Patient's question:
Patient: Female, 39 years old, had a Cesarean section in 2005 and gave birth to a daughter. She used safe period contraception afterward. Currently experiencing secondary infertility for 4 years. Her menstrual period started to decrease by half in October 2013. The first and second days of her period had slightly more flow, followed by 5 days of small amounts of dark brown discharge. Ovulation was detected with follicular development. Progesterone level before ovulation was 2.72-3.Doctor's answer:
The diagnosis of luteal phase defect can be based on basal body temperature, progesterone blood tests, and endometrial biopsy. Patients with this condition exhibit a biphasic basal body temperature, but the rise and fall are slow, with an increase of less than 0.3°C, a duration of only 9-10 days, and sometimes an extended follicular phase. On the 8th day of the basal body temperature rise, blood progesterone levels are lower than 10 ng/mL. Previously, endometrial biopsy was typically performed on the 21-22 day of the menstrual cycle, with a diagnosis standard being an endometrial phase delayed by more than 2 days from the normal. However, it has been found that some clinically diagnosed patients with luteal phase defect actually have unruptured follicle syndrome upon laparoscopic examination. Therefore, the definitive diagnosis of this condition should also involve ultrasound and laparoscopic examinations.Luteal phase defect can lead to menstrual disorders, early miscarriage, and infertility. Thus, timely treatment is necessary.