Luteal phase / progesterone issues?

[HM2024]

Hi all,

Does anyone have experience of luteal phase deficiency / progesterone issues?

I'll try to speak to the fertility doctor about this specifically (not sure how easy it will be to get a follow-up appt) but I'm really keen to hear from anyone who has had the same issue?

We have been TTC for about 18 months and having no luck. My blood tests were ok and DH's sperm analysis normal. Had internal ultrasound and HSG - both ok. I'm 38 so know age is a factor.

The only other issue I can see is that my cycles are on the shorter side (with spotting before) and my luteal phase is short. I've noted down cycles from the last year below.

Blood tests on day 18 (GP worked out about 7 days before my period) was 34.8 nmol/L which I've been told is normal. I also had one on day 16 (ovulation day according to LH peak on OPK) which was 3 nmol/L. These weren't the same month but shows my progesterone did rise, which is good. My query is - is it then falling too quickly so implantation doesn't have a chance.

I've been tracking BBT this month and it is a bit all over the place without a clear spike after ovulation, which has sent me down this rabbit hole again (I've been querying short luteal phase for a while).

I contacted someone private about testing and she suggested DUTCH Cycle Mapping test but it's over £400. It Starts With The Egg recommends Proov tests which are more reasonable (£30ish) - but with both options I'm unclear of 'what next' - as I doubt the NHS fertility doctor would prescribe something off the back of these results.

I read that progesterone supplements can help but the NHS NICE guidelines only seem to recommend after multiple miscarriages.

Any experiences or advice very much appreciated!

Thanks x

Cycles over the last year
28 day cycle, 10 day luteal phase (4 days spotting before period)
26 day cycle, 11 day luteal phase (1 day spotting before period)
25 day cycle, 9 day luteal phase (1 day spotting)
25 day cycle, 10 day luteal phase (1 day spotting)
25 day cycle, 10 day luteal phase (1 day spotting)
22 day cycle, 8 day LP (1 day spotting)
24 day cycle, 8 day LP (no spotting)
25 day cycle, 10 day LP (1 day spotting)
27 day cycle, 10 day LP (2 day spotting)
26 day cycle, 9 day LP (1 day spotting)

Be wary of Proov. I did one for my ovarian reserve and it gave me a very very false sense of security

luteal phases should be minimum 12 days I believe? Although could be wrong

Thanks for that. I had heard mixed reviews after a very quick search on Proov earlier and thought they may be inaccurate.

The guidance seems to vary on how long your LP should be.

this site may be useful @HM2024

this one too

@HM2024 I also have short luteal phases, usually about 10 days. Literally every medical professional I've spoken to about this has been super unbothered, maybe because I have got pregnant (ended in TFMR at 14 weeks bit not a miscarriage) but a private doctor was willing to prescribe me cylogest progesterone (NHS won't prescribe without miscarriage/bleed in pregnancy) but the private doctor said no harm in taking it, and it might help. It's not the cheapest but might be worth a go.

I have done a couple of progesterone tests and the timing makes a difference, the advice to test 6-7 days before your period assumes a 14 day luteal phase, I was told do the test 6 or 7 days after I'd ovulated for an accurate reading for my cycle length. I did superdrug finger prick blood test/got NHS to test my progesterone

I have short luteal phases - 7/8 days. I have a DS who is 2, and had him naturally after a year of trying. TTC again for the last 14 months. This time my NHS fertility consultant has just prescribed three rounds of letrazole with progesterone suppositories, in the hope that it might make me ovulate earlier in the cycle and thus have more success. They don’t seem too worried about short luteal phases though, just can sometimes take a bit longer to fall.

If we have no luck, we might consider IVF later this year.

With my DS I took high strength vitamin c and agnus castus which is also meant to help lengthen luteal phases. I’m also 38. Stay positive OP! Are you taking vitamins?

Thanks for your reply 😊

Sorry about your tfmr pregnancy, that must have been so hard.

I feel the same with the medical professionals being very unbothered re short luteal phase. Like they won't even consider it to be an issue. But then when I start looking into it, it seems like a very obvious issue!

Did your private doctor prescribe it after tests, or based on your cycle info? How are you getting on with it?

Ah, we're in a very similar situation. I have DD who is 3.

That's really interesting re letrazole plus progesterone. Can I ask how long your cycles are and what day you usually ovulate? Wonder if my fertility doctor would prescribe that.

I assumed that letrazole would only be prescribed if you weren't ovulating, not to help ovulate earlier.

I am taking so many vitamins! Including high strength vit C, but not agnus castus. Just reading about that now and wish I'd started taking it earlier. Will order!

How are you getting on with the letrazole and progesterone?

It was my idea when speaking to my GP. I’ve always been more worried about my luteal phase than them. Then I mentioned it to the private fertility doctor and he was going to prescribe them this month. Then my NHS referral came though a couple of weeks ago and so they agreed to prescribe the same on the NHS instead. I think the general feeling is it’s worth a try? Definitely worth asking! (Cost approx £750 per cycle privately fyi).

My cycles are 27/28 days, and I usually ovulate day 20.

I actually stopped the agnus castus s few months ago as I’ve read this time to avoid if you have a pituitary condition, which I also have.

Due to start letrazole tomorrow!!

@HM2024 thank you, yeah it was an incredibly tough thing to go through!

