Any advice about ?lack of ovulation (it's a long one!)

[Bexamundo]

I came off cerazette Christmas 2009. We were realistically having swi but not maybe as much as is recommended. Most of our close family seem to get pg within a short time frame so we weren't too worried. After a year with no joy we went to the GP to start investigations.
He didn't really seem to know what to check for (he had to go on patient.co.uk) and was a tad dimissive saying "Well 80% of couples conceive within one year and 90% within 18 months". He didn't ask me much about my cycles or what AF was like.
He arranged for me to get my fsh and lh checked and my progesterone over 3 cycles (which was a good thing) and did at least explain since I average a 27 day cycle I'd need my bloods taking on cd20. The first time I had all of them done together - the lh and fsh were ok (can't remember what they were both they were similar) I did wonder if they should have checked these on cd3 though. The first time my progesterone was done it was 15. I freaked a bit but GP wasn't too worried because I had a 26 day cycle that time. So I should have gone on cd19 I guess! But it is low.
Second cycle I went on cd 21 (cd20 was a Sunday) assuming I'd have a 27 day cycle and this would be ok. Results this time were 20 (better but not ideal!).
The last time I was charting - my chart indicated I ovulated on cd13 so I went on cd20 and the result was 25. So my issue is on this chart I did have a clear ovulation peak and bloods indicated ovulation (thought I believe it should be over 30 to clearly show ovulation) but my last two cycle fertility friend hasn't been able to show a clear peak. The last cycle (cd1=3/3/11) I was on holiday for week one so I wasn't accurately temping but it was the same this cycle, it initially said cd10, then cd15, then 10 again so I go v excited cos although we weren't swi we dtd around ovulation then I got 17 "above the cover line". then cd18 temp dropped and it said it couldn't detect ovulation! My two most recent charts should be
here
SO my concern is, maybe I'm not ovulating reguarly? Should I be chasing this is with a GP (who gets the idea of charting unlike the first one I saw - I go to a big practice)? or should I do a couple more charts? Thanks in advance for help.

bex so sorry to hear you are having such a frustrating time.

Sounds to me like you need another opinion from another GP. You're right, prog should be above 30 to indicate proper ovulation. The fact that sometimes your cycle length is short and also that it varies in length, sounds to me that you could be having some annovulatory cycles. Don't panic, most women have some of those each year. . However, given your charting seems not to be consisten either it sounds like your GP should be giving you some more support.

I've some questions if you're willing to answer - are you normal BMI? Have your cycles always varied in length? Also, how old are you?

Hi bex I agree with blackkat that it sounds like you might need another opinion. LH and FSH should definitely be taken on cd2 or 3 so you might need to get that checked again.

Can you see another gp?

I hope you get some answers, and a bfp!, very soon

Yes there are several Gps in my practice so I think I will head back.
I'm a fatty! Bmi is around 30. I am losing weight (lost about a stone going from 14 st 4lb to hovering above 13, I'm 5'5"). My cycles took a few months to settle but since I.kept a clear record of ky cycles they've varied in length from 26 to 28 days.
Not sure if it's relevant but I struggle with nausea and this month vomiting in my latter two weeks of my cycle. I also have short af (usually two days of quite heavy bleeding then just spotting cd3). I get a lot of pain just before and when af starts. Today someone asked me if I had a back back because I struggled to walk!
We're off on.holiday on Friday and I guess docs will be mega busy tomorrow so I think I'll make an advanced appt for when we're home. Think I'll go back to nice female Gp who was helpful before. Thanks for your input!

My view is that you need to get a referral to a gynae. Your GP really doesn't sound like he knows what he is doing. Seeing the other GP sounds like a good move.

Your latest chart doesn't look like it shows ovulation to me (as someone else said, I understand that is quite normal from time to time) and the previous chart on your link looks much more promising to me, even if FF doesn't think so!

The "Day 21" test should be done 7 days after ovulation rather than 7 days before your period is due (of course, these will work out the same if you have a 14 day luteal phase. So if you know when that is (or can take a decent FF-aided guess) if these are ordered again, that is when you should go.

LH and FSH should be done on Day 3, as you say.

Losing more weight might help (sorry!). I saw some stats (can't find where now!) that for each stone you lose your conception chances go up by x%.

bex thanks for sharing. Well done on the weight loss, you may well find this helps you conceive fx! (it helped me) Sounds like a forward appt is the best thing to do and see the female GP (that also helped me).

Have a lovely holiday

I am aiming to lose more but I find it tricky to maintain weight loss. On a weight management programme with my.gym (curves) so when back off hols I will give it my all again!
I will push for more investigations when I get home.

I find I can maintain my weight is to calorie count (I'm mid-30s now which makes all the difference - it was all so much easier a few years ago!). I use weightlossresources.com. It is shocking how little food I need to maintain my weight :(

I'll certainly look at that thanks. Curves has a programme that 'manipulates' your metabolism. I start really well but tend to get distracted! I've for someone checking my progress so hopefully I'll keep it up. No better incentive!

I second Eurochick Bex- you need a gynae. Many Gps don't have the training in fertility and will only know so much and unfortunately not much in a lot of cases. Interestingly when I got my results for progesterone this month, they were 30 which I was told was normal by my GP. My gynae has said differently and wants to see above 40 for a healthy figure.
Weight is a sod- And is difficult to keep it off, I could only eat air and still put on weight.

Right, quick update. Was waiting for the cycle to complete and see if I ovulated. Think I probably did but still bfn and 25 day cycle (shortest ever) which means I'm really not regular. So I will head off to my GP this week and demand further investigations. Dh had his appt to provide his sample so maybe we'll get some answers. Thanks for all your responses.

Relatively good news. GP agrees with me, don't appear to be ovulating regularly. Going to refer me for ultrasound and fertility clinic appt. Also will check bloods for fsh/lh on cd3 and testosterone levels (will do that tomorrow). More emotional than I expected but relieved I'm moving forward.