The Short Luteal Phase Gang

[onedaybaby]

Hi,

I've noticed that the question about a short LP comes up quite a lot, and I would love it if we had our own thread to discuss where methods we are doing to try to increase it, lengths and what the dr thinks!

My LP is 8 days with a 31 day cycle.

I am currently taking Agnus Castus and have had accupuncture for 2 months. I also use the CBFM.

This will be my 9th month TTC. I have had the 21 day blood test (which has to be done on 28), the day 3 blood test and an ultrascan. All tests are normal.

Hi H313N
I also have sometimes have lowish temps in my post ovulatory phase and have been wondering if that is bad news. Are yours below coverline or just dangerously close?
How did your appointment with GP go?

And one last post for now (you can see how delighted I am to have someone to talk to about this!!) - can anyone recommend a good accupuncturist in London? Thanks

Hi goose! It's been like tumbleweed in here, I posted over 2 months ago!! (and I've changed my name since, it's H313n).
I've now seen the nurse at the fertility clinic and she said my short LP will be sorted out with clomid which the doctor will prescribe when I go back after my HSG and internal scan. That appointment won't be until July . So I decided to try the B6 this cycle. On cd10 and don't usually O until cd19 at the earliest, usually later, so too early to tell whether it's done anything. fx it doesn't stop O completely....

Oh, and yes, sometimes I get a dip below covering post O.

Can I recommend you join the Elderberry thread in conception? There are a few of us in there with short LP's and we're all over 30 and have been trying a while (I'm on cycle 17 now). It's very friendly and you don't get the tumbleweed of waiting 2 months for a reply!

Hi - really great to get an answer so quickly - I will definitely look up the Elderberry thread. Why so long til your next appointment? I'm worried now, my consultant sent me away to call for an appointment for HSG on first day of my next cycle but didn't make me another appointment to see him afterwards or, now I come to think of it, tell me whether that is the next step or how to request the appointment (through GP again? or just ring hospital?)
What's the internal scan? The day 13 ultrasound or something else?! Thanks!

I went to the gp in December having been ttc a year and by the time we'd had the blood tests done and SA and got the results back and had an appointment with the GP (only the one who can refer you to the fertitility clinic apparently) it was February. It took almost 3 months to get the appointment after the referral, and that was just to see the nurse, who takes all your information again, explains the next steps, and then ticks the box to refer you on for an appointment with the doctor, which is another 3 month wait!! I saw the nurse on spotting day 2 of this cycle which was soooo annoying as I wasn't due on until the following day, so I could have called up to book my HSG the next day!! Anyway, same as you I'm waiting for next CD1 to call up and book the HSG and they are doing the internal scan (which is like an ultrasound but they stick the thing up inside you to get a closer look) just before the appointment with the doctor so I don't have to make an extra trip to the hospital. The nurse warned me that depending on who is doing the HSG, I may or may not be told anything on the day, I might have to wait until I see the doctor in July before hearing whether they found any problems with my tubes etc.
Are you ttc your first? I just assumed, as you didn't mention the LP as a new problem.

Would love to join the Elderberry group by the way - but I can't find the newest thread - could you post a link?

I am TTC my first, 38, but trying since 34 - have been incredibly head in the sand about it (not helped by my bf now fiance's theory that age makes no difference at all!!) - it's just hitting me, now that I'm staring at Clomid followed by IVF, that this isn't all necessarily going to work out rosy! Gulp.

So we're pretty much at same stage in diagnosis/treatment. I'll ask when book HSG whether they are doing internal scan, I presume so. How do you know that your next appointment with the doctor (as in consultant rather than your GP?) is in July? I don't have a date or know what I'm meant to do post HSG!

You have an 8 day LP and a fairly long cycle? Mine LP is 6-7 days in a 21-28 day cycle.
Did your 28 day progesterone blood show up as ovulatory? I had a cycle 21 test that was non ovulatory but as it was on the day I ovulated according to my chart I asked them to send me back for another. So I've just had three this cycle and waiting for the results...

