What tests do I need? Not sure I'm ovulating

[Mumontherunn]

I need some advice as feel like I'm at the start of my fertility journey, trying to conceive our second DC, but not even sure I'm ovulating.

I have a microprolactinoma - a small tumour in my pituitry gland that causes high prolactin levels, which can stop me getting pregnant. With DS, as soon as I was on medication for that I conceived that month. This time seems a different game though. I've been back on those meds since November, and my prolactin levels have been 'normal' since then. But actually my hormone levels still feel weird - I don't get sore boobs at any point in my cycle, whereas I used to pre-child. Some months I get awful ovulation pain, other months I get none. Some months I get egg white discharge, other months I get none. This month my digital ovulation test has said 'high' but 'no LH surge' for about 4 days, so I don't think I'm even ovulating this month.

I've had a blood test at docs today for prolactin, LH and FSH. What else should I be checking? I am seeing the GP in a couple of weeks to discuss where to go next.

I'm hopeful it'll happen eventually, but just want to make sure I'm doing all I can and checking everything we need to check.

Any advice much appreciated.

To check ovulation you need to do a progesterone blood test 7 days after the date you think you could have ovulated. Tricky to know which date if you're not getting LH surge positives (though keep testing - if it's the clearblue ones it's not uncommon to have several days of flashing smileys first).

Do you have regular periods? Could try the test 7 days before they start. Alternatively you could have a scan to check for a ruptured follicle.

Thanks for this @sirensong - I hadn’t heard of follicle scan so something for me to google. I have the digital advanced Clearblue monitor so slightly different. Specifically says no LH surge still. Seeing the DR soon so will keep researching and chat I guess

You need a day 21 progesterone test which as PP mentions isn't always on day 21, just 7 days after ovulation. A result over 30 will confirm ovulation. I have a microprolactinoma too, also have child (via IVF) and I no longer get sore boobs since giving birth. I definitely do ovulate as I've had the day 21 blood test. My endocrinologist arranged it but you can also ask your GP.

Thanks so much @Thinktad - I’ll definitely push for day 21 test. Have a call with endo team in a few weeks so if GP doesn’t organise this then I’ll get them to. And that’s really reassuring about your boobs, thought it was just me.

Bromocriptine helped me conceive first time but I’m on Cabergoline now