Understanding a Short Luteal Phase & Potential Chemical Pregnancy

Question
Hi,

I recently had an endometrial biopsy performed and it came
back as 5-8 days post ovulation... 3 days later I got what I
thought was my period.  3 days after that I took an hpt (because
I'm extra cautious after having gone through this 3 times now-
still bleeding) and it turned positive with a beta of 7.  Today is 4
days after the start of my so called period and I now have a
negative hpt.  I'm assuming a chemical pregnancy.  My doctor is
of course now calling the biopsy a luteal phase defect.  We're
going to be discussing treatment options today and I just want
to make sure I understand - the whole point of clomid is for
boosting the egg so you get a better corpus luteum and then
progesterone after ovulation to bump up the progesterone... am
I correct in this assumption?  

Also how come doctors say well this could be a reason for all
your chemical pregnancies (I've had 3) 2 in a row and then 1 in
the past, but that it's controversial at saying that?  

Just curious.

Samara

Answer
Did you have a progesterone level performed? If you have a low progesterone level, that can explain a luteal phase defect as well as the spontaneous abortions. If your HCG level was secen, that is pretty much close to negative (our standard of "negative" is any value less than 5). The best time to take a pregnancy test is seven days after missing you next period. A pregnancy test will not show an accurate result until 14-21 days from the suspected day of conception. If the biopsy showed that you were 5-8 days post ovulation at the time of the biopsy and you took the pregnancy test 6 days after the biopsy, you would have been 11-14 days post ovulation when you took the pregnancy test. This is too early and you would not have gotten accurate results. Certainly, a blood test for pregnancy, 48 hours apart, will help explain what occurred. I would start with progesterone supplementation. If you are ovulating, you really do not need Clomid. Clomid acts on the hypothalamus to turn off the feedback mechanism and allow more production of FSH in the anterior pituitary gland. This, in turn, allows more follicles in the ovary to mature and increaases the probability of ovulation. If you are ovulating, you do not need Clomid. HOwever, if you have a decrease in progesterone levels, that can influence the luteal phase as well as increasing the risk of spontaneous abortion (whetehr it is a chemical pregnancy or a miscarriage). Discuss it with your doctor.