Can't believe by the way that you had an extra step in there of seeing the nurse, that's a bit of a nightmare. The doctor referred me and it took 3 months but I saw doc.

Hi All,

As my name suggests, I've been inspired by all your stories to get more proactive in my treatment and to try and get to the bottom of this LPD business once and for all! So I thought I'd start by sharing my story:

I turned 41 in January and am extremely fortunate to have a 19-month old who was conceived very easily when I was almost 39. Back then, my cycles were textbook and I only needed to use EWCM to know when to do the deed! I've been TTC #2 since AF returned a year ago without success. I never have EWCM, just the wet, transparent type (2nd best type apparently, but still), which I have for most of my follicular phase, so it doesn't help pinpoint ovulation. I always ovulate (as determined by positive OPKs and subsequent temp shift), BUT my luteal phase always has a few low temps (sometimes below the coverline and often thereabouts) as well as spotting (not just brown, but fresh blood). This can all start as early as 3 dpo (!) Admittedly, my total luteal phase, until full flow, is reasonable, at 11-14 days, but the spotting and especially the below coverline temps before that mean that I already know I'm 'out' for that cycle for most of the luteal phase and can never get my hopes up or get to the stage of taking a pregnancy test.

As for diagnosis / treatment, I had to be TTC for 6 months to be seen. Then I had day 3 blood work, which was fine (don't know actual results) and normal thyroid hormone level (again, no numbers). They did ultrasound follicle tracing twice and everything looked fine, including state of uterus. I even had two follicles on of those months, not that this helped with my LPD symptoms (theory is that two corpus lutea should produce twice as much progesterone). They prescribed 3 months' of oral progesterone and told me to come back if still not pregnant or if no change in symptoms. I gave it two months and there was no change. Still got post-o temp dips and 4/5 days of spotting (after which I stopped the progesterone and then full flow soon followed). So am not happy to continue for another month, especially after what I've read on here about it being better to go straight to Clomid or perhaps even IVF. Besides, research shows that progesterone supplements do not increase pregnancy rates in women with LPD who aren't having IVF. I have appointment on Monday to discuss next step so am arming myself with info from your good selves to make sure I don't get fobbed off.

The stuff I've tried to reduce the LPD symptoms are Vitamin B6, agnus castus (tried it for one month, but seemed to make things worse), Vitamin C, acupuncture (only had it twice though) and yoga. And of course preconception multivitamin. We also use preseed in case the lack of EWCM was the problem. However, nothing has helped, perhaps because my problem is low temps and spotting rather than a short luteal phase and most of those vitamins showed an increase in LP length. I should add that sometimes my temp stays high for quite a few days after menses starts, which the acupuncturist said was even worse than the post-o dips (though I don't know why). Interesting what was said in earlier post about consultant looking at ultrasound and then saying acupuncture not likely to be useful. Could this be because acupuncture supposedly increases blood flow to uterus, so if uterus already looks good with a thick lining (as it also did for me), acupuncture may not be useful? Just a guess.

Hope this info is helpful to some of you. FYI, the paper that says progesterone supplements are not helpful for LPD (unless as part of IVF) is from the American Society for Reproductive Medicine ('The Clinical Relevance of Luteal Phase Deficiency'). It also says that day 21 proegesterone level tests and endometrial biopsy tests are not useful in diagnosing LPD, so I don't mind that I didn't get those and won't push for them. However, it also says that BBT charting is unreliable, which I don't agree with. Trouble is you can't ensure that people are using a good thermometer, doing it the same time each day and so on. If you do it right, it tells you loads. Good luck to all of you.

Thank you for your post Gettingproactive. I found it really helpful. I have low progesterone but my other hormones came back ok. I was taking B6 but ironically I didn't ovulate last month which is when I started taking it. Could be related or could not. Who knows? I am not going to take it this month anyway and see what my next blood tests show. If they come back as low progesterone then we get referred. We are TTC#2 too.

