Short luteal phase - GP was very dismissive!

(31 Posts)
Sparkle9 Mon 23-Sep-13 18:27:17

I've posted before about my cycle problems since coming off the pill. Basically I've been having cycles of varying length but all have been longer than average. Blood tests, OPKs and an ultrasound have shown ovulation (and normal ovaries). BUT I have been experiencing very short luteal phases of about 7 days.

I initially had a sympathetic GP who referred me for the blood tests and ultrasounds but this GP is no longer at the surgery. So I saw a new one today and he was very dismissive. Basically lectured me on how conception worked and said that it was all about a sperm hitting an egg and the luteal phase length doesn't matter. I tried asking about how inplantation could possibly take place if my luteal phase was too short but I got nowhere.

I'm currently 7dpo and just waiting for AF to show up. I'm delighted that it hasn't arrived yet! But is the GP right that short luteal phase means nothing really?? He even invited me to bring in medical journals showing evidence and we could discuss it!

joycep Mon 23-Sep-13 19:34:16

What a nob! I went to a fertility clinic many years ago and said my LP was 10/11 days and the male doc said it was impossible as every woman gets a period 14 dpo, so I understand the frustration! Have you had the day21 progesterone test which should be done at 7dpo? If it is continuously coming then, you should push for a referral to a gynae because it suggests there are ovulation issues. easily can be sorted but you need someone who knows. GPs can be pretty useless when it comes to fertility. There are so many books out there that will say the ideal LP is 12plus days and certainly not lower than 10 - can you Take somehing along like this to the GP? When I saw a gynae about my 10/11 day Lp she said it was too short. I am sure the odd person will manage to get pregnant with a short one but chances are reduced as apparently implantation happens on average around clearly not much good if your period has come by then.
I would also say that some people who have come off the pill can take a while for their LPs to get to something normal. Sometimes it happens naturally. Other people I know has to go on clomid to extend their very short Lp.

VJONES1985 Mon 23-Sep-13 19:38:39

Sparkle - how annoying! I'm experiencing the same thing with my lp. How long have you been off the pill?

HeyJudith Mon 23-Sep-13 19:49:40

That's annoying, the briefest of searches show that a pregnancy needs a luteal phase of 10 days minimum to support it.

I think the B vitamins help promote a longer luteal phase, have you looked into supplements at all?

Sparkle9 Mon 23-Sep-13 22:38:00

Thanks for the replies. AF arrived soon after I last posted. Very down about it. It's 7-8 DPO. Surely that is too short a LP!!?

I know I can try B6 but I've also read that this can delay ovulation. I was rather hoping to get a medical opinion on the best course of action!

What can I do next? Could I ask another GP? Is going private the only option if my surgery won't refer me anywhere?

It's incredibly frustrating. I've been off the pill since February. I had blood tests every week for a recent cycle and ovulation showed 7 days after CD28 rather than 21 with AF arriving 6-7 days later.

Then the ultrasound showed a dominant follicle at around CD21 on the next cycle with OV a week later and AF just 7-8 days later.

JoinYourPlayfellows Mon 23-Sep-13 22:39:31

See another GP who isn't a cocky, know-it-all asshole.

CountBapula Mon 23-Sep-13 22:47:51

I've always had a shortish LP (about 10 days) but it went down to 7 or 8 when I was breastfeeding DS. I took B6 for a couple of cycles and it sorted things out without my having to wean him (I was charting my waking temperatures etc). I'm now four months pg with DC2.

When I got pg with DS, I showed my charts to my GP and he was like this shock - he said he'd never met anyone who'd done it hmm I don't think all GPs are particularly knowledgeable about fertility.

Sparkle9 Mon 23-Sep-13 23:10:28

Okay I might give B6 a go. Should I take it all cycle? And how many mg?

I am getting crosser and crosser about the GP actually. He really did treat me like an idiot.

Snazzyenjoyingsummer Mon 23-Sep-13 23:13:23

Can you change surgery? If there are other GPs there I'd ask to see one of them. Don't go back to this one.

CountBapula Mon 23-Sep-13 23:34:36

Do you know what, I've totally forgotten blush

I think I took it all cycle, but it might be that it's just the first bit that's important. I do remember you need to take it along with other B vits. I got the info from a thread on here (TTC while breastfeeding) so if you do a search it might come up.

And defo try to see another GP. Yours sounds underinformed hmm

Sparkle9 Tue 24-Sep-13 08:05:14

Thank you so much for your replies. Making me feel like I'm not alone or a complete loon!

