Seeing the DR and when to have '21 day' tests when I ovulate cd18-21?

[leeloo1]

I saw the dr this morning - armed with my fertility friend print outs. It wasn't promising, as whilst friendly and willing to refer me, she clearly had no idea about fertility.

She looked at my charts - 28-31 day cycles, ovulation between cd 18-21 and 9-11 day luteal phase (I know, I know, LP shouldn't chnage but according to FF it does!). She said 'no, thats not right, you ovulate on day 14! This bit here (pointing at bit between day 14 on chart and ovulation line) is ummmmm'... ... to her credit when I said 'no actually the line shows when I ovulated', she did back down.

But anyway, it doesn't give me confidence that when she told me to go for the day 21 tests, on day 21 - when surely that'd be either the day or a couple of days after I ov that she maybe wasn't right. :(

Sorry, there should have been a question in there. Should I go for tests on day 21? try go 7 days past OV? Or a different time?

Oh and she's asked for tests for thyroid and prolactin (I think)

Any help or advice would be appreciated.

I'm 99% sure it's 7 days after ovulation. My GP said the same thing about ovulation being on cd14 (and it was a lady dr! ) so I think it's quite common.
So anyway, I think you'd need it on day 25ish?? I'm sure someone more knowledgeable will be along in a moment to confirm that

Yup mine was a lady dr too! I asked to see her as I thought she might be a bit better about fertility stuff, but clearly not! :(

It is definitely 7 days after ovulation which is when progesterone peaks if you have ovulated, day 21 is a misleading term that assumes ovulation on day 14!

Sadly most GPs are not that clued up about fertility but its great she has agreed to refer you as you really need to see a specialist in fertility matters!

She will have probably asked for a day 3 test which measure LH and Fsh levels. This kicks off the ovulation process and an inbalance here can indicate a problem. They should ideally be in line so its important to compare them to eachother. High LH can mean PCOS and FSH is an indication of your ovarian reserve.

It is great she has ordered a thyroid test as well as thyroid problems can cause problems with TTC as well.

Good luck!

They really should know that women do not all ovulate on day 14. It is fairly basic knowledge, considering they are doctors and all.
You should have a "day 21" test approx 7 days after ovulation. This tests to see if you are actually ovulating, it checks your level of progesterone, I believe. However it looks like you know you are ovulating anyway. Perhaps the short luteal phase might show low levels of progesterone or something?
The LH/FSH ratio test should be done day 3-5 of your cycle.

It does at least seem like you have been sent for the right tests though. Good luck with them, hope you get some answers.

My GP told me I should be seen about 7 days before the date my next period should be due.

Thanks so much for the replies. So the concensus is that I should go to the clinic about 7 days after I ovulate? Sometimes FF tells me I've ovulated, then moves it a few days later, so it should be fun to gauge! :)

I asked about the LH test and she said it was a bit pointless. I think because she said the (internal) scan would be a better indicator of it I'm ovulating.

Its thanks to reading advice on here that she ordered the thyroid test as I asked her about it and she said 'oh yes as we're ordering blood tests we may as well get that checked as well.' lol

Oh and she did an internal and said that was fine and did a couple of (agonising) swabs for gonorhoea(sp?), clamyddia(sp?) and thrush/infections. So in that way she was thorough.

Yes, it should be 7 days past ovulation.

should be 7 days before expected period so 21 to 24 days need a drop in progesterone to menstruate

As I understand it, it is 7 days post ov if you know when you ovulate or 7 days before your expected period if you don't know when you ovulate (as that would be 7 days post ov if you have a textbook 14 day luteal phase).

nice guidelines only advise testing if you are not sure you are ovulating (actually if your periods are not regular) not sure I really agree with that tbh 9can have regular periods and not ovulate). the peak you are trying to get at day '21' is to see if you ovulate does not tell you if progesterone will be high enough to maintain pregnancy if you want that info think you have to test again (I did and no wasn't high enough but good day '21'). Anyway that is how I understand it. so as op knows she is ovulating could be in her benefit to get a low reading and referral iyswim. Hope that makes sense. Anyway goodluck

Sorry, I'm a bit confused bugsylugs. I think I have a progesterone issue - hence short LP?! I have biphasic charts so it does look like I'm ovulating.

How would I artifically get a low reading? Would that be by going on day 21? I'm fairly confused by it all - what they're looking for and what the tests will mean. :(

Oh and day 21 (or 26/28) will be right around xmas, so no blood tests this month. :(

leeloo if you were to test before the progesterone has risen then you will get a low result. Some take higher than 20 meaning ovulation some 35 or some inbetween. At the end of the day your charting is showing to you that you are ovulating and that is all the day 21 progesterone is there for to 'prove' that you are ovulating ( it is not there to show much more). I would recommend testing pre christmas as that is what your gp said isn't it? then at least the test is done. If it is not raised which might be occur with your dates they will either refer you then (that is what you need I think), or get you to repeat it in Jan. The rational behind repeating it is that it is normal to not ovulate every month ie some women will ovulate say 11 times in a yr. In which case you are a month ahead. I would probably test say 31 minus 7 day 24. is that pre xmas? if not do earlier upto day 21 and if low you have lost nothing as you would be doing test in Jan. Is she doing day 3 tests and oestradiol? it is always a bit of a benifit if you can have them beofre appt with cons as they will talk order tests and then send you away to have them and then review with results so a bit of a delay. You can have all level ones at gp and to be honest they can be done at/ after referal if that is needed as there will be a few months waiting to see cons and results can be sent on. How long have you been ttc? and are you over 35?
Hope makes sense brain pretty scrambled as am due ET tomkorrow

scuse typo's. yes artificaially low reult would be from testing early but not necessarily the answer. good luck

Good luck, I had to cancel my test appointment - because I was pregnant with DD1
Sending you all possible positive vibes!