I also found i didnt ovulate after few months of b6, could just be coincidence of course. On tcoyf site moderator said its not a good idea.

Not sure if this thread is dead now? I sure need to be on here still, 8 day LP tops and GP doesn't believe in LP defects.

Hey totes I need to be on this thread too. In fact, one of the ladies on the other board suggested this thread - we have another thread running - guinea pig for natural progesterone. Basically, I'm lucky if I get 8-9 days luteal phase and going through the motions of trying all the alternative remedies whilst passing time before gp takes me seriously. Cycle 6 at the mo Ttc, but had this pattern for longer. Done b6 for a while, this month trying Angus castus to see if I can pull ovulation forward ( normally around day 19-29 of 26-28 day cycle).

Sounds like there's quite a few of us struggling with this. I'm Ttc number 2 so docs don't want to know until its been a year. I'm debating pushing for bloods in next few cycles to check progesterone levels. I have a natural prog supplement but put off using it for a few cycles, until get blood work done.

Anyway, fairly pointless post other to to say in the same, extremely frustrating boat, totally fed up with body not playing ball and very little I can do about it. Nice to know there are others out there, but also sorry you're struggling with the same issue. Hopefully we will get some good news soon!

Hi Springbells!
I am TTC#2 too and before DS my LP was 12 days so on the short side, but nowt major.

So frustrating as I thought we were meant to be more fertile post bebe, not less!?

I haven't tried agnus castus and dabbled with B6 but heard you were meant to take it only after ovulation or it can interfere with it and I took it for a month the whole way through.

I had my progesterone tested over two months. Doc said count back 7 days from when ERTD is due and get tested. I obliged and had very low progesterone tests back (7.2 and 5.4) and doc said I didn't ovulate either month. BUT, since I got ovulation pain the day before the blood test happened (and have worked out through BBT that I OV around day 18 of a 25 day cycle) I am now not convinced that the tests were not of any use, being 1DPO as opposed to 7 DPO, BUT, doc obviously won't believe that I could ovulate that late so I am banging my head against a brick wall.

Have you looked into soy isoflavines. Some folks swear by them but I have read mixed things about taking them. I think it can tip the balance and make matters worse in some cases so I am reluctant to take them without being under some instruction I may however get desperate

Also, I would be really interested to know how everyone else on here is getting on...

Hi totes I know, it's so frustrating! I think it's working out the timings that puts me off being pushier re bloods. It seems ( tentatively, as waiting for bbt to rise) that I may be ovulating earlier this month, day 17 as opposed to 19/20), will just have to wait be see if lp comes forward too, or if this gives me a couple of extra days.

Hi Springbells and Totes, I'm ttc1 and have a 7 day LP. GPs/Gyneas variously don't think that exist or that it doesn't effect fertility. After day21 progesterone test came back non-ovulatory I insisted on having another test later in cycle and sure enough it was higher and indicated I had ovulated just late.

I've given up on getting a diagnosis as basically the treatment seems to be the same (Clomid) whether or not ovulating properly and whether or not a short luteal phase exists/matters. Of course I may be wrong about this but that's what I've gleaned from my very hurried appointments!! Not sure how quickly they get you onto Clomid if your TTC2 though.

I did try B6 but it seemed to stop me ovulating. I did take it throughout month though and quite a high dose, so perhaps I was taking too much. I've heard a few success stories with it.

How's it going on the Progesterone thread?

Hi all! Well I went privately as the doc said to me to do OPKs for a few months and I am impatient! Anyway, we are going to do follicle tracking next month to see what is going on. Gyno thinks I might be overcooking the egg and either not releasing it or something else...can't quite remember. If not releasing it then I need an injection. If something else then I need progesterone. Anyway, he basically said a short LP is not right...it means something is wrong as if body is working at optimum then LP should be approx two weeks.

We wait and see....tracking due next month. In the meantime, DS has given us a rough few nights so took tired to obsess over it this month!!

