Hi can I get some help please ladies, thank you.

(23 Posts)

Ok so went to gp today and she's getting some blood tests done for me. Day 21 progesterone and day 1-4. Can some explain what these might mean and what result I'm looking for? The day 1-4 will look for fsh (shesaid it needs to be 4 or 5) LH and testosterone and tft's which was something to do with thyroid? Anyone clear that up a bit for me?
She gave me one bit of info which I challenged as she said you always ovulate 14 days before your period and I said that I heard read on mumsnet that that wasn't true and could vary. She said she's never been challenged on it before but she would check with a gynaecologist to make sure. She's wrong isn't she? Anyway at the mo my cycles are about 30-32 days and I've got the day 21 test booked in on cd24. I think I ovulate around cd19. Will that work out ok? She says they're looking for progesterone level?
Anyway really hope someone can clarify these bits for me, I'd be really grateful. Thank you in advance.

TFT is a thyroid function test, FSH is Follicule Stimulating Hormone, LH is Luteinizing hormone.

Progesterone levels rise after ovulation, so they are normally taken on day 21 (or 14 days before your period is due) as you should have ovulated by then. Low progesterone levels may mean that you haven't ovulated in that cycle, or that you have taken the test before you have ovulated.

The day 1-4 tests are a little more complicated, as the results are looked at in relation to each other rather than as individual results.

For example, FSH looks at how hard your body has to work to select an egg for ovulation. The higher the result, the harder your body is working, but it has to be looked in combination with the other tests as the different hormones have an effect on each other (if that makes sense). Also, the Day 1-4 test can give clues as to whether you have Polycystic ovary syndrome or not.

As an aside, the figures that your GP gave for FSH are quite low - they sound like they would be the perfect result, rather than a perfectly acceptable result. Many women have numbers that are higher than that with no impact on their fertility.

Ok cool thanks for explaining. If they do the day 21 on cd24 and I normally come on around say cd31 will that show the right level of hormone if I do ovulate on cd19? And if I don't ovulate on cd19 will the test give an indication of when I do? I'm just a bit worried by the whole you always ovulate 14 days before your period thing as I don't think that's true for me.

Your cycle is split into 2 phases - follicular (before ovulation) and luteal (after ovulation). The length of the follicular phase can vary, and can be affected by stress, illness etc. The luteal phase is more fixed and is roughly 14 days, which is what the GP was saying about '14 days before your period'. However, this is not true for all women, and some have longer and shorter luteal phases. I don't think the length of the luteal phase varies too much for an individual though.

Some women have a luteal phase defect, and their luteal phase is too short for successful implantation (less than 9 days, I think). I have read (on MN) of many women who have lengthened their luteal phase though.

Sorry for the disjointed reply - boisterous toddler interrupting.

If you ovulate on day 19, you should still show a raised level of progesterone on day 24. I'll see if I can find a graph for you in a minute.

Is there a particular reason you think you ovulate on day 19, and why you are waiting until day 24?

CaipirinhasAllRound Thu 07-Feb-13 11:04:18

I'm not sure about the 14 days thing. I was dubious as tracking my temp indicated my literal phase was only about 9 days but at least 2 different consultants insisted it's always 14 days

Because I get ovulation pain and over the last few months that's the da when its been most painful! So not very scientific but its all I've got. Opks are rubbish and I never seem to catch the surge. But she suggested to book on day 23, 24 or 25 because of my slightly longer cycle.

There's a chart here. It's only wiki, but it gives you an idea of how hormone levels change throughout the cycle.

If you haven't ovulated by the time you have the progesterone test, the test will not tell you when you will ovulate - it can only tell you if you have ovulated. When you release an egg, a cyst is formed in the ovary called a corpus luteum. It is the corpus luteum that produces the high amounts of progesterone that the day 21 test will pick up, so if you haven't ovulated, your levels will remain low.

Just saw your reply - sounds sensible, and your levels would still be high (as you can see from the graph).

EuroShagmore Thu 07-Feb-13 11:11:23

To add to what has been said, 14 days is just an average. A normal LP is 12-16 days (and some women manage to get PG with shorter ones).

