situation is patently NOT a funny one, but God bless you... YOU have a sense of humor, which is what will see you through!

Your doctor(s) need a good swift kick in the butt. I would administer it, but I have to believe that karma will get them. Maybe your female doctor will encounter some medical difficulties of her own and begin to develop a sense of empathy for her patients.

Making a whole other human being is NOT as cut and dry as they are trying to make it sound. Every woman is different, every pregnancy is different, right down to the last second and molecule. You'd think, being medical "professionals" and all, that they'd know this.
Me: 35 and holding; DH: 30
Keegan (DS), age 11; Ainslee (DD), age 3; Ash (DS), almost 2
M/C: '95, '04, twice in '07, and now '08. BLEH.
It's a GIRL! Due Dec. 22, 2008
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Postby namaste11 » Thu Feb 28, 2008 2:04 pm

Ok, girls. I was reading along, debating about whether to jump in, and as usual I succumbed to the inner voice. I just have some thoughts to share that may put me in the position of being a little bit of a "devil's advocate".

Having gone through my 5th m/c this January (4th in a row), I, too, considered the idea of LPD and/or progesterone production issues. Now, first, my own personal understanding of LPD is that your luteal phase (the time from ovulation until your menses begin) is too short to support an implantation - and generally they look at BBT charts to see if you've got 10 days or fewer from ovulation until the onset of bleeding.

As for the actual benefits of using progesterone therapy or supplementation, I honestly don't know. You can find research for and against it - it just depends on who the "sponsor" is and what their "end game" is. I'm more than a little bit of a cynic, and my view is that pretty much ALL research is somewhat skewed by who stands to make money from the numbers being in their favor. Sue me. :d

Anyway, once you get past all that, then there are vastly varied opinions about when during a cycle (pre-ov, post-ov, or post conception) it should be used, how much should be used, and how much the body actually absorbs in relation to that. And there are also those who don't believe the progesterone in and of itself is nearly so important as the hcg, because the production of hcg supports the production of progesterone. Again, it depends on which side of the fence you're looking at this from.

The other thing I have ferreted out on my own about recurrent losses is that, unless you have genetic testing done and are a carrier for something that in combination with your partner puts you at greater risk, or if you get tested for immunodeficiencies or certain infections (cytomegalovirus, bacterial vaginosis, etc), or some sort of structural abnormality in the uterus, more than half the cases of recurrent loss (2 or more m/c's in succession, without a live birth between them) go unexplained.

Sometimes it really is just a case of the wrong combination - whether it's a defect somewhere in the egg or somewhere in the sperm, or that together they just don't split and form what they are supposed to.

Because I am unwilling to subject myself to a battery of what would now become pretty invasive testing just to satisfy my curiosity, it becomes a question of whether or not we are willing to play the odds. I've been pregnant 7 times, and only have 2 children. But most of the research you find also states that once you pass 3 in a row, if you are willing to persevere, the odds are STILL in your favor that eventually you will carry a baby to term. Whether that heartens you or discourages you - it just depends on how you're "wired" and the kind of faith you have that you can endure whatever comes in order to have the desire for a child be rewarded by God. Yes, I've thought about Job numerous times in my own journey, that's for sure. :d

Anyway... those are just a few of my thoughts. I'll turn off the faucet now before this becomes really, really long, and see what comes back my way.

Hugs!
E> Andy
Andy (38) and Jack (36)
Anna Kate (7y) Jacqueline (5y) Alexandra (2y) Samantha (2y) Vanessa (newborn)
5 precious souls in heaven playing with our dog McKinley
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Postby vnsslfm » Thu Feb 28, 2008 11:06 pm

You should read my success story with progesterone. It is listed in here as I am lost about what is happening. We knew that we were having problematic cycles. We had only been trying for 2 months when I fell pregnant. 1 more month of trying with no success, and the doctor was going to start checking. Now that is a proactive doctor. She knew something was up when I had 26 days cycles 1 month and 36 day cycles the next. I began bleeding at 5.5 weeks and it was minor which I ignored because this happened in my first uneventful healthy pregnancy. 3 days later it returned and I went to the dr the next day. Without even knowing the results from my progesterone and HCG check she gave me progesterone. It does not hurt so why not she said. Well the following day the level came back low just like she thought. I stayed on it until 12 weeks and got off and am now 29 weeks prego. Oh yea when I first started to bleed I went to the ER and they said my uterus was empty. 2 days later at the dr I had a baby with a E>. According to my dr anyone who has suffered 1 miscarriage should have a progesterone level check right away. She does not believe in letting women suffer loss after loss. Especially in multiple miscarriage cases because progesterone is usually the problem! Boy did I pick the right dr, I have friends who have suggested progesterone to the dr and the just laugh. They all go to my dr too now! Take care and keep looking for the right dr that will help you. Progesterone is not harmful so why the heck not give it!
Mom to DD born 11/22/05
Miracle Baby Girl due 5/13/08!!!

