Chung et al. Reprod Med Int 2018, 1:002 Volume 1 | Issue 1 Citaton: Chung MS, Bou Nemer, L Carr BR (2018) Does Luteal Phase Defciency Exist and What is its Associaton with Infertlity?. Reprod Med Int 1:002. Accepted: June 04, 2018; Published: June 06, 2018 Copyright: © 2018 Chung MS, et al. This is an open-access artcle distributed under the terms of the Creatve Commons Atributon License, which permits unrestricted use, distributon, and reproducton in any medium, provided the original author and source are credited. Open Access Reproductive Medicine International • Page 1 of 7 • Chung et al. Reprod Med Int 2018, 1:002 Does Luteal Phase Defciency Exist and What is its Associaton with Infertlity? Monica S Chung, Laurice Bou Nemer and Bruce R Carr * Division of Reproductve Endocrinology and Infertlity, Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center at Dallas, Dallas, USA *Corresponding author: Bruce R Carr, Division of Reproductve Endocrinology and Infertlity, Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA, Tel: (214)-648-4747, E-mail: Bruce.Carr@UTSouthwestern.edu ton with infertlity. The goal of this artcle is to review the historical and current understanding of LPD and its associaton with infertlity. Luteal Phase Physiology The normal menstrual cycle includes a follicular phase and a luteal phase, which results in regular cycles and allows concepton to occur. During the follicular phase, a mature dominant follicle develops, producing estrogen, which stmulates development of a prolifer- atve endometrium. The end of the follicular phase oc- curs with maturaton of the dominant follicle, and the LH surge, which is released from the anterior pituitary. This is propagated by increasing levels of estradiol that is produced from the granulosa cells of the dominant follicle [5]. Afer ovulaton, the post-ovulatory follicle becomes the corpus luteum, producing progesterone from the granulosa-luteal cells of the corpus luteum. The progesterone released, stmulates and forms a se- cretory endometrium to prepare the endometrial lin- ing for blastocyst implantaton [5,6]. Maintenance and regulaton of progesterone secreton is dependent on many factors including LH, presence of LH receptors, specifc steroidogenic enzymes of the diferent cellular compartments of the ovary, and the amount and avail- ability of substrate, namely cholesterol [7]. Cholesterol, in the form of Low Density Lipoprotein (LDL), is the primary precursor for progesterone. It also acts as a substrate for all other endocrine organs in- cluding the placenta, ovaries, testes, and adrenals [7]. Carr, et al. observed the maximal synthesis of proges- Abbreviations LPD: Luteal Phase Defciency; CL: Corpus Luteum; LDL: Low Density Lipoprotein; BBT: Basal Body Temperature MiNi Review aRtiCLe Introducton Luteal Phase Defciency (LPD), also known as lu- teal phase defect, is a concept that was defned by Georgeanna Seegar Jones in 1949 as reduced proges- terone producton by the Corpus Luteum (CL) [1]. LPD results from low endogenous progesterone producton and the resultant insufciency to maintain a secretory endometrium to allow embryo implantaton and growth [2]. Jones studied the luteal phase by evaluatng basal body temperature charts, urinary pregnanediol excre- ton (48-hour urine collecton at the peak of luteal phase by basal body temperature), cervical mucus, and most importantly, tmed endometrial biopsies. In the inital study, Jones evaluated 255 cycles in 98 women with in- fertlity that was not due to tubal, uterine, anovulaton or male factor. By assessing the delayed datng of the luteal phase endometrium, she determined that at least 50 percent of these women had either inadequate lu- teal stmulaton or defectve endometrial response, in- dicatng many women could be sufering from this con- diton [3]. Noyes, a few years later, evaluated close to 400 histology slides of 100 uteri removed, to adequately date the histologic evaluaton of endometrial biopsies [4] (Figure 1). Luteal phase defciency has been a controversial sub- ject, with many doubtng its existence and its associa- Check for updates