Short Luteal Phase and Its Impact on Pregnancy Loss

Adverse pregnancy history and short luteal phase?

Hello Dr.
Tsao, I started trying to conceive in October last year, and I naturally conceived for the first time in January this year, but I experienced a natural miscarriage on day 33 of my cycle.
Then, I naturally conceived again in March this year, but I had another miscarriage on day 40 of my cycle.
During this time, I had my progesterone levels checked, and while my HCG was decreasing, my progesterone was at 96.69 nmol.
In this cycle, I began tracking my basal body temperature and noticed that I ovulated earlier (usually I ovulate on day 20, but this month I ovulated on day 14/15).
Additionally, my temperature could not maintain above 36.7°C, and my period started 12 days post-ovulation (after about 10 days of elevated temperature), resulting in this month's cycle being 4 days shorter than last month (typically around 30 days).
Although my luteal phase has generally been short, lasting only 12 days, my temperatures during that phase have usually remained between 36.7°C and 37°C.
However, since my second miscarriage, my overall temperatures have been lower.
Therefore, I would like to ask: 1.
Does this situation indicate luteal phase deficiency? 2.
Could my previous history of miscarriages affect my luteal function? 3.
Is there a significant relationship between luteal function issues and my past miscarriage experiences? 4.
Could the traditional Chinese medicine I am currently taking lead to early ovulation? Does early ovulation affect egg quality? 5.
If I conceive again, what can I do to address luteal phase issues? (Previously, my doctor suggested using progesterone and taking aspirin as soon as pregnancy is confirmed.) Below are my basal body temperatures for this cycle for reference: Day 1 4/22 36.59 (first day of menstruation) Day 2 4/23 36.49 Day 3 4/24 36.43 Day 4 4/25 36.45 Day 5 4/26 36.37 Day 6 4/27 36.40 Day 7 4/28 36.44 (end of menstruation) Day 8 4/29 36.41 Day 9 4/30 36.28 Day 10 5/1 36.30 Day 11 5/2 36.32 Day 12 5/3 36.35 Day 13 5/4 36.41 Day 14 5/5 36.10 Day 15 5/6 36.21 Day 16 5/7 36.50 Day 17 5/8 36.68 Day 18 5/9 36.93 Day 19 5/10 36.67 Day 20 5/11 36.64 Day 21 5/12 36.69 Day 22 5/13 36.83 Day 23 5/14 36.78 Day 24 5/16 36.73 Day 25 5/17 36.93 Day 26 5/18 36.67 Day 1 5/19 36.41 (first day of menstruation).
Thank you very much for taking the time to respond; I am grateful.

Xiao Sha, 30~39 year old female. Ask Date: 2021/05/18

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it may be related to luteal insufficiency, which is not related to your previous medical history.
Follow your doctor's advice, and if a miscarriage occurs, it is recommended to go to the hospital for an examination.
Wishing you good health.

Reply Date: 2021/05/18

More Info

Understanding the short luteal phase and its impact on pregnancy loss is crucial for women who are trying to conceive, especially after experiencing recurrent miscarriages. The luteal phase is the time between ovulation and the start of menstruation, typically lasting about 14 days. A short luteal phase, often defined as less than 10 days, can be a significant factor in fertility and pregnancy maintenance.

1. Luteal Phase Deficiency: Your observation of a shortened luteal phase, along with the inability to maintain a higher basal body temperature post-ovulation, suggests a potential luteal phase deficiency. This condition can lead to insufficient progesterone production, which is essential for preparing the uterine lining for implantation and maintaining early pregnancy. The progesterone levels you mentioned (96.69 nmol) during the decline of HCG may indicate that while you had some progesterone, it might not have been adequate for sustaining a pregnancy.

2. Impact of Previous Miscarriages: Previous miscarriages can indeed affect luteal function. The body may experience hormonal imbalances following a miscarriage, which can disrupt the regularity of the menstrual cycle and luteal phase. Stress, both physical and emotional, can also play a role in hormonal fluctuations, potentially leading to a shorter luteal phase in subsequent cycles.