I've found some research suggesting that thyroid problems can cause luteal phase defect. Has anyone heard this? I'll post the link this evening when I get home from work.

ImpatientOne Tue 24-Sep-13 08:15:17

Hi Sparkle. My fertility consultant has been equally dismissive I'm afraid sad They just seem to be bothered that I ovulate at all rather than when I ovulate...

I have just been prescribed Clomid as this can induce earlier ovulation & therefore by default help with LP issues but I am still undecided as to whether I should take it or not as there will be no monitoring. I would much rather have monitored cycles (without meds!) but that's a 'resources issue'.

My experience is that once basic tests done (bloods, semen analysis, HyCoSy) they go straight for treatment regardless. I asked last week about further hormone investigations but was told 'you don't want more investigations you want a baby and IVF is the way to do that.'

Hope you have better luck!

bonzo77 Tue 24-Sep-13 08:19:27

B6 I believe really helped my LP after a MC. I cannot rember the dose, but it was 2 of the cheapest ones from holland and Barrett, so I think it was 10mcg (or whatever the units are called). Went from 9 to 14 days in 4 cycles, then got a BFP. Though some if that might have happened anyway as my body settled after the mc. Another friend had a LPD and was given progesterone by a specialist. She too was pregnant within a few cycles.

learnasyougo Tue 24-Sep-13 08:25:28

Just wanted to add that b6 lengthened my lot, too. Didn't affect when I ovulated. and I had a BFP the second cycle I took it.

GPs don't actually know very much about the detail of fertility. I don't think it's covered all that much in their training. I would bring printouts on minimum lp length. Anything to bolster the case.

I also had a dismissive gp, who told me progesterone had nothing to do with it, when I asked for it to be tested.

eggsnbeans Tue 24-Sep-13 08:31:35

Hi Sparkles, GPs have so little knowledge on fertility, it's so frustrating! I had a 9d LP when I was ttc , GP totally dismissed it and my 21d bloods always showed low progesterone. However, I did manage to conceive DD eventually with a 9d LP smile

Now am ttc no 2, still bf and LP is 7-8d confused Have been trying b6 but has not really made any difference to my LP in 3 months sad although since starting it I am now ovulating on d21 rather than d25 (although maybe this would have happened anyway!) I have also read that B6 is not much use for increasing LP unless you are bf as it mainly helps reduce prolactin levels.

Anyway, sorry not much help I know, but just wanted to say you can conceive with a short LP so keep at it and FX for you smile

Sparkle9 Tue 24-Sep-13 12:59:10

Thanks everyone. I just don't see how a 7 day LP will ever allow implantation to take place. :-( I'm really gutted that AF arrived. In past cycles I've had a few days spotting and then AF but this time I had 6 days of no spotting after ovulation followed by AF appearing last night. :-(

I'm going to try another GP and then investigate private options. Although it's not like I have loads of money to throw at this so I will see if I get anywhere with my surgery first. Annoyed that the two good GPs have left!

Totesamazeballs Tue 24-Sep-13 13:37:30

Hi Sparkle. I just want to share my story in case it helps. After DS we started thinking about no.2 and when my periods returned I started temperature tracking as they seemed on the short side 24/25 days long. At first I thought I must be getting it wrong but temps and ovulation pain showed I was ovulating late with a 7 day LP. After four months I went to the doc. I knew it was no use talking about LP to them so I said I felt things weren't right, my cycles were short and coincidentally I was also having bouts of insomnia. I had read about low progesterone being a cause of short LP and it can also cause insomnia so i had a feeling it might be the issue. i asked for the full gamut of hormone tests and the doc obliged ( she was new and keen)!

Everything came back normal EXCEPT my progesterone which indicated I hadn't ovulated. My temps showed I had but herein lies the issue. The 21 day progesterone test relies on you having a 14 day LP. The doc said for me to count back 7 days from last day in cycle and take the test. This happens to be 1dpo for me instead of 7dpo so of course my progesterone was low.

Anyway, they ask me to repeat the test next month and the same thing happens. So, the doc says, it looks like you aren't ovulating and at this point I try to explain about LP and get nothing. Doc then recommends I use OV sticks for a few more months and then come back and she will refer me to a fertility expert.

