Low Progesterone Levels at CD21

[zippygeorgebungle]

Hello. I wondered if anyone could help. I have a baby who is 1 and was conceived first cycle. Been TTC for 8 cycles but no luck, I am 35. Had a scan for PCOS, all normal. Had blood tests on different days of the month and the GP receptionist called for me to make an appointment today, she said that progesterone levels on CD21 were abnormal. They can't see me for an appointment until mid November, so I wondered if anyone knew what this meant. I am still occasionally breastfeeding, and have been using Clear blue sticks which always give a smiley but usually only about 10 days before AF (flashing smiley before that). Cycle is 27 days and regular. Thanks in advance for any help, it is a stressful time.

[eurochick]

Usually progesterone needs to be over 30 (some drs say 25, some say 35) at day 21 to confirm ovulation. So it sounds like your level was below this.

However, if you are ovulating late in your cycle, it might mean that day 21 didn't catch the peak progesterone level (it's based on having a 28 day cycle with ovulation on day 14). If you are getting a smiley at day 17, you are probably not ovulating (if you are) until a day or two after that, so your day 21 test might not have caught the peak.

Progesterone levels can also be abnormal by being very high (80+) at day 21. This would be indicative of PCOS.

[zippygeorgebungle]

Thank you, that is very helpful. Do you have any idea how they remedy abnormal levels, if they can?

[eurochick]

If you are not ovulating, Clomid is the usual first port of call.

I see that you are still bfing. I think it's possible that could be suppressing ov, even though your periods are back. I'm just guessing on that one though.

I'd expect you to be referred for some cycle monitoring to see whether or not you are actually ovulating. If you are, there are more tests they can do to check hormone levels and blockages in tubes and so on. If you are not, I would expect you to be prescribed Clomid.

[zippygeorgebungle]

Thank you. It sounds like it might be time to stop bf'ing, which I was thinking of anyway. I do get clear symptoms of ovulation and even before using the CB sticks I always felt I knew when it was, though very late in the cycle which I gather might be a problem for conceiving. But it does seem to happen after the smiley face. I felt very upset when I got the call today about the results but rather than despairing it might be good to see it as identifying a problem that can hopefully be overcome.

[eurochick]

If you think you can feel ov, then it could just be that the test was done too close to ov so the result didn't pick up the peak, although it probably does mean that you have a rather short luteal phase (some drs don't seem to think this is a problem though).

If it is the case that you aren't ovulating, ovulatory problems are supposed to be the easiest to overcome, because they can give you drugs to make you ovulate and for most people that does the trick.

[Theonlyoneiknow]

I had this issue following a miscarriage, low progesterone and late ovulation. I ended up going for acupuncture to try and bring my ovulation forward from Cd19 to CD14 ( which it did) and also took vitamin B6 and b12 supplements. Three cycles later I fell pregnant, whether or not the above was what did it I don't know but the fertility clinic had also told me I was peri menopausal due to my LH and FSH numbers.

Might be worth a try though?

[zippygeorgebungle]

Thank you, both, I appreciate you responding and giving me some hope. I take Pregnacare Conception which looks like it has those vitamins in, but is some other supplement better? I am shocked and sad it has taken so long because the first time was so quick, just a couple of years ago, though I know how lucky I am to have one healthy baby and I am grateful of course. I will look into acupuncture, stop the breastfeeding and see what the GP says.

[Theonlyoneiknow]

I don't think there is enough in the pregnacare vits. I was taking in addition to my conception multivitamin. I can't remember the exact mg though, there are a few threads on B6 on here, it might say there x

Taking charge of your fertility is also worth a read x

[zippygeorgebungle]

thanks, I am learning so much from the helpful advice! I had to take the baby to a routine appointment there today and asked the receptionist to print off what she had on screen. The results just say "serum progesterone RM19 Abnormal 3.0nmol/L" with a footnote that says "Progesterone greater than 30 nmol/L consistent with ovulation if sample taken on day 21 of a day 28 cycle". So 3 sounds a long way out.


The blood test was on Tuesday and I had had the smiley on Friday, but got symptoms of OV of Weds. AF due on Monday.

[Theonlyoneiknow]

Have you tried temperature charting on fertility friend? I found it really insightful but it is hard not to get obsessive when you use it :)

[zippygeorgebungle]

I haven't tried this but shall start now, thank you! I am already obsessing so it sounds another way to do so but a productive one.

[RubySlippers77]

Hi everyone, I'm also waiting for the results of my CD21 test for progesterone (actually had it on CD23 as the GPO told me to have it 7 DPO). Cycle is between 25 and 28 days.

I've bought some B50 as it seems to be highly recommended on here, but nowhere can I find if I should take it all through my cycle, only pre-OV, only post-OV or something else.....! I'm also taking EPO but only CD1-12 as I read it was pre-OV only. Can anyone advise on when I should be taking the B50?!