3. Relationship Between Luteal Function and Miscarriage: There is a significant relationship between luteal phase issues and miscarriage. A short luteal phase can lead to inadequate progesterone levels, which are critical for maintaining the pregnancy. If the uterine lining is not properly prepared, it can result in early pregnancy loss. Therefore, addressing luteal phase deficiencies is vital for women with a history of miscarriage.

4. Herbal Remedies and Ovulation Timing: The use of traditional Chinese medicine or herbal remedies can sometimes influence hormonal balance and may lead to changes in ovulation timing. If you are experiencing earlier ovulation, it could be due to the effects of these remedies. However, early ovulation does not necessarily correlate with egg quality. The quality of the egg is primarily determined by the health of the ovarian follicles and the hormonal environment leading up to ovulation.

5. Addressing Luteal Phase Issues in Future Pregnancies: If you conceive again, it is essential to discuss with your healthcare provider the possibility of progesterone supplementation. Many doctors recommend progesterone support (such as vaginal progesterone or injections) upon confirmation of pregnancy, especially for women with a history of luteal phase deficiencies or miscarriages. Additionally, low-dose aspirin may be suggested to improve blood flow to the uterus and support implantation.

In summary, a short luteal phase can significantly impact your chances of maintaining a pregnancy. It is essential to monitor your cycles closely and work with a healthcare provider to address any hormonal imbalances. Lifestyle factors, stress management, and possibly medical interventions can help improve your chances of a successful pregnancy in the future. Always consult with a fertility specialist or an obstetrician who can provide personalized advice based on your medical history and current health status.

Similar Q&A

Understanding Luteal Phase: Impact on Fertility and Implantation

Dear Doctor, If the luteal phase after ovulation lasts only 8-10 days, is this considered too short, and could it reduce the chances of pregnancy? Does a short luteal phase indicate insufficient progesterone, affecting the likelihood of fertilization (making it difficult for th...

Dr. Lü Lizheng reply Obstetrics and Gynecology
Hello! A short luteal phase can indeed reduce the chances of pregnancy, but it is not absolute; pregnancy is still possible. Insufficient progesterone can affect the implantation of the fertilized egg. This is a response from Dr. Lu Li-Cheng, Director of the Department of Obstetr...

Understanding Short Menstrual Cycles and Their Impact on Fertility

A short menstrual period lasting about 2-3 days with light flow, where only one day is heavier, and irregular cycles occurring every month or every couple of months, may indicate a thinner endometrial lining, which could affect fertility. Thank you.

Dr. Li Guanghan reply Obstetrics and Gynecology
Hello: Irregular menstruation and low menstrual flow are usually caused by poor ovulation or even anovulation. This may be triggered by stress, anxiety, or lack of sleep, and it can also be due to medical conditions such as thyroid disorders or polycystic ovary syndrome. Please s...

Understanding Luteal Phase Deficiency and Its Impact on Adenomyosis Management

Hello Dr. Lu, my menstrual period was from April 4 to April 7. From April 30 to May 2 and again from May 13 to May 18, I experienced the same situation where there was a small amount of fresh blood on the first day (very brief, only a few minutes, and it was gone after using the ...

Dr. Lü Lizheng reply Obstetrics and Gynecology
Dear Moss: Indeed, supplementing with progesterone has an inhibitory effect on the growth of adenomyosis; however, it requires long-term medication to be effective. Wishing you peace and health. Sincerely, Dr. Li-Cheng Lu, Director of the Department of Obstetrics and Gynecology, ...

Understanding Early Pregnancy Signs: Could It Be a Miscarriage?

Doctor, I usually have a luteal phase of only 10 to 11 days, and my menstrual cycle is consistently 29 days. However, this month my luteal phase lasted 13 days (with temperatures ranging from 36.7 to 36.8°C), and on the 13th day, my temperature spiked to 37.1°C. But the next day,...

Dr. Lü Lizheng reply Obstetrics and Gynecology
The response suggests that while it doesn't seem like a natural miscarriage, the possibility cannot be ruled out. A blood test for pregnancy would provide a clearer confirmation. It's important to note that a miscarriage may not always be accompanied by noticeable sympt...