Gooey - if you want to, I can recommend my gyno wholeheartedly. He is based in London and although he is private, you an say to him that you are pay as you go and he tries to keep costs down.

Thought I would give a quick update.
Changed doctor in the end (said straight out that I wasn't happy with first one and wanted 2nd opinion) and new doctor was 100 times nicer and more competent. Admitted she cannot solve my LPD, so in view of that, plus my age, plus TTC for 1 year, it's straight to IVF. Also found out my FSH was 9.9, so not totally normal as first doctor had said, but a bit elevated. Grrr! So now I am far more concerned about my age and egg quality than any LPD problems, which supposedly don't get in the way of IVF. Anyway, I am not getting hopes up too much as the chances aren't great at my age, but at least it's the best treatment. Ironically enough, I had the first normal cycle last month since TTC. I did not take the progesterone supplements any more, but I had no post-ovulation temp dips, a 14 day luteal phase and only 2-3 days of premenstrual spotting. Don't know whether the progesterone just had a delayed effect at balancing my hormones or it was a freak good cycle or it was a result of the yoga + acupuncture + vitamins B6, C and coenzyme q10 (recently added q10 as supposed to help with egg quality and general cell health, especially before IVF).
Good luck to all of you. I really agree with Totes about the importance of finding a good, sympathetic doctor. I showed the new doctor my spreadsheet of cycle length, LP length, days of spotting etc and she said it was very useful and photocopied it for my notes! Dealing with someone like that gives you so much more hope and really reduces anxiety.

Thanks for updating Gettingproactive and although the IVF path is a major thing, I am glad that you don't have to faff around anymore getting frustrated with unsympathetic docs. Good luck!

Not sure anyone is still reading this thread apart from Totes but got some news that was so important, I felt I had to share. As I said in previous posts, I recently switched doctors and the new doctor ordered me an ultrasound with saline injection. There are a few cases where small polyps can be seen on these having been missed on normal vaginal ultrasound. Sure enough, this was true for me! So they removed the polyps last week under hysteroscopy guidance and predict that my premenstrual spotting will be gone. Could kick myself because the wonderful blog by Dr Licciardi does say that polyps are #1 cause of spotting, but I thought that if I'd had them, they'd have been seen on my regular ultrasounds. So if anyone's main problem is spotting, I really would urge you to get the saline ultrasound and/or hysteroscopy. I still must have had an LPD up til a few months ago because the polyps don't explain the post-ovulation temperature dips, but in my last few charts, there were no dips, so I guess that problem must have gone away. Maybe I just needed a bit longer than most people to get my hormones balanced again after pregnancy / breast-feeding. Unfortunately, the polyps were deemed too small to have explained my failure to conceive, so the diagnosis for me is still age-related infertility with not much chance of conceiving even with the IVF, but at least I now have a clearer picture of where I stand.

Thanks for the update! That is great news. I know they say they are insignificant but it all counts as little steps to getting things in better shape down there. I have my tracking next week. Tried OPKs this month and never saw an LH surge so that ties in with the theory that I am not ovulating.

Thanks Totes - it's so nice to have some support from the virtual world! How did the tracking go? I never used to get a surge with the OPKs the first few months of TTC, but now I get surges for up to 3-4 days in a row, which is probably worse (like high FSH, high LH levels can be a sign of ovarian decline). I would recommend doing two tests a day, as you can miss it if testing only every 24 hrs. There are very cheap multipacks of OPK sticks on Amazon.

Hello totes and getting, good to see you're making progess. I got bolshy recently, and demanded (nicely!) blood tests to see whats going on. Unsuprisingly first test came back annovulatory - and just like goosey i 'suggested' that the should be done later, as fairly sure i do ovulate, just v late. Still waiting for those results and watching this space on lp. I binned b6 and agnus this month to give get a true bloods picutre, so waiting to see what happens. 9dpo here, which is unheard of, so if i can make it to 10dpo I'll be happier. Hope it all goes well with the ivf, getting, and with tracking, totes.

Good to hear the updates as it def gives hope.