Heatherwood hospital referral low progesterone

[princesssunshine]

hi everyone. I'm new here. We've been trying for a baby for about 15 months now, no luck. I went to the docs, had a 21 day blood test and this came back as 'no signs of ovulation' and a level of 12 progesterone. I have been referred to Heatherwood hospital clinic at the beginning of May.
Is this a really low level of progesterone, why would that be?
What happens when I go to the clinic, will I be prescribed clomid to stimulate ovaries or will they give me more tests? Anyone been in the same position that has gone to Heatherwood?
Look forward to meeting a few of you on here. I'm a bit gutted to be fair. Why can't life be simple? x

Progesterone is produced after ovulation in the second part of your cycle by the part of the ovary that the egg emerges from. I think a level of >30 is normally considered evidence of ovulation. There are lots of things your results could mean, including that the test wasn't done at the right point in your cycle (7 days past ovulation) which can easily happen if you have irregular cycles. Or it could mean you didn't ovulate that cycle - which could reveal a problem that needs to be treated (e.g. by clomid) - but that's not necessarily the case because it's quite common for women to occasionally miss a cycle.

You should probably have the test done again (to see if it was the wrong timing or a skipped month) before starting treatment but the clinic will advise you. Have you had other tests done, eg sperm analysis and day 3 bloods (LH/FSH) as these are helpful to build up a full picture?

Hi - no other tests were done. My cycles are pretty regular, but only bleed for about 2-3 days. This was done on CD21. Yeah, waiting to see what they say at the clinic. All a bit confusing as the doctor didn't really say much other than there were no signs of ovulation.

If at all possible I'd try to get at least a sperm analysis done by your gp before you go to the clinic as it will save time; they need to investigate both of you before treatment starts (no point making sure you're releasing eggs if they don't also make sure there are healthy sperm to fertilise them!) and they often like to do a second SA 3 months later if the first one isn't great (for us they recommended some supplements that made a real difference by the second sample). Good luck!

hey all. gosh it's been a while since I came on here! So, I had an appointment at Heatherwood hospital in mid May. The fertility consultant confirmed i had low progesterone from that first 21 day blood test, but then (1) made me feel bad because my partner hadn't come to the appointment (noone said he had to on the letter or anything so I didn't know) and (2) refused to help me further until my BMI is reduced. I am 5 foot 1, and at that time in May I was 16st 7 (so BMI 44). She said she will only help us if my BMI is seriously lowered, and at least in the region of about 35. I have been desperately losing weight since then, have now reached 14st 9 (BMI 39) so on the way, not sure how much it is physically possible to lose to reach her target by mid November but I will give it a go

I had a 2nd progesterone day 21 blood test and this also came out low (4)
I had a FSH test done (came out as 7.6) and FH test done (came out as 4.4) but no idea what these mean as yet. Is this ok? I know my progesterone is low, but not sure of these results
I had all the necessary blood tests (rubella, hepatitis immunity etc) (all ok)
I had a chlamydia test (all negative)
My partner had his sperm tested (all ok)
I've got a scan booked for 31st October. Not sure what this looks for but I guess I'll find out.

Phoned the fertility consultants secretary today as hadn't heard of when my follow up appointment had been, and no wheels had yet been set into motion, but she is getting that sorted and requesting an appointment which will hopefully be in November.

Of course no luck on the conception! Maybe down to this progesterone issue... anyone got experience of this? Or know if my FSH/LH tests were ok? Any help or advice gratefully appreciated :) (or just kind words, you know this whole thing is difficult, and when you dont always want to tell friends or family about it, it can be quite lonely)

Thanks in advance lovelies xx

Was that fsh 7.6 and lh 4.4?
Well its good in that that wouldnt indicate pcos as a cause of not ovulating.
I would get your tsh checked. Do you have any hypothyroid symptoms? (My clinic wanted under 2.5 for ivf)

I guess i would consider age as in it may be worth getting bmi to towards 25 or under to get best success rate but as this could take time.

