Can I have some help please? Day 21 test showed I didn't ovulate

[QuietNinjaTardis]

Ok got my results today. Everything normal apart from progesterone which indicated I didn't ovulate. Thyroid fine. All the other hormones fine. I normally get what I believe is ovulation pain and I must admit I didn't last month so I'm hoping its just an abnormal month for me. Obviously she wants me to repeat the day 21 tests this month and next month to check.
If it happens that I'm not ovulating then what could it be? She doesn't suspect pcos as the other hormones were fine and I don't have any symptoms of that anyway.
Dh gotta give a sample next but might take a couple of months for appointment to come through. So bit in limbo at the mo for a bit now. Still dtd. Trying to keep calm and keep shagging feeling a bit blue though.

What other hormone levels were tested and on which days?. You should also ahve had a day 2 test done to check and compare your LH level against that of your FSH level; these should be about the same. I say compared against as well as these two levels can actually look ok if only looked at separately; this is why comparison is necessary. These two levels are very important as they kickstart the ovulation process, if these two are awry then progesterone levels can be affected.

Who arranged for such tests to be done?. If you have been ttc for a year or more you'd be better off now having the referral to the subfertility unit made rather than the GP messing around with more tests (because they will be repeated there anyway) and/or in potential ignorance. This sort of issue is well outside a GPs general remit in any case.

Yes day 2 tests done and gp said the other hormones (I presume LH and fsh) were normal. Gp is sorting it out at the mo. also having a scan to check for endometriosis and as I said dh will have to give a sperm sample when appointment comes through.

It is not uncommon for women to have the odd cycle when you don't ovulate. As you age and get closer to the menopause, such cycles get more and more common. But even a younger woman could have one a year without it meaning anything is really wrong.
How long is your menstrual cycle? The test should not necessarily be day 21. It needs to be 7 days post ovulation. If you have a longer than 28ish day cycle then the progesterone will not be high enough at day 21. If you have a 31 day cycle which is not uncommon for many women, you probably only ovulate on day 17/18 so there is potentially only 3 days between ovulation and the test.
I would talk to your doctor about this if your periods are more than 28 days apart. Also test each month to find out when you might be ovulating. The cheapo ovulation predictor piss sticks are fine for this, but if you prefer digital, I can recommend the CB fertility monitor. If you get a peak on that, then the test should come 7 days after the second peak day.

Thanks katandkit my day 21 was done on day 24 because my cycle is normally 30/31 days and I ovulate about day 18. Had to be day 24 as day 25 was a sat. Am using opks this month to try and pinpoint a bit better and hopefully some ovulation pain will confirm it. Keeping my fingers crossed it was a one off.

It is so annoying that these bloods can't be done seven days a week. I had a similar thing when i was having investigations and had to have a so called day 3 test on day 5. Not my fault my periods happen on a Thursday and with a 27 day cycle I would have been waiting three months to get day 3 on a weekday!

This whole ttc malarkey has been a pain in the bum. If my body would just co operate and get pregnant I wouldn't have to worry about all this bollocks. Still positive mental thoughts and patience. I can do this.

I don't trust day 21 progesterone. Mine was 19 showing I hadn't ovulated however it transpired that not only had I ovulated but i was pregnant (and I didn't ovulate late as dates show that I must've conceived by then)

Don't want to necessarily raise hopes but I don't think day 21 progesterone means anything on its own.

Thanks cogitosum. I will bear that in mind with the next one. I think if nothing shows up on this or the scan then we'll be referred to a fertility specialist I hope. Maybe ill ask for the actual numbers next time and ask here if the gp is right. Thanks everyone.

Hi QuietNinjaTardis,

re your comment:-
"Yes day 2 tests done and gp said the other hormones (I presume LH and fsh) were normal. Gp is sorting it out at the mo. also having a scan to check for endometriosis and as I said dh will have to give a sperm sample when appointment comes through".

I would certainly ask for further clarification re the results of the day 2 test as you cannot assume anything when it comes to subfertility.

You will need to be persistant in order to get answers. DO not forget that!. Its all too easy to be fobbed off.

Why a scan for endo?. I have endometriosis and have also had more internal scans than I care to mention!. Its not picked up on any ultrasound scan or blood test; it is usually only diagnosed through a keyhole surgery op called a laparoscopy. Some GPs are truly ignorant when it comes to endo.

Ok when get results of next day21 test ill ask for the results from my day 2 test as well. and put them on mumsnet for some expert analysis Gp said a scan will pick up any large bits of endometriosis. She's not expecting it to be that at all but I asked for it to be checked as years and years ago when I had a laparoscopy it showed a small bit of endo and its always been in the back of my head so i asked for it to be checked out.
Thanks Attila will try to put my assertive head on when we see gp again.

I've never heard of a scan picking up endo, other than endo cysts.

I agree with others that day 21 tests can be hit and miss. We don't all ovulate on day 21! I've had varying results from mine. But I ovulated enough to get pregnant once, even if it wasn't a sticky one

I would put my foot down and ask for a referral. If you have known fertility issues, you don't need to have been trying for ages first.