At this point my impatience kicked in and so we went privately. Consultant sent ,e for follicle tracking which confirmed that I was ovulating and had a 7 day LP. He explained that the corpus luteum secretes a certain amount of progesterone for 7 days in everyone and then after 7 days it can vary and they don't really know why. He prescribed a few months worth of progesterone pessaries to be taken two days after ovulation and sent me on my way. The very first month we got a BFP. It makes me wonder if we were fertilising eggs but my body was chucking them out, or perhaps it is coincidence and luck but certainly going privately saved a lot of frustration and heartache and fortunately it was just two appointments and some tracking so not major bucks.

I have my 12 week scan this week and hopefully there will be a healthy baby in there....if not that is a whole other hurdle but I feel like we were lucky with the LP hurdle.

Sorry it's so long but I hope this gives you something to cling onto and investigate. If you are near London I am happy to recommend my consultant.

blamber Tue 24-Sep-13 17:20:23

I am having the same issue. Stopped the pill almost 6 months ago, but am only in my third cycle now. However, ov is always late (cd 18 now and think it's close), but then I have my AF a week later. Took B6, 50 mg a day, and ended up with tingling arms and legs, which after two weeks have not gone yet. The GP is doing blood tests for the tingling, but if my LP stays short, I'll be going back for that as well. So I would recommend staying off the B6 and getting a new doctor.

I know LP can be short after the pill, but after 6 months or more than three cycles, I think it should be checked out.

Totes, thanks for your story. It makes sense about the 7 days of progesterone, and after that it can vary. Good to hear progesterone can help so well. Was the private consultant expensive? Good luck with your scan!

Sparkle9 Tue 24-Sep-13 17:34:17

Thank you for sharing your story. And congratulations on your BFP! I hope everything is perfect when you have your scan. Your progress (or lack of it) with the GP sounds just like mine.

I have been stewing over this and feeling very angry and upset. Perhaps it's due to AF but I even cried all the way home from work and this is not at all like me.

I phoned the surgery and politely explained that I really wanted to speak to an experienced GP who was likely to be sticking around for a while. The receptionist was lovely and booked me in with a GP in two weeks time. It will be a long wait but I'm going to use it to prepare and go in armed with data.

I'm going to request thyroid testing and then referral to a fertility specialist. I am willing to consider private if that is what I have to do. Unfortunately I don't live anywhere near London so I'm not sure where to go just yet but I will explore options.

I would be interested to hear how much private consultations have cost others? Just so I can prepare financially.

Sparkle9 Tue 24-Sep-13 17:35:50

Totes - could you tell me more about your consultant? Do you think it would be workable for me to travel to London for consultations or did you have to have lots of them?

Totesamazeballs Tue 24-Sep-13 19:29:52

Hi Sparkle. I had two appointments with him. The follicle tracking was done at a local clinic that offers scans privately.

The scans cost me £70 and I had two or three. I can't quite remember how much the consultations cost - I think between £100-200.

I thought I knew what the issue was and had done the bloods already with GP and had the details. He knows we were paying as we go so doesn't make you do tests unnecessarily so we didn't have to repeat blood tests.

Sparkle9 Tue 24-Sep-13 20:41:14

Thanks for that Totes. I've googled fertility clinics near me and there are a few offering private treatment so I've sent off some emails asking about their approach to luteal phase problems. I'll see what (if anything) comes back.

Will my GP give me (or private doctor) copies of my blood tests and ultrasounds? I think I had 4 blood tests done in just one cycle plus the ultrasound the next cycle.

Although I have my fingers crossed that I will get somewhere with the second GP in two weeks.

Totesamazeballs Tue 24-Sep-13 22:21:12

GP should give you copies if you ask. Good luck!

Sparkle9 Sat 05-Oct-13 12:08:34

I have my blood test results from the GP now. Can anyone shed any additional light on these:

CD16 - serum progesterone 1.600nmol/L. GP notes say still low try 7 days before next period.

CD23 - 4.900nmol/L. GP notes say OV not happening. Referred for ultrasound.

CD23 and 24 - positive OPKs

CD30 - 47.300nmol/L. GP notes say OV happened.

CD30 and 31 - lots of spotting or light AF
Day later - medium flow AF. Lasted a full 5 days with some heavy days in there followed by at least 2 days of spotting.

Explanatory notes on blood results:

Follicular phase 0.5-4.5
Luteal phase 10.6-89.1
Menopause <2.3
Ovulation is confirmed if levels are above 30
Male 0.9-3.9

Totesamazeballs Sat 05-Oct-13 13:56:04

Hi Sparkle, well you have the evidence right there that your LP is short. I am afraid I can't interpret them anymore than that as yours are much more detailed than mine.

Did your GP say anything to you about them? Did your thyroid come back ok? Have you heard back from any of the private clinics ?

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