I think all the doctors I spoke to weren't fussed as while my LT is short, it's not too bad, and I got pregnant naturally quite quickly so they didn't seem to think it a big deal. The Dr who prescribed it also wasn't concerned but was happy ro prescribe in case it helped.

As it turned out, I had adhesions as a result of the surgical TFMR I had so I've never really taken the progesterone as we figured that was the main issue stopping us conceiving again, and now we are doing IVF so will def be on progesterone once we get to transfer, hopefully very soon!

I've done acupuncture, reflexology and loads of diet improvements which I think can help with LT but hasn't made a difference to mine, I think it's just the way that I am!

I'm not convinced the GP I last spoke to would know what a luteal phase is so I'm going to try get in touch with the fertility doctor again. Hopefully now I've had one appt, it's not a case of waiting months for a follow up.

Ooft £750 per cycle! Definitely worth begging my NHS doc. I keep saying "it's cheaper than NHS" for supplements, acupuncture etc...but it's starting to add up!

Good luck with the letrazole. Hope it make a difference 🙏

Good luck with the IVF. 🤞🤞 for you.

I've been doing acupuncture - not sure if it's helping but it's at a fertility clinic, which has been useful to be able to chat things through holistically. This had led me to some good diet changes and a lot of supplements.

I tried to speak to someone at the fertility clinic today. I'm on the waiting list for a phone appt follow up from the doctor but no idea how long this will take.

A fertility nurse phoned me back and heard me out (it is very nice to feel listened to!). She said that she can prescribe anything and knows the doctors are very hesitant to prescribe progesterone, but offered that I could come in for a blood test for it about a week after ovulation. And we will have that information by the time I can speak to the doctor again.

So I'm going in later this week for that. Felt like I've slightly got somewhere!

I asked about prescribing letrozole/ clomid but she said she wouldn't do that if there's evidence you are ovulating or to shorten your cycle 🤷🏻‍♀️🤷🏻‍♀️

• can't prescribe anything!

@HM2024 I've heard of some private pharmacies that prescribe progesterone, Dr mortons and the rose pharmacy, not tried myself but might be worth a go... annoyingly I've often found it's holistic practitioners (acupuncturist, reflexologist) who are more interested in luteal phases and recommended progesterone but can't prescribe! Have you had a full thyroid panel check too? I found I had elevated thyroid levels and high antibodies (never had any symptoms and didn't affect previous pregnancy) but can impact fertility and possible cycles too so that might be worth a look. I did medichecks which gave me a more thorough picture, but GP also tested for it (bur GP parameters of what they think is ok for thyroid is nor the same as optimal for fertility!)

Ohh I wasn't aware of the online pharmacies. Reading the Dr Mortons website makes it sound so easy! Do you have any idea what the cost would be?

No I haven't had thyroid panel check - i'll look into this - thanks!

My BBT is just all over the place, I'm so confused. I wish I'd measured it before but I was thinking that it was just to know timing of ovulation.

@HM2024 I've not used the online pharmacies but I think I was told about fifty quid for a prescription

We have worked with The Fertility Suite who basically review where you're at, suggest further testing and give you advice on what to do esp if NHS nor being super helpful. My reflexologist gas also been super helpful on all things cycle tracking and luteal phase, she's in London but does online Fertility awareness courses too - Reflex East is her business name, Katy Ewen, might help you out! She's the queen of BBT charts

Wondering has anyone used or looked into working with Plan Your Baby and Proov? It seems like they will prescribe progesterone based on Proov results (and a consultation) and it is not completely extortionate so I think I'm going to give it a try. Keen to hear any experiences.

https://planyourbaby.co.uk/proov-consultations/

No but I have heard of Proov. I’ve been in progesterone about a week now and my body feels different to before, which feels somehow positive?

So go for it!

(Forgot to add that bit!)

I've ordered the tests so let's see what they show. Annoyingly will need to wait until my next cycle to do them. What kind of difference do you feel?

I just feel more hormonal. Nipples more sensitive, lots of watery discharge, fatigue, wild dreams. Just feel like everything has been elevated a bit? Might be overthinking of course @HM2024

how are you getting on @HM2024? Did you get anywhere with Proov test?

I just wanted to update. First cycle of Letrozole made me ovulate on day 13 annd gave me an 14 day luteal phase for the first time and I’ve been on progesterone since ovulation. I’ve had a bfp this cycle and the line is getting stronger (day 19dpo). Not sure whether the Letrozole or progesterone is to thank - or both - but ovulating earlier has definitely helped imo. I’ve also asked the consultant if I can continue the progesterone for the first 12 weeks of pregnancy, as research shows this can help after a pregnancy loss. (I will speak to a private gp if he doesn’t agree)

We know our bodies better than them sometimes. Good luck x

Oh amazing news, congrats!! Hope your consultant will agree to the continued progesterone too.

Thanks for updating, and also for your message before re symptoms you've been feeling. Actually made me realise I've been missing some for a few months - like the post-ovulation sensitive boobs.

No progress here - need to wait until my next cycle to do the Proov test then can make an appt with the consultant if the results show my levels drop. I wonder if the consultant can prescribe Letrozole too. I have zero expectation that the NHS consultant would consider either.

Thanks for sharing your news - it gives me some hope.

I listened to the creator of Proov on a podcast a few days ago and she had the same experience for infertility which made her create the company and testing.

Hello, this was a while ago but I just wanted to see if you had an update @HM2024