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Question re Day 21 Progesterone Test

(18 Posts)
Readynow Thu 13-Oct-11 09:34:27

Am very confused! Having been ttc for 8 cycles but nothing happening I went to see my GP who requested Day 3 & Day 21 tests. The Day 3 tests all came back fine but the progesterone test is low & my GP said it looked like I hadn't ovulated! My confusion surrounds whether I actually got tested for progesterone on the right day! My GP said that you only have the progesterone test on day 21 if you have a 28 day cycle but mine ranges from 25 to 28 days. I do OPK & so can predict the length of my cycle from the day I get my positive OPK result. Last cycle I knew I was going to have a 25 day cycle so took the progesterone test on cd17 (For 28 day cycle you take it on CD21 ie 8 days before so I figured for a 25 day cycle you take it on CD18). As CD18 was a Saturday I had to get it done on CD17.
My GP has said I should have actually had it done on CD19 but I think this is not right ?
Has anyone else had a similar issue with variable cycles? - Sorry for the long post.

Joycep Thu 13-Oct-11 10:03:19

REady - which day did you see your positive opk? you should have the test 7 days past ovulation rather than 7 days before you expect your period. 7dpo is normally the peak of progesterone. So if you wanted it done on CD18, I am assuming you ovulated on CD11 (probably roughly a day after you got your positive on an opk).

Readynow Thu 13-Oct-11 10:18:07

I got my positive OPK on CD11 in the morning & going by EWCM & CP I reckon I ovulated CD12 maybe although FF did not confirm this with a temp rise until CD15! So if I'm not exactly sure when I ovulated how should I work out the best day to have the blood test?

PieMistress Thu 13-Oct-11 10:31:35

I normally book my appt when FF confirms my ovulation so it's at 7dpo.

This month though the consultant wants me to have 2 lots of blood taken, one this Friday and again next Monday to check we aren't missing my rise.

My results are all between 20 - 25, which is borderline for ovulation (they like to see 30).

What was your actual result?

galwaygal Thu 13-Oct-11 10:33:31

The day 21 test should be taken 6,7,8 or 9 days post ovulation. So for the test on the 17th to have been accurate, then you would have needed to have ovulated on cycle day 11.

I can't quite work out from what you say when you got the positive OPK, and when you think you ovulated. So I will make some assumptions..... forgive me if I have it wrong.

You guessed you had a 25 day cycle, if you assumed that you have an LP of 14 days then you are thinking you ovulated on day 11. The would have meant that you got the positive OPK on day 9,10 or 11?????

OPK's do not accurately predict when you ovulate, they only show a rise in LH whick indicates that you might be about to ovulate. Sometimes (like I do) you can get the positive opk on the day you ovulated. However in most women the opk goes positive 24 to 48 hours before they ovulate.

Therefore if you got your positive opk on cd11 you might not have ovulated until cd 13, and therefore getting a Day 21 test on day 17 would only have been 4dpo, which is far too early.

As I say I don't know which cd you got your positive OPK so if you got it on cd 9 and you wer 6dpo getting the test, then it is possible that if the progesterone levels were low that you may not have ovulated.

I hope that this explains why you may well have tested too early.

Are you measuring ov any other way eg CM or temping?

galwaygal Thu 13-Oct-11 10:34:24

Sorry got interrupted and x-posted

galwaygal Thu 13-Oct-11 10:42:21

Unfortunately you clearly got tested too early this time. So the results are not valid.

I agree with PieMistress that when FF confirms ovulation is a good time to arrange the test for 7dpo.

OPK's are not a good method of determining when to go for the test. However, CM is ok, if you arrange to go 7 days after the CM has dried up. (not from when ewcm is seen, but from when it stops).

I hope this helps.

Readynow Thu 13-Oct-11 11:51:42

Thanks for your replys. My GP had told me I had to have the progesterone test 7 days before my AF she didn't explain it should ideally be 7 days post ovulation!

I got my positive OPK on CD11 so from that I predicted that I would have a 25 day cycle. I have been testing with OPK's for the past 8 cycles & the days between my positive OPK & my AF has always followed a pattern of 14/15 days (15, 14, 14, 15, 14, 14, 15, 14). I do temp as well but I find my temps are quite erratic, although they do tend to be higher in the latter part of the cycle. Generally I get a temp rise on the day after or 2 days after my positive OPK but a couple of cycles I have not seen this!
galwaygal from reading your post it appears I prob did go for the test too early so maybe that explains the result.
I know the LP is supposed to remain constant each cycle & it is just the ov day that can change but according to my temps on FF then my LP ranges from 10 to 15 days which I know can't be right.

