What Makes A Successful Implantation

A woman’s menstrual cycle is a month-long span of time where a delicate balance of hormones dictates everything from the growth of the endometrial lining in the uterus to triggering egg production and release in the ovaries. The precise timeline relies on estrogen, progesterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and human chorionic gonadotropin (hCG) for key milestones to occur. LH, estrogen, and FSH are responsible for triggering ovulation while estrogen and progesterone are both linked with endometrial thickening. Yet, if progesterone levels aren’t right, implantation might not happen if an embryo is present in the uterus.

Luteal phase

The luteal phase is the last of 4 stages in menstruation. The first 1-5 days is menstruation when the uterine lining is shed. The follicular phase on days 6-14 is when an egg matures in the ovaries. The ovulation phase takes place on day 14, followed by the luteal phase on days 15-28. During a normal luteal phase, a temporary gland that formed on the ovaries where an egg erupted, known as the corpus luteum, produces progesterone which helps to thicken and nourish the uterine lining. The step is critical to prepare for a potential embryo to implant.

Luteal phase defect

Luteal phase defect is a condition in which a woman’s ovaries aren’t producing enough progesterone. As a result, the final step in the menstrual cycle when the uterine lining should be thickening ahead of implantation doesn’t fully occur. Research shows that there is an optimal thickness range for the endometrial lining to foster implantation and improve the chances of carrying a pregnancy to term with a live birth. Common culprits that lead to the defect include stress, endometriosis, polycystic ovary syndrome (PCOS), obesity, eating disorders, thyroid conditions, excessive exercise and pituitary gland disorders.

Impact on implantation

Because an optimal thickness range exists, women with luteal phase defect are more likely to struggle with getting pregnant. Specifically, repeated miscarriages may be a sign that a woman has this condition. However, failed pregnancies aren’t the only sign. In some people, infertility may be a bigger issue.

Know the signs

Many women might overlook the signs of luteal phase defect because the symptoms can mimic other common conditions like dysmenorrhea. Common symptoms include spotting between periods, more frequent periods that occur less than 21 days between each other, and a span of 10 days or less between ovulation and period onset. Additionally, for people who track basal body temperature (BBT), there may be a slower rise.

Talk to an expert

Most people won’t know that a luteal phase defect is the culprit until after experiencing multiple failed pregnancy attempts that end in miscarriage. A fertility specialist can work with women and couples to perform tests and determine the best options for moving forward with pregnancy goals such as hormone stimulation or even fertility treatments like in vitro fertilization (IVF).