6 months TTC - advice & support

[meggles]

morning everyone - I was hoping for some advice & support. My DH & I have been TTC since Sep 09, a little over 6 months. I had been on the Pill/Patch for 13 years, and have stable hypothyroidism. My cycles since coming off the pill have been: 50 days/anovulatory, 49 days/anovulatory, 42 days/ovulatory, 32 days/ovulatory. I'm currently on CD25, 5 DPO. The (2) ovulatory cycles have had well-timed intercourse, as well as this month. I've been seeing fertility acupuncturist for last 6 weeks. I went to see my GP in mid-February about long cycles and anovulatory cycles. She wasn't overly concerned, but ordered basic hormone tests. My results are:

Day 22 (Ovulation)
LH=17.3
FSH=4.1
Progesterone=6.9
Prolactin=225

Day 29 (7 DPO)
LH = 2.3
FSH = 1.7
Progesterone = 39.6
Prolactin = 117

I went back to the GP 3 weeks ago to get these results. She was happy with the results, especially the progesterone which shows a strong ovulation. I was expecting her to say keep trying, and come back in 6 more months if you haven't conceived. But she didn't. She said that the next step would be for me to have chlamydia test, and DH to have SA. She asked if we wanted to be referred to fertility clinic. She said that since the waiting list is 4 - 6 months, that she would advise putting in a referral, and hopefully never having to use it.

As I was walking away from GP office, clutching a SA sample pot, I was in a bit of daze. I'm not sure I'm ready, we're ready to take this step. It is somewhat reassuring that there's an appointment in the pipeline which we could attend if need be. Alternatively, I feel like a 'watched pot'. I came home to poor DH, who was slightly taken aback by my 'gift' for him. He sort of thinks I shouldn't have gone to GP so early. He thinks we're putting too much pressure on ourselves.

Low and behold the appointment just came through - scheduled for only 6 weeks after the GP referral.

Not sure exactly what my question is, but would be happy for any advice on what to do next. I'm thinking about suggesting we move the appointment out another 4-6 weeks to give us some more time, and 2 more cycles to go 'natural'. Any suggestions, advice or support? Thanks.

[AttilaTheMeerkat]

Hi meggles,

Are you certain that the hypothyroid is completely stable now?. When you state that some cycles were ovulatory was this actually confirmed through blood tests?.

Your prolactin levels are far higher than the usual level expected and this could also be linked to the previous problem with the thyroid. A progesterone level on day 22 showing a level of less than 30 would not necessarily indicate ovulation occured.

GP should also ideally have done TSH and T4 testing around day 3.

I would have gone to the GPs when you did and sought a referral given your circumstances; I don't think you have gone there too early at all.

I would certainly attend this appt in six weeks and go from there. I think otherwise you could well have another two months of anovulation and you'd have delayed things even further. You should both attend this appt if at all possible. Such an early appt in terms of wait time as well are akin to golddust; if you choose to move it back you will likely not get seen another six weeks later.

BTW the tests you had done (apart from the progesterone) are normally done far earlier in the cycle. LH and FSH are two very important hormones that kickstart the ovulation process, it should be tested around day 2.

Re the semen analysis as well, this test should be repeated.

[AttilaTheMeerkat]

Normally cycles of over 35 days are often anovulatory ones particularly if the cycle is persistantly long.

[meggles]

thanks for your reply.

my hypothyroid is under control- TSH a few months ago was 1.78, and I am currently asymptonatic. (having been symptonatic in the past - i know the difference)

the last 2 cycles, as well as the current cycles, have had ovulation confirmed via OPK tests, cervical mucus/position, and BBT. my Progestrone on day 29 (which was 7 DPO) was 39.6. In my GP's opinion, this indicated that ovulation had occurred. (chart here: www.fertilityfriend.com/home/2b6234)

as for appointments - when I went to 'Choose & Book' to change the appointment I had 10 different appointments to choose from. it was slightly amazing/odd to have that much choice.

as for SA - my husband is dragging his feet. as I was lying on the table today, getting clamidia test done I was getting very annoyed at him. I understand having SA can be an 'affront to you manhood' but seriously, its def more dignified that my test today (sorry for the vent)

Can you tell me more about prolactin & thyroid connection? I have read that high prolactin levels can suppress ovulation, but my GP said my levels were fine.

now that I know that I will need to have more bloods taken, especially as GP ordered ones weren't at the correct time, I'll def see more of a need for the Fertility appointment.

[Keziahhopes]

Hi - it is great, I think, that you had a supportive and proactive dr and had all that choice of places to go and a quick date.

Your prolactin levels were great - the highest it should be is 494 (mine is way above that sadly, hence I am into prolactin numbers!) and your progesterone looked really good.

I have just had my first fertility appointment (4mth wait in the end) and they ordered a 2nd SA, chlaymidia (had smear but they didn't do that annoyingly),2nd lots of bloods etc. Hope it goes well. I agree - one/two SA is little compared to your test and possible iternal scans etc!

[Keziahhopes]

Sorry - I should say I am not a medic, but my blood test results shows the range of acceptable prolactin level at 7dpo and the highest acceptable was 494. As mine wsa 843 I asked at the fertility apt and was told they do nothing until it reaches 1000. Which didn't impress me if it shoudl be nearer 500. You can ask all these questions at fert apt, as they went over blood test results with me.

[Katiesluck]

Hello I have been with ARGC 4 7 months my best blood text was on mothers day fsh at 22 then two weeks later it went too 117 have not had a period since going too have scan tomorrow as I think I have hit early menapose.

[Katiesluck]

Hello I have been with ARGC 4 7 months my best blood text was on mothers day fsh at 22 then two weeks later it went too 117 have not had a period since going too have scan tomorrow as I think I have hit early menapose.

[eurochick]

Bear in mind the wheels of the NHS grind very slowly so this might feel early it while probably be a while before much happens. I went to see the GP in cycle 5 of 2011. I've had blood tests, hubby has had his SA and now I am waiting for a gynae referral. I'm now 3 cycles further on and probably won't get to see the gynae until cycle 9 or 10 so it is good that your GP has started the ball rolling early.

However, I am surprised that she has, withonly 2 ovulatory cycles since coming off the Pill.


@rses. I have just seen this is a really old message. I hate it when that happens!