'normal' cycle length, low progesterone, anyone similar?

[victoria401]

Hi ladies, me and DH have been ttc#1 for 15 cycles now and I was getting concerned and begged for tests. GP said I was prob fine as have mostly 28/29 day cycles (occasionally 27 or 30, nothing more, nothing less). I also assume I've ovulated every month as I get a stitch in my side days 13/14ish. Reluctantly GP allowed me a cd21 test to confirm ovulation. She said if results were over 30 I was fine and no need to come back blah blah. I just got the result back and it was 20! I've been doing some reading and apparently between 3 and 30 means you've ovulated but there is not enough progesterone for an embryo to implant! It needs to be 30+. I still need to have the other day 2 bloods after af starts next week before I see GP again. I assume they'd check more than one cycle? Can it vary or if you have it you have it?!

Has anyone had a similar story?

The only symptom I can think of is that I get spotting 4-5 days before af,otherwise my luteal phase would be a normal length from ov-af. Hubby is also being tested but there is a 3wk wait for SA tests! By the way I'm pushing 34 and he is pushing 36.

Anything over 20 indicates ovulation, but I would recommend that you have another test at the same time in the next cycle. Just to make sure.

Good that your early follicular phase is being checked - very sensible.

As you have been trying for over a year you are entitled to be referred to a specialist. Might be worth considering, if nothing else then to put your mind at rest. But it's good that DH is being tested too.

Age wise 34 isn't horrific! And male age generally has nowt to do with fertility potential, so there is a bit of time to play with (although the waiting and hoping and anxiety can be utterly soul destroying, especially after 15 months)

We were told that it had to be 2 years before we can see a specialist! After the first appointment with GP she said "see you in month 25"! She said there was no point getting the tests now as she'd have to do them just before a referral. I said I needed to know if we at least had a chance of getting preg naturally as I was not planning my life more than a few weeks into the future "just in case I was preg", like not booking holidays or trips with friends. She then offered me stress counselling!! I said I didn't need that I just needed the tests done! I couldn't do this for another 9 or 10 months! So yeah, I got my way! And I was right to as there is a potential problem. And I've now booked a weekend away with my friend in September as its now unlikely I'll be pregnant.

But... Do the GP or the specialist prescribe progesterone or other drugs to help?

The GP should never prescribe anything - they don't have the skills to make sure that things are done safely.

I'm afraid that the GP is talking utter bull shit - you are entitled to a referral now, although, if it is found that there is nothing "wrong" and if you haven't conceived by either the two or three year mark (and this depends on where you live) then you won't be entitled to IVF until that point. Basically, you need to have either a two or three year conception delay before you can have IVF. However if may be that there could be other treatments that are available to you that aren't as complex/expensive as IVF.

Obviously if there is a reason for a conception delay then treatment can be offered sooner.

I'd recommend that you have your early follicular phase bloods done (this should be LH, FSH, oestradiol and testosterone) and be between day 2 and day 5. Then you need to have a repeat progesterone 7 days before the expected onset of a period (so with a 28 day cycle this should be day 21). It would also be useful to have an ultrasound scan to check ovarian morphology.

Regardless of the results you should be referred to a specialist. If you want to pm me where you live I might be able to point you in the direction of your local fertility treatment policy and details of where you can be referred to.

In the meantime, the advice is "the usual": make sure that your BMI is between 19 and 30, take folic acid daily, if you/ your partner smoke then stop (these last two points are likely to affect your treatment entitlement) and if you drink alcohol do so in moderation.

On the more "human" side of things, it's a bloody difficult thing to go through. Try to make plans etc as you would normally do, get as much support as you can and, in the nicest possible way, don't forget to live. It is one of the hardest things to do, but the more "normal" you can keep things sometimes the easier it is to cope with.

Thanks for a very detailed reply and your time, it means a lot.

I can't work out how to pm you but I live in Bristol, or more specifically South Gloucestershire, which probably makes all the difference!

I'm due a day 2-5 tests after period starts which should be sometime mid week. You think I should book myself another day 21 next cycle without asking the GP? She only works half day one day a week. Very hard lady to get hold of!