Hope is contagious!
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Postby namaste11 » Thu Feb 28, 2008 11:17 pm

What a wonderful story of hope. Congratulations on your pregnancy!

And you're right - in some cases, it really does help. However, in the case of my last miscarriage, I was also put on progesterone suppositories, but it was only effective for the first week I was on it, and then my levels fell again.

There are two schools of thought, and I actually think both are right. In some cases the progesterone just needs a little boost until the placenta is well formed because the corpus luteum can't support the whole production on its own. But in other cases, the low or falling progesterone is suggestive of a failing pregnancy, and no amount of supplementation will sustain it.

And your doctor is right - there is absolutely no harm in trying it.

Be well and I look forward to reading your birth story!
E> Andy
Andy (38) and Jack (36)
Anna Kate (7y) Jacqueline (5y) Alexandra (2y) Samantha (2y) Vanessa (newborn)
5 precious souls in heaven playing with our dog McKinley
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Postby Thistle » Sat Mar 08, 2008 12:10 pm

Okay, vnsslfm... You live in Texas, I live in Texas... Don't suppose your doctor is anywhere near Conroe, is she?? (Not that I don't love my doctor, 'cause I do, but yours is the stuff that dreams are made of...!)
Me: 35 and holding; DH: 30
Keegan (DS), age 11; Ainslee (DD), age 3; Ash (DS), almost 2
M/C: '95, '04, twice in '07, and now '08. BLEH.
It's a GIRL! Due Dec. 22, 2008
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Postby vnsslfm » Sat Mar 08, 2008 10:27 pm

Actually she is in The Woodlands pretty close!!!! She is amazing, and after my daughter was born I had tons of problems(I was discarded by my other dr, and she took me in long story), and I could tell she was already gearing up for fertility problems. She would only let us try for 3 months, and then she would begin intervening. I had never heard of a dr willing to help that soon usually they tell you try for a year!!!!! It happened before then, and she put me on the progesterone before she even had results back...she said we can not wait one day in case that is what it is! I LOVE HER SHE SAVED MY BABY! Her name is DR. Marra Francis she is in with Dr. Young(I like him too he helped me with a UTI) They are located in the memorial Herman professional building the glass building next to the hospital. 281-419-5010 is the number. You will never find anyone who is more kind and caring than she is. She is really young, and seems really up on the newest research. She has me on Procardia to stop pre-term labor since 22 weeks, works awesome without all the side effects of the Brethine!


Finding someone who loves you baby as much as you do is such a challenge, and I can honestly say she loves my little bug! She is usually more excited at the u/s than I am!!!! She also adores my 2 year old, and loves it when she comes to the office! I just can not say enough nice things about her! Best of luck!
Mom to DD born 11/22/05
Miracle Baby Girl due 5/13/08!!!

Hope is contagious!
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Postby Thistle » Sun Mar 09, 2008 12:01 am

OMG!! I LIVE IN THE WOODLANDS!!! I just said "Conroe" 'cause it's a somewhat more well-known name than The Woodlands. This is CRAZY! I have been seeing Dr. Crowder at Women's Healthcare Affiliates; they used to be in the same building as your doc, but they recently moved to the new building behind the hospital. I like my doc very much, but he's often too overbooked to fit me in; how awesome to know there is possibly another alternative right here in town!

