Diagnosis and Treatment of Luteal Phase Deficiency

LPD is a clinical diagnosis and may be present with a luteal phase ≤10 days in length.

Abnormal luteal function may occur as the result of several medical conditions.

True isolated LPD implies an underlying pathologic abnormality of the luteal phase in the absence of an identifiable disease process negatively affecting normal LH support of the corpus luteum.

No diagnostic test for LPD has proven to be reliable in the clinical setting or in differentiating fertile from infertile women.

Endometrial biopsies only have the precision to distinguish the early luteal, midluteal, and late luteal phases, and have been shown to not discriminate between fertile and infertile women.

No treatment for LPD has been shown to improve pregnancy rates in natural, unstimulated cycles.

Infertile women suspected of having abnormal luteal function due to an underlying medical condition should be evaluated and appropriately treated for an identified abnormality.

Histologic dating of the endometrium with endometrial biopsies is not recommended.

Additional research is needed to determine if testing modalities, such as combined testing (i.e., luteal progesterone measurement and luteal phase length <10 days for the diagnosis of LPD), identifies a subgroup of patients with poorer reproductive outcomes and, if so, whether treatment improves outcomes