Not ovulating, GP a bit slow [confused]

[helloeggy]

Hello all! I'm very new here so I hope I'm not asking silly questions...

I'm 30 years old and healthy. Last Depo nearly a year ago, regained very irregular periods over the last 5 months. GP did blood tests showing low Progesterone which suggest I'm not ovulating, as does my CBFM. Doing pelvic ultrasound next week.

I'm a bit annoyed that after many tests GP is giving me the whole 'Must be the Depo still around' spiel, suggesting I come back a year after cycles return to even consider Clomid or referral.

What do you lovely ladies think?

[LittleSilver]

eggy I have no experience or qualifications in this matter, but I do know that I wouldn't hang about with A GP I felt was unsupportive/unknowledgeable/a bit clueless. I would either change GPs or change surgeries. And do my research so that I knew what I wanted the GP to do; imho if you go in with a plan and an idea of what you want to happen (carefully phrased so as not to upset!) it is much better than just going in and being passive. I wish you all the best and hope that a better informed poster comes along soon!

[LittleSilver]

Oh yes, and no way would I wait a year to see what's happening. Are you charting or just using CBFM? I really recommend charting. Join us on Charter's Anonynous!

[Ellie78]

Hi there

Not 100% sure what depo and cbfm - not quite down with the lingo but am guessing at contraception and fertility monitor...?
I am going through the same thing at the mo. Have just been told that my Progesterone and FSH and LH are very low and indicate non ovulation. My doctor has been very blase about the whole thing too and in fact it has taken 2 months to find out that my test results were abnormal having been told she would contact me if any problem...sorry, I digress!
It is a difficult one as it is hard not to over worry. Are your periods supposed to take a while to return to normal after depo?
Have you had any other tests or just progesterone? Depending on the outcome of the ultrasound, if you are still worried I would think about asking for further tests or a referral. As someone who has spent nearly a year trying not to worry I wish I had asked for a referral earlier. Someone told me on here that you don't need to wait a year for a referral if your blood tests show up an abnormality. Maybe just a question of being firm with your GP about what you want.
Hope that is reassuring in some way. Good luck and let us know how it goes.

[Haliborange]

I think I would suggest to the GP that while he might suspect it is the depo hanging around he can't be sure and therefore a referral to a specialist to rule out any underlying issues is in order.
Also isn't the depo shot only supposed to be effective for 12 weeks? If it is affecting your cycle a year on then he ought to be referring you because who knows how long it could continue to do so. Maybe you need something (clomid, for example) to get you back on track.
Have you tried just straight out asking for a referral? That's what I've always done, including asking for referral to specific hospitals/clinics that I have heard are good. It generally gets the right result!

[helloeggy]

Thanks Littlesilver!

I tried to chart earlier on but my temps made little sense after a night out, jumpy sleep, etc. so I stuck to CBFM.

After doing research I do have a 'plan' (as in, Make me ovulate, dammit!) and some medical training so I'm aware of what would be truly worrying like high FSH or MC symptoms, but would still not like to alienate only female GP at surgery.

I think that if my ultrasound comes back inconclusive, a bit like low Prog which didn't get followed up, I'll get a bit more assertive, grrrr!

[helloeggy]

Thanks Ellie and Halibo, I do agree with ya'll. This whole year wait nonsense is so silly and subjective, I'd love to hear form someone who actually did wait and conceived right on cue.

P.S. Periods after Depo contraceptive should come back within 18 months, but nobody wants to sit and wait on a potential problem for that long, I'd say.

Thanks for the encouragement! x

[2ndDestiny]

Hi eggy

I agree with the others about getting this checked out sooner rather than later if you can get your GP on board. I don't know much about depo, but at this stage I would want to rule out other problems since if something is wrong chances are it can be treated.

The most common cause of irregular cycles is PCOS (know this because I have it!), often masked by hormonal contraception like depo or the pill. So it's very good that you're having an ultrasound - ask if your ovaries look polycystic. It is possible to have PCOS without the polycystic-looking ovaries, but unlikely. Other markers for PCOS include raised testosterone (even high end of 'normal' range) and higher LH than FSH on cycle day 2/3. Ask your GP to test for these if not already done, and make sure you get actual numbers - not just 'oh it's normal' - as the 'normal' range for LH can sometimes mask an imbalanced ratio to FSH which is the critical thing. The ultrasound is crucial though as many PCOS women do have normal hormone profiles. Other hormone tests your GP should do if she hasn't already are thyroid function and prolactin. Both of these can sometimes reveal problems which would explain lack of ovulation.

Either way, push for a referral. Good luck.

[helloeggy]

Hello 2ndDestiny,

You're quite right, I had worries about PCOS initially, but luckily my blood test with Oestradiol, Prolactin and Thyroid seemed to raise no concerns on that front.

I did get the 'its ALL normal' business, and when I asked about FSH figure to check I had reasonable egg count she was a bit uppity, bless. So I have appt. for after the scan to get a) Proper lowdown on numbers and b) referral either way, because I have just had a 13-day period which is just not on, methinks.

Thanks for raising the details of hormone profile for PCOS, I was less aware of that than physical symptoms so I'm glad you've alerted me to it.

Off to wait for lovely scan, when I'll be at my most charming - I might as well since doc won't even buy drinks / chat me up beforehand ;)

[helloeggy]

Hello lovely peeps!

I'm back to GP today, so I'd appreciate some help in asking her to do more to investigate my problems, but she's a bit young and laid back.

To recap, after five months of post-depo short-cycle and long-period problem, I had bloods and a scan that showed one fuzzy ovary and one polycystic, so rang GP after test and got referral for Whipps Cross Gyn (appt not until mid-June).

I'm going to vigorously ask for the actual values in my 'normal' blood test, but I wondered if any of you had experience of cycle monitoring on the NHS and how to ask for it, or indeed whether an infertility referral can be done at the same time as Gyn.

Thanks for reading! x

[Keziahhopes]

Hi Helloeggy - after a year ttc we went to our gp who gave us all the basic tests fertility consultant would want before seeing anyone:
2 cycles of blood tests (so can compare and see if differ) - the 3 day one and 7dpo (day 21 of 28 day cycle) and prolactin, adrenal glands etc to rule out non gynae issues.
Had to have chlaymdia sweep at same time as a current smear test.
Husband got his gp to order a Semen Analysis - which involved quick trip to hospital to provide it, results to gp.

Then got referred to fertility consultant, had session wiht their junior dr, was weighted - BMI worked out (important as some treatment is limited to BMI number on NHS, eek!) in our pct and then they order repeat tests that were low/inconclusive and transvaginal scan to check for PCOS, womb health.

helloeggy - when gp got results he referred me to the fertility consultant - which is the same thing as gynae, they work as a team, but my consultant is expert in gynae issues and deals with infertility. So no need to see 2 different consultants, though may see different Junior Dr's and SHO's. I am managing to get 3mth waits only between sessions which is good as some tests are cycle dependant.

[helloeggy]

Thanks Keziah, that's pretty much the course things have taken for us.

We're still waiting for his SA test and waiting for my first referral, but GP said I'd see Gyn first and then they would pass on to fertility specialist if my Gyn issues were sorted / investigated conclusively.

These 'inconclusive' tests are a bit of a pain, aren't they? Apparently once we're in Gyn hospital system things move a little more swiftly,I hope that is the case for you too!

Best of luck