confused by doctor's advice after blood tests

[valleygirl]

Hi

I recently had a hormone blood test done to check specifically for my progesterone levels. I have been tempting and also doing OPK tests, and after 3 months I realised that my luteal phase is 8 days - so there is a definite temp increase 2-3 days after a positive OPK and then period starts 8-9 days later.
My blood test came back normal, so aparantly I have normal levels of progesterone.
i had the tests done on days 20 and 23 - my temp went up on day 21. my period started on day 30.
this measn it was a 10 day luteal phase this month??!! i have been taking Agnus Castus - could this have had an affect?
what confusd me was what the GP told me.
She said that luteal phase is ALWAYS 14 days - never more, never less.
this can't be the case can it?
She said that egg white CM indicates that one has ALREADY ovulated and so having sex at that stage is too late as the egg is already dead.
She said that you should have sex regularly throughout cycle every 2 - 3 days, no more often as then the sperm is uselss.
she told me to stop temping and charting immediately as this is the most harmful thing you can do as it causes far too much stress.

well i can agree with the last 2 points but EVERYTHING i have read points to the fact that luteal phases vary from woman to woman and that without a 10-12 day luteal phase no woman can manitain a pregnancy.

when i queried this she sais that she had been an obstetrics doctor for 3 years before she became a GP and so she knows best.

now i don't know what to think and she has basically said that the problem has to be my dp who has a slightly less than normal sperm count.

i shoudl be glad that my hormone levels are fine, but it still doesn't explain why i have had short luteal phase and why everythign else i've read contradicts what my GP told me.

As far as I'm aware it varies and yes, if it is too short that could stop a pregnancy. I suggest you check what fertility friend says on this (I think there is a fairly good explanation). Can you get a second opinion - your GP sounds a bit too sure of herself and shouldn't brush off your concerns like that(like my gynecologist who categorically told me I was not pregnant whatever I thought and gave me all sorts of pills to help me get pg (all of which are strongly discourgaged during pregnancy) despite the fact that I was 9.5 weeks pregnant!).

Don't follow all the intracacies of your post valleygirl, but here is what happened to me - hope it of some use.

When I didn't conceive (after 2 yrs off the pill), after various tests went to see the specialist who told me to use the clear plan test & then on the go signal, have sex 6-8 times in the following 24-48hrs. We stuck to every 2-3 days in the lead up to the go time & then followed instructions. This worked on the 2nd attempt for child 1 & then the 1st attempt for children 2 & 3. So his advice was somewhat different from your GPs!
DP was rather diappointed it worked so well for numbers 2 & 3!

Your GP is fundamentally wrong about the 14 days and needs to learn a thing or two about cycles. .. that is such bollocks

the CM is wrong too .. definitely

You should have sex every other day for maximum sperm health .. but sperm does NOT become useless

temping and charting does stress you out but so does not conceiving when you want to

demand a different doctor and demand she learns her facts before spouting rubbish

oo that makes me mad and sad for you

BTW I was treated by Kings ACU for a short post-luteal phase ... so the head consultant there made it up did she?

and I had normal hormone levels too

ooo I'm spitting mad .. the woman needs shooting how dare she spout such fundamental rubbish ..

give me her phone number .. I'll let her know a thing or two (serious offer there)

calm yourself twigglet.

well that's such a disgusting abuse of power .. and palatably wrong advice that it makes me want to spit

Hi Valleygirl,

Is this woman prepared to refer you to a gynae?.
She ought to at the very least to have you both further evaluated.

BTW did she also check your LH and FSH levels?.
What did your progesterone level read as?

Some more info on LPD for you:-

The luteal phase refers to the span of time in the menstrual cycle between ovulation and the onset of the next menses. Most women have a luteal phase that lasts 10-14 days. If the luteal phase lasts less than 10 days or greater than 14 days, you may have a luteal phase defect (LPD).

Why the Defect?
Information gathered by the InterNational Council on Infertility Information Dissemination, Inc. (INCIID) in Arlington, Va. describes LPD as a commonly misunderstood condition that frequently affects fertility.

