Day 21 bloods as first stop?

[katemumtwo]

Hi - have been ttc dc3 for the past 14 months (including 4 month break last summer as H had a midlife crisis, though - yuck!).

Dcs 1 and 2 came along in the first month of trying but this one is being stubborn, so I saw my GP last month (I'm 35 so didn't want to wait too long). He has put me forward for day 21 bloods only, so I just want to make sure that this was normal - aren't you supposed to have day 3 ones as well? Also, my cycle uses to be about 37 days when ttc my dcs but is now only 28 days... might just be old age but I have a feeling the problem with failing to get pg is mine because of this? If they find all is normal, what would happen next? Just want advice from someone who has been through all this... thanks

Hi Kate

The day 21 test is the first in the line. They use it to check your progesterone levels are high after ov. It is a tricky one as its meant to be 7 days before you get af so if you find gap was not that big this month i would tell doc and redo the test.

I would in the mean time start temping so that you can begin to see when you oving or use opk to time it just right. It might just be that with two young children you are missing the right days.

Hope that helps

I would be looking at having day 3 blood tests done as well. Your cycle would be seen as irregular as there are more than 4 days of variation between month to month.
Day 3 will check LH and FSH; these two hormones kickstart the ovulation process. If those are awry then it will all be awry.
If you have a day 3 done ensure that the levels of LH and FSH are compared against one another.

As your periods are irregular the tests can actually be done according to calendar days i.e the 3rd and 21st of the month. Have never seen or read any reference about the day 21 meaning to be done 7 days before a period (only 12% of all women have such a cycle anyway).

Timing of intercourse is of no benefit either and can put pressure on yourselves.
Would refrain from either temp charting or using OPK's simply because of the irregularity of periods. OPK's are beset with problems anyway; these work on the principles that there is only one rise in LH every month and that such a rise is immediately followed by ovulation. Not so.
Also if you are one of many women who are producing higher than average levels of LH the kit reads that. Therefore they are best avoided.

You need to find out why they are irregular now and I would also look into having a referral with a gynae. Fertility generally speaking as well declines with age, I would not delay unduly.

I'm about to undergo blood tests for infertility.
Need to have two tests: one at day 2, 3 or 4
The other needs to be 7 days before my period - the GP says that as my periods are irregular, it may be a bit hit and miss and so has given me three blood test envelopes.

hth

Ah - meant to say I USED to have 37 day cycle but now it's mostly 28 days with the very odd 29 or 27 day, so I'm pretty spot on regular! I did go to the GP as H noticed I was leaking a little from my boobs during sex (just a drop or two) so had tests for prolactin (normal) and he did my 21 day bloods then, too.

However, I did warn the GP it was actually day 24 that day and sure enough I came on 3 days later and it came back as a level of 28 and so borderline. So I'm having them redone next week. I do have a Clearblue monitor but it hasn't made a blind bit of difference so far (usually records a surge with the egg showing on anything from day 12 to 15) so I'm going to eBay it shortly...

Well a surge on day 12-15 is just about perfect with a 28/9 cycle, so don't worry about that!

It is absolutely pointless doing day 21 bloods by the calendar, they need to be done according to your cycle. However day 21 is a misnomer, as it really should be 'mid luteal' progesterone that is measured. For most women, the luteal phase (the bit between ovulation and the start of the period) is fairly consistent, roughly 14 days (as it is for you) but it could be a couple of days shorter or longer. Your blood test needs to be roughly in the middle of that time. If you time it wrong the result will be unreliable.

To time it, you can either use your LH surge from your monitor and do it about a week after that, or if your periods are predicatble, do it 7 days before that should come. For most women there is likely to be only a day or two difference between these two days anyway.

If you aren't quite sure of the dates, then doing serial bloods a few days or a week apart can help catch the progesterone peak. This is probably why you have been given 3 forms.

It is pointless doing a progesterone at any other time, you will get a completely meaningless result. If you have very irregular periods, then you may well not be ovulating anyway, so doing the progesterone is not going to give a positive result anyway!

In your case though, it is probably worth getting day 3 bloods done too, these look for different things that give different information.

Okay, I'll bring it up with them... they seem to be quite quick here with the results so by the time my 21 bloods are back (prob on about day 25 or something) I can get in and ask for the day 3s to be booked for the next week.

If they find I am okay with these, what comes next on my side? I am guessing they will try and get H into the lab, but would they refer me to a gynae to have a poke about and make sure nothing is blocked up?

Kate this is quite interesting because lots of people have different ideas from their own experiences.

I am currently undergoing IVF treatment with a fantastic professor. He explained that the bloods that the docs do are totally different from what the specialists do so dont get too tied down with those.

I believe that the fertility clinic uses OPKs to let the girls do frozen embryo transfers on a walk in walk out basis so would expect them to be fairly accurate.

If you wanted to check tubes its a gynae or fertility specialist they do either a lap and dye or a HSG test. Both are not too invasive.

You really mustnt worry about any of it. IN the mean time do some temping and/or the OPKs and relax.

Hope that helps

XX

Thanks - I'm not keen on the whole full blown IVF thing and seeing as we already have two children I'd feel bad approaching the NHS for that as it's so costly. So hopefully it can be solved with a few bloods / pills and a poke about! Thanks again for your help... maybe the Clearblue will stay off Ebay for a while longer, then?