The Short Luteal Phase Gang

(297 Posts)
onedaybaby Thu 24-Mar-11 18:20:34

Hi,

I've noticed that the question about a short LP comes up quite a lot, and I would love it if we had our own thread to discuss where methods we are doing to try to increase it, lengths and what the dr thinks!

My LP is 8 days with a 31 day cycle.

I am currently taking Agnus Castus and have had accupuncture for 2 months. I also use the CBFM.

This will be my 9th month TTC. I have had the 21 day blood test (which has to be done on 28), the day 3 blood test and an ultrascan. All tests are normal.

greenygrassy Mon 04-Apr-11 17:19:04

Hi gang,

Have been in follicular phase and trying to focus on non ttc stuff for a bit, but I went to the private consultant recommended by Joycep today and thought I would let you guys know what she said, along with my symptoms, as I know many of you have similar patterns.

She said I may have a slight hormone imbalance which would make it harder to get preggers, and might increase miscarriage risk. She came to this conclusion for the following reasons (as far as I can tell):

I have been pregnant but miscarried around 6 weeks
Have been trying for 11 months
Late lh surge around day 15
Spotting for days before AF
Luteal phase from ovulation to spotting between 7 to 11 days, luteal phase from ovulation to first day of full AF 10 to 14 days
My womb looks fine
No reason to think there is a problem with my tubes

Plan of action for now:
Progesterone to help support luteal phase this month
Clomid or similar next month to help with hormones and bring ovulation forward

Will be going for another ultrasound on Thursday and for blood tests soon.

PS She said Vit B makes nooooo difference to LP. She has done research on it! She told me and hubby to take a multivitamin and said she didn't think acupuncture would be useful for me. She only said that after the ultrasound, and am not sure why she decided against it, as she said she might be recommending it before the ultrasound.

Joycep She was lovely. Thank you so much for the recommendation. I had told my GP and the NHS consultant all the same things, but for the first time today I felt like someone was really sitting down and looking at the whole picture and trying to help me find out what was going on. We will be redoing the blood tests, because, as I suspected, my GP did the fsh/lh tests at the wrong time of the month. (It is going to be super expensive though - I'm down £850 already, and will probably have got through £1500 by the end of the month. So do try to get your insurance to cover it if you can.)

Mary Thanks for the encouragement!

Mapleleaf MrsHY1 I never thought Clomid or something similar would be recommended for me, as I do ovulate, but as blueberry said it can help to make you ovulate earlier, and if we were to ovulate earlier, then our LPs would be longer. Yay!

onedaybaby If they offer you progesterone - take it! I was offered it months ago on the NHS, but then the consultant said 'why don't you try on your own for another six months' and I foolishly agreed.

joycep Mon 04-Apr-11 17:49:42

Hi Greengrassy, thank you so much for coming back with such helpful feedback and am so pleased that she has given you such helpful advice. She does sound proactive and the fact she recognises a hormone imbalance is a breath of fresh air rather people fobbing you off. Apart from the spotting, our situations sound very similar. How interesting she wants to give you progesterone which is hardly ever prescribed on the NHS unless you have had multiple m/cs. What form are you getting it in? And interesting that she didn't advise acupuncture either - this has not helped me in extending my LP nor have B vits.

Out of interest - what is costing so much? I know the initial cost is £300 but the price seems to have trebbled....!

I went to my GP last week and she is giving me buckets of blood tests. I know she is testing me for LH/FSH on the wrong day (day 13) - she didn't even mention a specific day to be tested. I have a scan next week at St Mary's and once that is done, I'm going to go back to her. I'm bascially banging on about my periods being different to what they use to be after m/c, in the hope that I can get referred to Sarah for this issue rather than TTC which insurance wouldn't cover. I'm not sure this is going to work though but I thought I would give it a whirl and now especially after seeing what you're paying.arrgh!

It just shows the difference though if you pay!

MrsHY1 Mon 04-Apr-11 17:56:02

Hello ladies!

Well, I had my scan and blood tests at hospital this morning! I saw a doctor for my scan - she was brilliant. She said I have a 'beautiful uterus' (!) and that my tubes and uterus lining all look OK. They can't tell for certain from a scan that there's nothing wrong with my tubes, but there was no liquid in them, which is apparently a good sign.