Hi, yes it is NHS policy to need BMI to be lower - under 30 for ivf in my areas or both partners and above 19 from memory.
it was encouraging they said nearer 35, as it indicates that if your BMI is nearer 35 than 30 ( and yours is well on the way to 35 for nov and they can see you working at it which is what matters at this point) they should:

• do more tests.
• re-do your bloods to see if weight loss is helping progesterone levels.

Personally I would go to gp while you wait and request:
Prolactin, thyroid and another day 3/21 blood tests to take with you to nov apt. If prolactin too high ( mine was high at 850 but they would not treat until over 1000) or your thyroid above 4.5 these need medicating and could be a contributing factor. I had to delay 2nd ivf cycle as found my thyroid level too high and needed 3 months of meds first.
Be useful to see if BMI lowering improved progesterone level and not wait for consultant to order more tests!!!

If the fertility dr not ordered a HSG type test do ask - checking if Fallopian tubes blocked.

Hello princesssunshine

I just wanted to add that whilst it does look that in the two cycles your progesterone tested you didn't ovulate, there are other ways of finding out if you're ovulating at all without having to wait for the clinic to tell you.

What I did was take my temperature every day- known as "charting". You record it on the chart, and if it shows a sustained rise that cycle, then you've ovulated. This way, you can also find out when you ovulated- if you're not sure of that, you can't be sure your bloods were taken on the right day.

For example, the progesterone test is called the Day 21 test because the average woman has a 28 day cycle, and ovulates on day 14. Progesterone peaks 7 days after ovulation, so that's what they're aiming to record. It's not unknown for doctors to insist on the test being on day 21 even if your cycle is 24 or 36 days long! But even when they do what they should, they're still calculating that your luteal phase (period between ovulation and period) is 14 days long- and often it isn't!

Complicated, much?! . I found a book called "Taking charge of your fertility" good for explaining how to chart, and it has a website linked to it- www.tcoyf.com - which is crammed with information about stuff like blood tests, cycles, when to go on Clomid etc. (One word of warning specifically re. blood results though- it's an American site, and they measure progesterone on a different scale).

Good luck!

thanks everyone some good points. Thank you for helping me think clearly! Good idea re asking for more tests before November also, which I think I'll ask the doctor for. Thyroid was checked (has been several times) but all ok, not sure of the number though. Not sure if they checked prolactin and don't think I've had an HSG one. I tried to chart when we were trying initially, thought I saw a small rise in my basal temperature but couldn't quite work it out. I will check out that website. Just want it to all happen... trying so hard with the diet and things, and luckily having regular dtd (esp in ovulation weeks). I get the mucus and stuff, but not sure if thats also an indicator of proper ovulation. Will defo have a look on that website. Thanks so much for your comments x

Definitely find out the tsh as gp uses 4.2 as a cut off but ivf clinic 2.5 for ivf. So i started treatment with 3.7. Though i had short LP and spotting and a low body temp

The HSG is not a blood test - it is when they check whether Fallopian tubes are not blocked by injecting fluid/dye through them. Sorry should have said. You will need hospital to book that test.

Oops, I realise my post might have sounded a tad patronising, especially as you've already tried charting. Sorry.

Yes, the website is great, and it has free charting software too, so you can do it online!

Oh, and apparently egg white cervical mucus is a sign your body's gearing up to ovulate....but not a cert that you have ovulated, IYSWIM. Sometimes your body can have a big hormonal surge.....but not quite enough to pop that egg.

thanks girls. Got my scan on 31 Oct, then consultant again mid November. I am part of a local support group - turns out there is a lot of anger towards this particular consultant, and I might be best asking my doctor for a referral to another hospital so dont know whether I might try that too. Too old for IVF in Berkshire I think as cut off age is 35! Thanks all for your help, and no, it's not patronising, even though I have tried charting I'm by no means an expert and to be honest any help and advice is good as my mind is all over the shop. xxx