I'm a healthy weight, non smoker, cut down big time on booze (still need to work on coffee, currently 2 cups a day!), been cooking healthy nutricious food. Hubby gave up smoking 3 months ago, yay! He is classed as overweight though but he's not massive! Waiting for a date for his semen analysis. They said approx 3 week wait.

I know I should be living my life and I do day by day. I have my work which I enjoy, and I swim and salsa dance a few nights a week. I'm just not going to book a holiday abroad 12 months in advance!

Thanks again :-)

Agreed, you are entitled now. I know different health authorities work different but more than a year of trying should get you a referral anywhere. Look into it, our clinic wanted all those tests to be done before first appointment too so don't let docs tell you that you would have to wait, they might be wrong.

I can't find a straight answer to the correct level question. I had two 21 day tests now, one was 26 and clinic said needed to be over 30 like you mentioned so might be not ovulating. Sent me to retest and got 14.9 but nurse on phone said that's fine. But it's not fine according to clinic from first result.

I also read somewhere else that between 17 and 23 meant you ovulated but the level wasn't enough to keep the uterus lining for sucessful implant. The higher the better apparently. I can't seem to find proper medical info through googling tho!

Anything over 20 is fine!

Victoria I'll look into your area and let you know.

Dulcet, how are you doing?

I'm alright fox, just fed up with the waiting. All my tests are done but next appointment not until May which is when all the ultrasounds are booked too.

I'd like to do another 21 day test as well as, although the 14.9 was on day 21, I had a fluke 23 day cycle for some reason so might have thrown it out. Can you request to do it again do you know?

Just had another progesterone test on day 26, was meant to be 25 but that was obviously a Sunday. I'm also due for a day 29 unless bleeding has started, which it probably will have. Then I need the day 2-5 one. Does it matter that the day 2-5 will be on a different cycle?! I didn't really think that through when I booked the day 21, it was just the next date to my appointment with the GP and I was desperate to get the process started!

I did look up North Bristol Trust and they said anyone over 12 months trying is entitled to the blood tests. Its just over 2 years for ivf etc if nothing is found to be wrong. I presume I can be referred for other tests and investigations too? I was diagnosed with a fibroid in 2003 from an ultrasound, but GP said was prob not important, what if it is? Can it be?

Hi Victoria, I'm in a similar position to you, though my progesterone was only 8! I'm also nearly 34, ttc about a year. My doctor said she'd like to have seen my progesterone over 10, but didn't seem too concerned- I think because I get positive digital opks. We're waiting for the result for my husbands SA so I think after that I will ask for progesterone suppositories. I have an appointment next week so I will let you know what she suggests. Your progesterone level sounds great to me!

perdita123

What are your periods like generally speaking?. If they are irregular in nature, OPKs can be misleading to use.

Progesterone as well is only part of the story. They actually like to see a result of over 30; doctor should refer you to a subfertility unit rather than just mess around in ignorance (your doc should indeed be concerned). Multiple positive opk results can also be problematic.

You should also have a day 2 test done to check and compare your LH level against that of your FSH level. If these two levels are awry then ovulation can be affected. These two levels should normally be the same; an imbalance of LH to FSH could well indicate a condition called polycystic ovaries which is very common and can be treated. Apart from yourself being tested, your man should also be tested at the same time to see if there are also any male factor issues.

Ive read a fibroid can act as an iud and stop implantation.
I also had spotting before AF and i have pcos and hypothyroidism so havent been ovulating. (Never got ov pain)

AttilaTheMeerkat

Thanks for your advice. My periods are fairly regular, around 28 days generally, but I get the positive OPKs at around CD16 or later, so usually only a 10 day luteal phase, sometimes less. I'm fairly sure I am ovulating because the OPKs are the smiley face ones so I'm not trying to interpret 2 lines, and i get a decent temperature shift in the luteal phase. I only spot 1 day before AF if at all. I had the Fsh test on CD4, which came back as 5.1, which I was told was fine. However I don't know why the LH test wasn't also done.

I will bring this up at the appointment this week. Any other info greatly appreciated. Hope this helps Victoria too.

Just found out some people get their progesterone results in ng/mL, and others in nmol/L. Mine was 8.2 ng/ml which is 25.44 nmol/L. Do you know what units yours was Victoria? Hoping mines not as low as I thought..