As suspected (and I knew this from my last scan 5 yrs ago), I have polycystic ovaries - but only 13-14 cysts on each ovary which apparently isn't bad (although it sounds horrendous!) which is why they feel I am ovulating each month, albeit rather late in my cycle.

I told the doc about how I ovulate late and get my period fairly soon after, inc spotting, and she proactively used the term 'luteal phase deficiency.' So it looks like they take it seriously which is good. NB she didn't seem overly concerned about the spotting - more that my overall LP length (inc spotting) is 9 days.

I now have a follow-up appt booked to see the consultant gynae 2 weeks tomorrow, to discuss treatment. The doc who did the scan told me there's a good chance I'll be offered Clomid, but due to my 'healthy ovaries' (albeit cysty ones!) they would be a little worried about over-stimulation and/or multiple pregnancy.

So, between now and 19th, I'm going to research my head off about Clomid so that I can ask the doc lots of questions and know what I'm talking about! The doc who did my scan said that I'll also be put on the list for IVF. That's a little scary so I'm not thinking too much about that yet - I'm hoping nature or Clomid will do the trick first!

xxx

greenygrassy Mon 04-Apr-11 19:30:21

Joy Great that you're getting somewhere too and your plan sounds like a good one. I reckon you will get referred and it'll be interesting to see how far you can take it. I was thinking about going back to my GP and getting referred to her for investigations for adhesions (which were suspected by a sonographer who had no idea what she was doing) and weird mid-cycle pains which I think my insurance would have covered, but then I felt like I really wanted someone to look at the whole picture and for someone to do all the fertility tests (ovarian reserve, fsh/lh, progesterone and DH) as I haven't had them done properly before. As you've already had those done at the clinic, and have narrowed down the issue you want her to sort out, it'll probably work really well.

I'll let you know about the progesterone when I've seen her again on Thursday.

Also, she was really conscious of ensuring that I don't have another m/c, which I found reassuring as she's clearly thinking about the whole picture.

I've just realised totting it up for you that I need to look into the £850 figure that her secretary told me I owe today, as so far I think I've (only!) racked up £300 for the consultation, £175 for the ultrasound (thought this would be part of the consultation fee but it isn't) and £175 for hubby's test. So that's £200 short. She said the Thursday ultrasound would be a further £175 and the blood tests would be another £400. I'll let you know on Thursday when I actually pay.

It really does show a huge difference, because, actually my GP was really nice, but clueless, and the NHS consultant was nice, but unwilling to engage with my cycle. I'm really happy I went and DH and I think it's worth the money - for now!

MrsHY1 Great that you're making progress. We seem to have had a similar day today. Maybe we will be Clomid buddies! I've been googling and have been worried by OHSS and multiples too (though after a year of this I'm starting to think that twins would be lovely).

MrsHY1 Mon 04-Apr-11 19:52:43

greengrassy - it's a real conundrum isn't it - I know the statistics about multiples - the complications, how the uterus is designed for one baby at a time etc - but I can't say that it would be bad news if I had twins.

Sounds like you've having a really positive experience with your investigations too...

Interesting what she said about B6 - am still taking a B complex along with my multi vit (as I figured it couldn't do harm) but dropped my B6 high-strength dose ages ago - because my lp that cycle was exactly the same, but ovulation was delayed by 5 days! It could have been a quirk, or it could have been the agnus castus I was taking (also now ditched!) but I didn't want to take the risk of another long cycle.

Yep, hopefully Clomid will be the answer... I really hope so!

joycep Tue 05-Apr-11 09:58:43

Goodness thanks very much Greengrassy, it does mount up doesn't it. I think it may be wishful thinking that i can get this covered and certainly if I need to be put on to progesterone etc, it's not going to fly! I should probably just go straight to Sarah and stop dithering about it. Let me know about your next appt.

MrsHY1 - I'm pleased you have made progress yesterday and that they recognise a short luteal phase. I don't dare touch agnus cactus, I have heard too many stories about it messing up cycles.

