Short luteal phase - GP was very dismissive!(31 Posts)
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!
That's really positive, and the wait isn't too long. Hope they will be helpful!
Thanks Totes. I really appreciate your replies.
Glad you are making some headway. Good luck!
Thyroid TSH were normal. This was tested in first blood test but just wasn't on the copy I got. GP showed me on the screen though.
This GP was lovely. She listened to me ranting about short luteal phase and was appropriately unhappy with me having the cycles I am having. I was so relieved! She has referred me to a fertility clinic with about a 3 week wait. DP will have to come too so my next challenge is persuading him to give a sample. He is not at all keen on doctors, hospitals etc!
I just don't understand how they could question its existence? I am sure it is possible to get pregnant with a short LP and there will be people on here who managed, but a luteal phase half the length of a normal healthy one isn't going to help your chances and I felt for me it was hindering the process.
How long have you been trying? I had the dye in the tubes thing before DS and although there was no blockage, we did fall a few months later. People say sometimes it just helps to flush the system out. You can get it on the NHS as part of their general fertility investigations.
Also, it is a good idea to get DPs sperm checked. We too often assume we are the problem! But again, you can get this on the. NHS too if you have been trying for long enough.
I saw your other post about your thyroid suspicions. I too have a basal temp that matches yours but my thyroid never came up as abnormal fortunately. It certainly can be an indicator though.
I really sympathise with your frustrations. I have been there and felt absolutely miserable and stressed with it. The first time round I didn't even have a short LP and for no obvious reason it took us 18 months to conceive.
The progesterone pessaries cost us around £80 for a three month subscription.
The dismissive GP just said to keep DTD and not worry about the luteal phase because it doesn't affect anything. Grrr. I'm seeing another GP next week.
The private clinic emailed me back and said that there was little evidence regarding treating LPD and some controversy over whether or not it exists. However they recommend checking my tubes and DP sperm and they could prescribe progesterone pessaries. I emailed to ask for a guide to cost but haven't heard back yet.
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 ?
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
Ovulation is confirmed if levels are above 30
GP should give you copies if you ask. Good luck!
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.
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.
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?
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.
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!
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.
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!
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
Now am ttc no 2, still bf and LP is 7-8d Have been trying b6 but has not really made any difference to my LP in 3 months 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
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.
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.
Hi Sparkle. My fertility consultant has been equally dismissive I'm afraid 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!
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.
Do you know what, I've totally forgotten
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
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.
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.
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 - he said he'd never met anyone who'd done it I don't think all GPs are particularly knowledgeable about fertility.
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