In a normal cycle, your body creates a hormone called FSH (follicle stimulating hormone) which causes the formation of a mature, egg-containing follicle in one of the ovaries. The follicle bursts and turns into what is called the corpus luteum, which secretes the hormone progesterone. The elevated progesterone causes the uterine lining to thicken and gives the embryo a place to attach. When a luteal phase is less than 10 days, a pregnancy cannot be sustained because there is not enough progesterone being produced.

There are several places where a normal menstrual cycle can be interrupted. Poor follicle production, premature demise of the corpus luteum and failure of the uterine lining to respond to normal levels of progesterone are some of the causes. These can be separate problems, or they can overlap each other in causing disruption to the normal cycle.

Hence me also asking about your LH and FSH levels. These two hormones both play a key role in ovulation. If these two are out of balance then this is indicative of there being a possible hormonal problem. It can be treated.

Would suggest you see a gynae as a matter of course to be further evaluated.

HTH

sorry to say but most of the GPs are a bunch of quacks!!!!!

slef refer to another!

Agree with everyone else here valleygirl, time for a new GP. FFS, what a lot of rubbish.
And if she was such a good obstetrician, what is she now doing in the ninth circle of hell which is General Practice, I wonder?
My group practice seem finally to have given their cards to a moronic mis-prescriber who brushed aside any queries from parents with an airy "I used to be a microbiologist you know". (Yes, and you were obviously useless at that too).
Her replacement is excellent so now the good doctors outnumber the bad. Wishing you similar luck with getting a second opinion. All of us who have ever trodden the TTC investigation path know how important and how variable luteal phases are. Jeez.

thank you all - i thought i was going insane. she was just so dismisive of everything that i have learnt from beign here on musmnet - i have contacted the practice and have aksed them to send me a hard opy of the test results - i think they were checking all possible hormones - including LH and FSH, but find out soon enough.
i suspect that she may have felt a bit pissed off that here was a complete layperson daring to tell her what she went to university for 10 years to learn.
once i have the results i'll come back again and share what i've learnt.
i've literally just joined this practice, but there are about 10 GP's here, so i haven't sen or spoken to the same one once since i've started querying this.
It's such an important issue that i am loathe to just let it lie just because one GP says i'm taling out of my arse and that everyone i;m getting advice from is completely ill-informed.

in our pratice, once you start a course of treatment with one doctor you have to stick with that one. possibly see another one, which hopefully u'll like and then stay with that one? LP does vary thou - we're not all text book cases!

(munnzieb)

i have my blood rest results at home now - i asked the gp to send them to me - anyone out there know anything about scientific figures if i post them here. they mean absolutely nothign to me i have to admit.
i also read somewhere that testing for LH and FSH shoukd be done at different times of the month to get an accurate diagnoses. typically this month, as i have been away in India, i haven;t been able to take temp or make detialed notes about this cycle, so will have to try again in January.

Hi Valleygirl,

Post them up and I'll see if I can make any sense of them.

Meerkats

i'll bring them into work with me tomorrow and type them up.
thanks
vg

ok here they are:

SERUM FSH LEVEL 3.5 u/L (3-11)
SERUM LH LEVEL 3.1 u/L (1-12)
SERUM PROGESTERONE 33 nmol/L (1-4)
THYROID TEST TSH SERUM LEVEL 2.42 mu/L (0.4-4.0)
SERUM FREE T4 LEVEL 13.7 pmol/L (10.2-24.5)
SERUM PROLACTIN LEVEL 222 mu/L (40-530)

Means nothing to me i have to say.
if you can work it out you should be in medicine!!
thanks and don't worry if it's gobbledygook to you too!

the prog is above normal at least, my Dr says u need at least 30 to be able to say u've OV'ed also u have enough of the hormone to sustain early PG. (but then again he said 22 was boarder line, so I suspect around 25-30 would be ok and as ur 33 looking good hon, (mine was 31 and the DR wasn't concerned by that)

Hi,

Would agree also that your prolactin level is above normal. Your TSH serum and your T4 levels are also on the higher than normal side (these two are to do with your thyroid gland).

Have they checked whether you have any problems with your thyroid gland?. I would ask them about this.

HTH

Meerkats

P.S am off now till the New Year so will write further then.