I find it interesting that Clomid is being mentioned for both of you even though you ovulate. I guess they have to monitor you very carefully. I wonder whether we just all have lazy ovaries and they need a bit of incentive to move a bit quicker!

Karbea Tue 05-Apr-11 13:29:13

Hello,

According to my cbfm i haven't ov'd yet which makes me think that I must have a short lutual phase which i've suspected for a while.

what vitamins etc are you taking to increase yours? Is it Agnus Castus? anything else?

xx

joycep Tue 05-Apr-11 14:39:19

Karbea - I've tried B6 (100mg) but didn't work. As Greengrassy mentioned above, her gynae has researched it and has found it doesn't lengthen LP although some people on here have said it worked for them so you could try it. As far as i know you have to be a bit careful with Agnus, it can mess around with cycles. Again though it has worked for some people.
How long is yours?

Karbea Tue 05-Apr-11 14:58:46

Joycep Hello smile

My chart is here

I think it averages out at 10 days, but can be 7... I seem to have one longer cycle and then a shorter one, I wonder if I don't ov every other one, but my temps don't suggest that confused

joycep Tue 05-Apr-11 16:46:41

Hey Karbea - Your March 01 and your Jan chart look like 11day LPs but your Feb one says 7 but by temps alone I think it looks like you ovulated 2 days earlier giving you a 9 day lp...obviously i can't see whether use OPKs to suggest otherwise! Apart from the short LP, your March one looked like a good graph. Your temps in your Feb one didn't go that far above the coverline though...but I'm never sure how far above they're suppose to go to suggest adequate progesterone production...
How long have you been trying?

Karbea Tue 05-Apr-11 16:55:58

Joycep Hello this is cycle 6 for us.
Part of the reason for buying the CBFM was to see if I ov at all every other month - I do wonder if I didn't in Feb (lower temps).
I've been a bit lazy with temping this month as I thought the CBFM was definitive but someone in that group said it was just an indication so i think i need to look at that plus CBFM - Ooo gawd why is it soooo complicated! I feel like a bloody chemistry experiment in the mornings!

What qualifies as a short LP then?

I'm really interested to see what happens this month...

How long have you been trying?

joycep Tue 05-Apr-11 17:24:50

Yes I know tha feeling. I am so bored of popping pills and potions and taking temps and peeing on sticks and counting days!
We started trying in May last year so nearly a year. I had an early m/c in July and am now in cycle 10 since then.
Many places say 12-14 days is normal. That's 12 days of elevated temps before AF. 10-11 days potentially can be a problem and many gynaes will acknowledge that under 10 is not great. Of course there are always people out there who will have got pregnant on shorter LPs but it can make things more difficult. Implantation can take up to 12 days and I think I read that the average takes 9.2 days...god knows where they would have found that out! But you can see from this that a longer LP is highly desirable...if an egg did happen to get fertilised, my womb lining would have started to disintegrate by the time of 9.2 days.
But I think it's important to get to the bottom of what is causing the short LP, it could be several factors but getting medical people to acknowledge a shortish LP in the first place is a bit hit and miss!

onedaybaby Tue 05-Apr-11 20:37:33

Hi Everyone,

I am soooooo disappointed. I went to the gyno today and he has said everything is normal. Unfortunately, he did not agree with the theory of a luteal phase defect. He said that 9 months wasn't a long time, I was young (28) and although I may have a tendency confused towards PCOS, my results suggest that everything is fine, and that I am to stop worrying and keep trying. DH is to have a sperm test just to make sure everything is healthy, but at the moment, I am to just carry on and "forget about it".

I wonder what would have happened if he did agree with a luteal phase defect...

He didn't think up to to 14 days bleeding was anything to worry about either. I'm glad the insurance paid this time, as I feel it was a waste of time, and I am no further forward.

I certainly don't want to be told something is wrong, but I would have liked something to speed up the process!

Hi Karbea, I am taking agnus castus. I am going to take it until I have run out but I haven't seen any changes yet. I am also going to do acupuncture for one more month, and then knock that on the head if nothing changes as it is expensive.