Congratulations startail! It'd be lovely if that happened, then no more having to worry about tests. :)

Thanks bugsy, that is making sense (I think). I'm on day 9, so day 24 would be Xmas day! not sure the blood test centre will be open then (you just have to go along and queue for an appt!). If they're open on the 22nd or 23rd Dec then that would be day 21 or 22. I like your rationale for going then anyway though, so will do that and see what the results are.

Dr didn't order day 3 tests, as she said it wouldn't show much more than the scan would (which has an 8ish week waiting list). I've not heard of oestradiol - everywhere I look there's another hormone or test to learn about!

My ttc story:
I've been ttc since February - using CM as a guide to when to try. Then I started charting properly in July, so 5 cycles ago. I got pregnant with my 3yr old DS the 1st month we started trying (although I'd been charting for 6 months) and back then I had odd irreguar cycles (between 28 and 90 odd days!) after coming off the pill. Since having him I've had around 30 day cycles, so expected it'd be much easier... maybe its just old age as I'm 36 now.

I've been taking 1000mg of Evening Primrose Oil til I Ov each month for 3 or 4 months. Then last month I started taking 100mg of the Mega B vitamin supplement, which apparently pushed my LP from 9 to 11 days and also raised my post OV temps a bit, but I had almost no EWCM that month. So this month I'm keeping going with the Vit B but upping the EPO to 2000 to see if that helps the CM (which it was doing before).

Sorry thats long. Anyway, thanks again for the advice. Good luck with the ET Bugsy - not sure what it is, but I hope it goes well.

Well you have been ttc for 6 months so referral on the cards as you are over 35 some gps make you wait until 1 yr (but that would be a bit naughty as earlier indicated by NICE if older than 35). US scan will show that your ovaries are there no cysts etc, left one likes to hide so do not worry if they cannot find it. That your womb is correct size and no fibroids etc. It will not tell you hormone levels did she say what she was looking for or ruling out?? as katand kit said usually do day 3 tests for LH and FSH often testosterone. Google NICE then in NICE search put in fertility there is an flow chart of what should be done and in there it mentions LH and FSH. Do not forget she should also have requested a sperm analysis on your other half. She would not have been able to unless he went with you is registered in same practice. So go get him an appointment if it has not been requested as there will be a delay for that test aswell prob between 2-3 months.
Hope that helps. It is so very frustrating when DS came so easily but this is a common story makes it no easier for you but does cause couples to delay getting advice. Hope you have been taking folic acid think there maybe sometihing in the mixed vits with folic acid but too early to def say but pregcare conception is not too pricy at times. Do avoid vit a. Also make sure you are BOTH eating well not smoking decrease alcohol, caffeine decaff coffee fine cannot comment on the tea as I hate the stuff. Preconception supplement for him and poss vit c 100mg plus zinc.
ET embryo transfer having IVF/ ICSI at moment were told we would need it for DS but he was a miracle.
Sorry it is long hope a bit helpful. Think it is a bit unfair the blasting GP's get re fertility but then I am biased. Very specialised service, very little good grade scientific evidence. The important thing is that they move and refer at the correct time and ideally do initial tests

What is it with gps and the day 21 test? I just had this last week with my gP who insisted I go at cd21 even though that was in fact cd1 of my next cycle. Just book the test for 7 days after you ovulate (or as close to that as you can estimate , a day either way won't affect things too dramatically) I wish I had done this it would have avoided me having to have a second blood test!

I don't know if this is applicable, and not necessarily related to your original question, but I recently found that my doctors' surgery has a website (which I didn't realise, I always just phone or pop in!), and it lists the credentials and a little biog of each doctor, including any areas they specialise in. There are a number of lady doctors but one who specialises in infertility and one in contraceptives so I always ask to see them rather than the ones who specialise in children or respiratory illnesses, as they should have a better grasp of these things....perhaps you could see of anyone at your practice would be better placed for your needs? Good luck!
XxX

Wow Bugsy. Good luck with the ET - really hope that it works for you!

Crumm24 - that is helpful thanks! Apparently my Drs is very good if you speak Serbo-Croat or Russian! :) The dr I saw states an interest in Women's health, the other female dr there was interested in sexual health? Not sure which of those would be more relevant?

That wasn't great Roger! Did the tests show useful things (when you weren't on CD1!)?

ooh diff one. sexual health prob is more contraception may include fertility as it is sexual aswell. Shame about your gp