Worth asking for an AMH test. You may need to go private for it. That will tell you your egg supply, which is apparently a good indicator of overall fertility.

Thanks gin. Ill ask for a referral after the next day 21 test. Will also see about the amh test. We could possibly go private for some things so will look into it.
We don't have known fertility issues but have been trying for quite a while with no success so went to gp to get ball rolling. We have one ds who is 3 and got pregnant really quickly with him and nothing is happening this time.

"Gp said a scan will pick up any large bits of endometriosis".

Smiled wryly at that comment of hers. A skilled sonographer may detect endometrioma aka "chocolate cysts" but won;t detect anything in the uterine cavity or other areas like for instance the bladder or pouch of douglas.

My endo fwiw was all over my uterine cavity like a lot of paint splats and that was not detected at all till I had the laparoscopic type surgery. Would also state that endo can recur so you are wise to be looking into this further. Would certainly mention to the gynae when you see such a person that you've previously had endometriosis diagnosed.

GP should refer you as of now to my mind. Secondary subfertility is not that uncommon I am sorry to say.

Oh this is shit. Must admit I lost my faith a bit when she told me that you always come on 14 days after you ovulate with out fail! I challenged her on that and she did say to me today that she had looked into it and I was correct in that it is not true. So shall I have the next day 21 and then when I get results ask if I can be referred onwards?
She doesn't seem to think endo is a possibility as I'm not in horrific pain all the time. My periods are painful and always have been and ovulation is definitely giving me pain but doesn't hurt during sex or anything.

Sorry, but your gp is talking shit! Get a referral straight to a gynae, the sooner you get an by an expert the better.

I hope it all resolves itself.

Thanks gin. Will do. Really appreciate you lot talking to me

I would not bother with the amh test, it does not show fertility. A good number can indicate lots of eggs but that does not mean that they are good enough quality to get pregnant by, and conversely a bad number indicating few eggs left does not mean no pregnancy there still could be that one golden egg that leads to successful pregnancy.

The only real use for the amh test is in terms of ivf where they use it to indicate likely responsiveness to the treatment.

But agree that you should see if you cn get referral to fertility consultant.

My periods have always been painful as well QuietNinjaTardis both during and up to and including menses. You've previously been dx'd with endo as well via a previous lap op.

Any pain that is cylical in nature and gets worse up to and including menses should be checked out properly to see if endo is present.

Not too surprised at your GPs comments; some are truly ignorant when it comes to endo. I took one of them to task post diagnosis when he had the audacity to tell me that endo was not common; I replied that it was the second most common gynae problem seen in women after fibroids.

I didn't realise it was that common. Could it have anything to do with not ovulating or is it to separate potential problems?

Hi QuietNinja - this happened to me and on my second set of tests I did then ovulate. Since then we've had problems with DH's SA and should now be referred to a fertility specialist. But when I asked the doctor after the first set of results, no lie, she just shrugged her shoulders at me and said to redo the test. She said, 'Could be anything'. So helpful. Bloody chocolate teapot. I found out more from Dr Google and from the lovely ladies on here than I did from my GP.

As others have said and you've experienced, I think some GPs are completely clueless and you need a specialist. Just thought I'd share my experience and to say you're not alone.

It could be that you just had an anovulatory cycle as another poster mentioned. Unfortunately I didn't realise this and GP didn't explain this might be the case so I went home thinking I couldn't have children and grieved for a few hours before DH arrived home with Dr Google. I hadn't even been able to bring myself to look as I was so upset. Maybe this makes me really dim and naive, but if only she'd said. Anyway, waiting for referral now so can get away from clueless GPs. Hope you get some answers soon.

Thanks bearface. Think I will ask for a referral ASAP to try and get some answers properly. Hope you get your referral soon x

Hi quietninja - I am in a similar position to you and feeling very frustrated!! I have a DS who is 4 in April and we have been trying for almost a year. I had the same tests as you towards the end of last year and was told that based on my day 21 test I wasn't ovulating however 3 weeks after the results I discovered that I was pregnant (I discovered very early on however I miscarried at 6 weeks ) but I must have ovulated late - surely?? When I asked the doctor for an explanation they just shrugged - helpful!!!

I have now been told that I won't have any further investigation for another year as I managed to fall pregnant however I will be going back in 6 months to push for some further tests or referral as I have discovered that you have to be forceful!!

I also have endometriosis but when I mentioned this to the GP they didn't really think it was an issue?!?

Good luck lovely - hope it works out for you and don't be worried about being forceful xx

Oh mummy I'm sorry about your miscarriage. What gits to push back further investigations. I really hope things work out for you too x

Another one whose levels didn't indicate ovulation despite days being spot on for my cycle...first result was 16 the second month it was 12, I thought I was maybe late but the doc wouldn't test add she said there was no chance I could be pregnant...17 Weeks atm x

Ah congrats bluer. I'd love that to happen but its not likely. Not having much luck with anything at the mo. aargh