[RubySlippers77]

I'm also trying to work out if I can start the B50 now (I'm CD9) or whether I should wait till the start of another cycle..... it's all very tricky!!

[zippygeorgebungle]

I would also be interested in knowing this. In addition, if you become pregnant and are taking the B vitamins, is that safe etc?
I am getting a call from my GP tomorrow now, given they can't see me for a fair while, so shall try remember to ask.

[blamber]

What is b50??

I took b6 for a while, started after ovulation because in some women it can delay ovulation, but then I got tingling in my arms and legs which lasted two months even though I quickly stopped taking it. So be aware of side effects!

I am having my CD21 test done this cycle too. Now just waiting for ovulation, because it's always late. Apparently it shouldn't be taken on 7dpo, but halfway between ovulation and your period. This is difficult for me, because my luteal phase is always different!

[RubySlippers77]

B50 is from Holland & Barrett - I'll try to post the product info here or you can look it up on their website if that doesn't work!

Thanks blamber, I will start taking after OV, for this cycle at least. I'm vegetarian and meat contains a lot of B6, hence why I wondered if I could be deficient in that.

Blimey, the GP didn't explain about that and it would be the same for me, I'd have no idea when half way is!!

B50:
Each caplet contains: %EC RDA*
Thiamin (Vitamin B1) 50mg 4,545%
Riboflavin (Vitamin B2) 50mg 3,571%
Niacin 50mg NE 313%
Pantothenic Acid 50mg 833%
Vitamin B6 50mg 3,571%
Vitamin B12 50µg 2,000%
Folic Acid 400µg 200%
Biotin 50µg 100%
Choline Bitartrate 50mg **
Inositol 50mg **
PABA 50mg **

[DulcetMoans]

Joining as my cycles and situation is almost identical to yours zippy. I have only just started looking into dealing with luteral phase so this is some helpful tips.

[Theonlyoneiknow]

I took it all the way through my cycle and first trimester (it is also recommended for morning sickness) I then weaned myself off in second tri, ie took half a tablet then stopped after a couple of weeks

[zippygeorgebungle]

The GP (a different one from normal, he was far less sympathetic) called me today and said that failure to ovulate/low progesterone was quite frequent and there was little or nothing that could be done about it. He said the bfing had nothing whatsoever to do with it and as I had a baby already he wasn't sure anything further would be investigated and there was nothing I could do myself to encourage ovulation. I asked about Clomid but he said GPs didnt prescribe this. I have an appointment with the original GP next week so hopefully rather more of a positive response than the rather devastating implication that I may as well give up now.

I wondered about paying for an appointment with a consultant, it looks like about £200 for an initial consultation but I will see what the usual GP says next week at the appointment. The more rational part of me knows that at 35, with regular periods, in good health and with a baby conceived immediately two years ago it surely can't be hopeless?

AF was due today and hasn't arrived yet which is making me think maybe the test was a little early or something if the cycle is longer than usual (which again, he dismissed)

[AttilaTheMeerkat]

Think this GP could have done with having a better bedside manner. He is wrong in one respect though, failure to ovulate and low progesterone problems can be dealt with but it may well be a long and hard road.

Unfortunately as well two years is a long time in fertility terms and fertility generally speaking declines with age. It does not always follow that if a woman conceived the first child readily it will be the same with the second.

Secondary subfertility which is how your situation could be described is unfortunately not all that uncommon.

BOTH of you need to be tested further, subfertility is not the sole preserve of the woman.

Progesterone though is only part of the story; you could really do with having a day 2 test done to see what your LH and FSH levels are like. These two are important hormones as they kickstart the ovulation process; if these are awry then ovulation will be affected.

I would consider paying to have an initial consult as a private based patient and go from there. You need a diagnosis first and foremost.

[zippygeorgebungle]

Thank you. I had the tests at the earlier part of the cycle on day 3 but he said all other levels were perfectly normal and that the scans showed normal ovaries and everything to be fine internally. I am still thinking it could potentially be the bf'ing that delayed the ovulation perhaps because we did go from very occasional feeding to a bit of a surge in feeding this cycle as the baby was not well and just wanted to feed all the time. I have given up completely now since last week (she is 20 months) so I suppose we can see if it makes a difference.

[zippygeorgebungle]

Hello, AF is now late and not feeling imminent. As such, I wonder if the day 21 test might just have been done a little early. I am assuming that as AF is delayed, it could be that OV occurred late this month and the test just didn't pick it up? It is usually 27 days exactly. I think it could be delayed because it has been an unusually stressful month with a bereavement and the surge then stop in breastfeeding. I may of course be simply clutching at straws which is easy indeed when TTC tut may ask to have another test next month.

I am grateful for all the info I have learnt from this thread, thanks.