The reason the prog test is done on day 21 is that it is midway through the LP, which is usually when progesterone peaks (if you have ovulated). If you are pretty sure that you ov on day 19 and come on around day 31, I'd go for the test on day 25, personally (6dpo and midway through your expected LP).

CaipirinhasAllRound - a perfect example! It's as if they have never heard of a short luteal phase.

I had great success with tracking my temperature, and even though I couldn't alays temp at the same time in the morning, it gave me a really clear overall picture of what was happening with my cycle. I found it very helpful, though I know some people find it a bit stressful.

EuroShagmore Thu 07-Feb-13 11:21:32

brown I'm a big fan of temping too. I like knowing what is going on with my cycle. I also feel ov pains, but it is nice to get the confirmation of the temp rise over the following days in case it was just wind or something!

BTW, my LP is 12-13 days.

Euro, Unfortunately cd25 is a sat which is why I went for cd24. Thanks so much for your help everyone. I don't think temping would work for me as I have disturbed sleep and I think you have to be asleep for at least 4 hours before you take your temp? I am up and down In the night needing a wee and so e time just with insomnia so I don't think I could do it accurately otherwise I'd have given it a go.
If anyone else has anything further to add with information or advice then I'd really appreciate it. I'm on cd9 at the mo so not due for blood test till later in the month anyway. Thanks again and thanks for the link browneyes.

Oh I think my luteal phase is 11-12 days? I got a bit confused because I started spotting a day or 2 before af so may have miscounted for a couple of months but last month my luteal phase was 11 days if I count up to coming on properly and not just spotting.

Euro the temp rise is nice and reassuring smile

Just bumping in case anyone else has anything to add. Advice or info a.ways appreciated. Cheers.

moggle Thu 07-Feb-13 14:27:13

Ooh i have a couple of related questions- just got our appointment through at fertility clinic at the end of April and I need a few more tests doing beforehand: day 2, day 21 (already done), rubella immunity, chlamydia swab and an up to date smear (done).
So question 1: how precise does the day 2 test need to be, I noticed someone called it day 1-4 above? My periods are reasonably regular, cycle is within 28-31 days, but on any particular month I couldn't really predict it with much certainty.
Question 2; do the day 2 and day 21 tests need to be done on the same cycle? Hoping I don't need to have the day 21done again (it was fine last time tho I don't know the exact number atm)
Question 3: probably stupid, but is the rubella immunity a blood test? And is rubella German measles? Think I might have had that when I was little...

moggle Thu 07-Feb-13 14:28:04

Sorry meant to say- these weren't questions to OP, sorry, but just gate crashing to take advantage of knowledgeable other posters!!

EuroShagmore Thu 07-Feb-13 14:33:26

moggle I think GPs differ on exactly when they want to have the early test done. The aim is to get it done really early in the cycle before all the hormones start ramping up to do things (see the WIKI chart posted above). I had to just call to book mine when my period started.

The two tests don't need to be done on the same cycle.

Rubella is german measles and it is a blood test. I had it when I was a child too, but they still wanted me to have the test (pointless because I wouldn't have stopped TTC to have the vaccination, but the NHS does like to waste money to do things its way). I was immune.

Lol at euro not stopping shagging whatever the results!
What euro said basically. Doc said to me that they do this test on day 1-4 of your period because of the hormone levels. Rubella is to check immunity. Mine definitely won't be the same cycle as I'm already on cd9 so day 21 test this cycle and day 1-4 when I next come on which is a new cycle.
And feel free to hijack as the more questions people ask the more info is out there for anyone due to have this tests.

EuroShagmore Thu 07-Feb-13 16:02:58

(Because of my age, Quiet - I didn't want to lose a couple of months for a disease I am very unlikely to contract (do not work with children, etc)) But yeah, nothing will stop me! wink

moggle Thu 07-Feb-13 17:18:51

Thanks guys! Cool I will wait until the first day of my period then call to get a test. I've got two chances so if it starts on a Friday evening or something this time I should be ok next cycle!
My mum's confirmed I did have rubella as a toddler and also that I had the MMR when we moved to the US aged 10, so pretty sure I am immune but i'll let them do their tests anyway...

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