We appear to be neighbors! How small the world actually is!
Me: 35 and holding; DH: 30
Keegan (DS), age 11; Ainslee (DD), age 3; Ash (DS), almost 2
M/C: '95, '04, twice in '07, and now '08. BLEH.
It's a GIRL! Due Dec. 22, 2008
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Thank you for your post

Postby broadrippian » Sun Mar 09, 2008 3:37 am

Wow! I have decided you have to be the coolest person on the planet! I think it your comment to my post really calmed me down. I love my God and prayed to him incessantly! But, than, I would read stories on this site and cry. And If there was a positive story I would still cry because my situation seem so different. But you, never give up! And look the possibilities that await you and your family sooooooo cool! Thank you so much for the comment. I think people underestimate how much it really helps even if you feel you do not know what to say. I started thinking in the beginning when I first posted the last months events of my life that, no one cared, or than my situation was hopeless! My Husband, love his heart, would see me get on the computer and the next thing he would know is I would be crying. He would tell me they are not going to say “Lannie you are going to be fine and the baby is just fine too do not worry.” I would laugh with tear streaming down my face because secretly, that is what I wanted. However when you posted your comment I told my husband that "Look someone said that me and the baby was going to be alright!" He smiled. Even though that is not what you said it felt like it! At that very moment it felt like it!

It is almost Monday, I go tomorrow for my next beta. Tuesday, PM I will get the results. Scared but ok. I barely spotted at all this weekend not enough to worry about! ( I contribute my small amount of anything to Vacuuming...we had company lol) And I have felt ok…not at all like something was or is wrong. I have decide 2 things no more u/s in the first trimester. If my numbers go up I am not going for another u/s I really did not keep checking on my 1st baby and she was fine. Wonderfully fine. And if I am going to m/c I do not need a machine to tell me! 2. If these numbers go up I am not going to keep check them fanatically! I am going to assume I am fine until I have a miscarriage! Sometimes I feel that doctors get an idea in there head about what is suppose to take place in certain weeks and think that if that does not happen then you are going to miscarry. I am sorry if my baby does not know the doctors rules! I am going to let the little one alone and stop poking and prodding at my baby and let him/her grow in peace.
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Postby Thistle » Sun Mar 09, 2008 12:34 pm

*blush* I think you are referring to the post from a few days ago, when you were worried about them not finding a heartbeat at 6 weeks? (Assuming you meant this for me at all?) If so, then I am very, very glad to have given you some measure of peace. That is the primary thing I wish for every woman on this board: I cannot alter the outcomes in the least, but I can wish you a sense of **peace**, and maybe help offer some in the knowledge that you are heard, you are not alone, and you are understood.

I can't remember the first place I heard it, but I have heard it several times over the years, and this phrase always gives me a strange sense of calm: God *does* answer all of our prayers, but his answer sometimes may be "no." I have to believe that when it is, there is good reason for it. And I have to remember to be grateful for all the times he says "Yes!" even though I may not realize it was something I asked for to begin with.

Wishing you peace, and I will be stalking on Tuesday to hear about your beta results!

~Thiss.
Me: 35 and holding; DH: 30
Keegan (DS), age 11; Ainslee (DD), age 3; Ash (DS), almost 2
M/C: '95, '04, twice in '07, and now '08. BLEH.
It's a GIRL! Due Dec. 22, 2008
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Postby vnsslfm » Sun Mar 09, 2008 1:10 pm

[quote="Thistle"]OMG!! I LIVE IN THE WOODLANDS!!! I just said "Conroe" 'cause it's a somewhat more well-known name than The Woodlands. This is CRAZY! I have been seeing Dr. Crowder at Women's Healthcare Affiliates; they used to be in the same building as your doc, but they recently moved to the new building behind the hospital. I like my doc very much, but he's often too overbooked to fit me in; how awesome to know there is possibly another alternative right here in town!

We appear to be neighbors! How small the world actually is![/quote]



What a small world we live in!!!! I am familiar with Dr Crowder. I worked for years at a pharmacy in The Woodlands before I left to care for my daughter. Hey it is always good to hear things about other docs! I am glad I found her, and that she is So young. She will be around for a while, and we can have a long relationship before she retires. My Other doc who I lOVED Dr. Durst no longer delivers babies. He is about to retire! Best of luck with all your endeavor's, and if you are looking for a playgroup I am a part of a fabulous one in The Woodlands! Some really nice ladies, and lots of fun(especially BUNCO)! They are through Meetup.com, and they are called dragonflies and ladybugs! Can not participate right now due to all my problems, but I still pass the word around every time I meet someone in the area!
Mom to DD born 11/22/05
Miracle Baby Girl due 5/13/08!!!

Hope is contagious!
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