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Infertility Cubby

Delayed Ovulation and the Luteal Phase Defect
By Sam Thatcher, MD, Ph.D.

Sam Thatcher, MD, Ph.D.Q. I have been using the basal thermometer for temping this cycle and have discovered (along with charting all babymaking encounters for the past 5 months, as well as cervical mucus) that I am not ovulating until cycle day 19. However my period begins on day 27 or 28. Am I looking at a luteal phase defect and if I am, what is my first choice of treatment? I am almost 38 and do not want to just try for another year after trying for almost 6 months now. Could the problem be in the first half of the cycle if signs point to the fact that I am ovulating or is it more likely that the problem is just too short of a luteal phase and therefore implantation is unlikely? What questions and information should I take to my doctor?

A. I do not believe in the luteal phase defect as such. I believe that most defects of the luteal phase are in fact defects on the follicular phase. This may seem to be splitting hairs, but it put the emphasis back on the developing follicle and egg and not the resulting corpus luteum and progesterone production. Good luteal phases follow good follicular phases. Conversely, if ovulation is delayed, the luteal phase is often inadequate. Yes, I think that implantation could be less likely because I believe egg quality is decreased.

Depending on a more complete history, you might be a candidate for clomiphene therapy. Hopefully it would promote a more timely ovulation. The good news is that a late ovulation, is miles above no ovulation and you might need just a little help to push you over the top.

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