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The information presented on this website has been developed and reviewed by Besins Healthcare. It should not be used as a substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare professional.

Luteal phase support

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Who might need luteal phase support?

Some women and birthing people may have luteal phase deficiency (LPD). LPD can happen when the body doesn’t make enough progesterone after ovulation, or when the uterine lining doesn’t respond to progesterone as it should. Because progesterone is essential for preparing the uterus for implantation, problems in this phase can make it harder for an embryo to implant.1

LPD has been linked to fertility challenges and early miscarriage, but it has not been proven to be an independent cause of infertility or recurrent pregnancy loss.1 What we do know is that several health and lifestyle factors can affect the luteal phase, including:2

Hormonal or medical conditions

  • Thyroid disorders (underactive or overactive thyroid)
  • Polycystic ovary syndrome (PCOS)
  • High prolactin levels
  • Endometriosis
  • Low ovarian reserve or aging ovaries

Lifestyle and stress-related factors

  • Chronic stress
  • Very intense exercise
  • Low body weight or significant weight loss
  • Eating disorders

Inflammatory or structural conditions

  • Chronic inflammation of the uterus (chronic endometritis)
  • Fibroids or polyps that affect the uterine cavity

Treatment-related causes

  • Fertility treatments, especially IVF or other assisted reproductive technologies

Symptoms of LPD include:1

Short menstrual cycles (<26 days)
Short luteal phase (<9 days)
Spotting that occurs between ovulation and your period
Difficulty conceiving
Early miscarriage, that may be recurrent

If you are experiencing, or have experienced, any of these symptoms, it does not mean you are infertile. In fact, the American Society for Reproductive Medicine committee states that luteal phase deficiency (LPD) is not a proven cause of infertility.2

You should, however, discuss your symptoms with your healthcare provider. They may suggest several tests to establish whether you have LPD or need further fertility support.

Tests for LPD will look at:2

Luteal phase length:

Luteal phase length:

A luteal phase shorter than about 10 days may suggest a problem, but short cycles can also happen occasionally in women who do not have LPD
Progesterone levels:

Progesterone levels:

A blood test about one week after ovulation can show whether progesterone is rising as expected, though levels naturally fluctuate
Ovulation timing:

Ovulation timing:

Understanding when ovulation occurs helps determine whether the luteal phase is the right length
Underlying health conditions:

Underlying health conditions:

Thyroid disorders, high prolactin, PCOS, endometriosis, stress, or significant weight changes can all affect the luteal phase.

There is no gold standard to diagnose LPD, so you may not be offered all these tests. Your healthcare provider may provide you with treatment to support your fertility journey based on your medical history and presenting symptoms.

Luteal phase support (LPS) is also required for women and birthing partners pursuing assisted reproductive technology (ART). In those requiring an embryo transfer, they will not naturally produce the corpus luteum that provides progesterone to support implantation. Therefore, LPS is needed to maintain the uterine lining to help establish the pregnancy.1 

For reasons not quite understood, the luteal phase for those undergoing IVF can be dysfunctional. LPS is usually provided to these patients to help improve the chance of establishing a pregnancy.1

IVF, in vitro fertilisation; LPD, luteal phase deficiency; PCOS, polycystic ovarian syndrome.

Next: Assistive Reproductive Technology (ART)