Readynow Thu 13-Oct-11 11:54:16

Piemistress I stupidly forgot to ask the GP what my result was - she just said it was lower than she would have liked to see.

PieMistress Thu 13-Oct-11 12:05:38

ready I can just phone up and get my results? Does your Health Centre have a results number/extension? Worth a try

farfallarocks Thu 13-Oct-11 12:09:12

<waves at pie>

ready its definitely worth asking the result.
I believe anything over 16 confirms ovulation but they like to see over 30. A lower result can indicate poor follicular development or a luteal phase defect.

It is worth repeating it anyway regardless of days as you can have an off month.

AttilaTheMeerkat Thu 13-Oct-11 12:10:06

What were the results of the day 3 test?. You say they were okay but was the level of LH compared against that of FSH?. Both levels should ideally be the same.

Sometimes you can get a temp spike in the second half of the cycle when an egg has not been shed so charting is not totally infallible.

Would not put an awful lot of store into the OPK results as LH levels do fluctuate throughout the month. The progesterone test last time around seems to have been done too early; it should have been done actually on day 21 or at least after day 17.

Re luteal phase some gynaes think its a problem whilst others do not. It is perhaps unlikely that the GP will take any notice of such an issue.

Readynow Thu 13-Oct-11 12:19:26

Thank you all. Didn't imagine there would ever be so much to learn about this ttc malarky!
I will phone the GP to get the actual results of all the tests as when the GP said the first lot were all fine I didn't think to ask for the actual result. blush
I need to repeat the progesterone test this cycle & currently on CD5 so will try & get it for 7dpo if I can

farfallarocks Thu 13-Oct-11 12:30:09

One more thing one I don;t want to overwhelm you BUT......

If your LH and FSH are normal (and as Attila states they must be compared to each other not in isolation, a raised LH can indicate PCOS) and you are still getting low progesterone result do ask to have a thyroid profile done.

I have low progesterone problem and mine is linked to to slightly underactive thyroid. It is the TSH level in particular you want to have a look at. Normally anything under 5 is ok but for TTC purposes you ideally want it under 2 according to my consultant.

PollyRoxs Fri 14-Oct-11 18:30:44

Sorry to jusmp on this post but I have a similar question. I have just been for my results today from my day 3 / day 21 results and am struggling to know what to do next. My day 3 were FSH 12.4 & LH 8. My day 21 was progrestrone 17. I know this is the low end of normal but Dr didn't say it was a cause for real concern.

I couldn't get a blood appointment on day 21 so had them taken on day 23 then got AF arrived day 25. I am not sure what day I ovulated that month either.

My GP says I should have the day 21 done again this month. Again I have struggled to get a blood appointment when needed. I think I ovulated on day 12/13 this cycle and can only get an appointment on day 20.

Will this make a difference to the result? or should I push for one a few days before?

LIG1979 Fri 14-Oct-11 18:52:02

Hello Polly,
Day 20 is probably better for you as you ovulated on day 12/13 rather than day 14. The aim of a day 21 is to catch the progesterone at its peak - however to do this it assumes ovulation on day 14 and a 14 day luteal phase. If you ovulate on day 12 and have a 25 day cycle then your luteal phase is about 13 days so probably should get your day 21 done on day 19. Day 23 was always going to be low as it was 2 days before your period.

PieMistress Fri 14-Oct-11 19:34:07

polly did the Dr say anything about the other results or just the progesterone? If you can only get an appt on Day 20 that might be okay but as LIG says Day 19 would be better. I've gone twice this month - today and back again on Monday as I have irregular cycles and although I think I know when I ovulate the consultant wants to make sure he has my dates covered.

PollyRoxs Fri 14-Oct-11 20:15:34

Thanks for the replies. I also have irregular cycle which is why it wasn't timed right last time. I will ring on the morning of day 19 to see if I there are any cancellations or if i can wait for the nurse. Otherwise i will have the day 20 appointment to fall back on.

Dr didn't mention any other results but I had to ask for the progresterone result, he just said it was on the low end of ok. What else should I be asking for?

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