Joycep, how did you get on this month? You were very excited at the beginning of the weekend.

onedaybaby Tue 05-Apr-11 20:45:28

Sorry Joycep, that question was aimed a JulesAbs! But how you doing anyway?! xxx

MrsHY1 Wed 06-Apr-11 14:04:38

Hi ladies

OK - so I read something really interesting in Toni Weshler's 'Taking Charge of Your Fertility' last night which I thought I would share - this book seems to have become a bit of an institution for women TTC everywhere...

In a section about BBT charting (basically the core premise of the book) there is guidance on what to do if you don't have 10 or more high temps above cover line and before AF comes. I only ever get 9-10.

She offers the advice that this could be a)luteal phase defect, or b) that the woman in question is a late responder to the progesterone released by the body in response to ovulation - apparently some woman can take 4-5 days to see a temp shift. So, 10 + 4 would equal a much healthier 14 days. Who knew? When I got my kit from Boots it was fairly specific that temp rise is usually seen 24-36 hours after O.

I know a lot of you OPK anyway rather than rely on charting - but this might be useful for those of you who don't. She advises that your 'peak' day of EWCM production should be the main marker of O in this case. Bit difficult when you might not always get that much!

Anyway, sadly I think I'm still stuck with a LPD as in the one month I used OPKs (I soon gave them up as I was sick and tired of seeing negatives...until I did get my positive on day flipping 24) I'm fairly sure the temp shift correlated with the positive OPK - but I might try OPKs again this month just to be sure.

Hope that's helpful to someone! MrsHY1x

joycep Wed 06-Apr-11 14:10:25

Thanks MrsHY - I had read that as well. I was hoping this was me but since combining charting with OPKs, it all corresponds nicely. The only thing that doesn't is my EWCM which doesn't seem to dry up after the temp rise, it is there for a couple or more days. NOt sure what that means.

onedaybaby Wed 06-Apr-11 16:05:39

My EWCM is always at its peak maybe one or two days before my cbfm has its peak. So is the book saying I'm actually ovulating then? I think next month I might not dothe cbfm and conentrate on bd every other day or something.

MrsHY1 Thu 07-Apr-11 14:01:26

onedaybaby - you could be!
My plan for this month is to start to bd every other day from the first day I notice something even vaguely resembling EWCM - and if I get a lot of it (I don't every cycle, but sometimes I do) then bd on that day as well. Maybe twice!
x

Joycep Fri 15-Apr-11 16:36:37

How did you get on with your next appt Greengrassy? I'm seeing her next week. Hoping she can be as helpful with me as you.
Hope everyone else is getting on ok.

greenygrassy Sat 16-Apr-11 13:32:14

Hi Joycep It went well. She told me not to worry about my ovaries any more - they are her concern now!

Last Thursday the ultrasound showed that I'd just ovulated, but she gave me an hcg shot anyway to try to extend the luteal phase. I'm 9dpo so we'll see. She decided against progesterone suppositories this month because apparently they are unpleasant. She's given me Clomid to start on day 2 next month if I'm not pg.

The extra expense was £360(!) for a full screening for DH, £175 each for 2 ultrasounds, and another £300 for hcg, Clomid and my day 2 tests for next month.

Let me know how you get on next week.

How's everyone else doing?

Cloclo15 Sat 16-Apr-11 16:25:40

Can I join you ladies? I haven't been trying for long (5 months) and used opks for the first time in month 4. When I noticed that I started spotting at just 7dpo (af arrived 9dpo) I went to see the doctor. She sent me for a day 21 test in cycle 5. Day 21 turned out to be 4dpo. This cycle I started spotting 11dpo based on opk sticks again (af not started yet) so I thought it was better but blood test results were only 13.6. Doc says I my not have ovulated or that the egg/follicle hadn't matured properly. She is now sending me to the gynae.

Very sad about this and a bit clueless about everything to be honest. Do you think they will give me progesterone to make my test results higher? What does clomid do?

MrsHY1 Sun 17-Apr-11 19:53:01

Hi Cloclo15
Welcome! But sorry to hear about your concerns, of course. I think that progesterone can be given to extend the luteal phase. But Clomid can also be used to balance things out. I ovulate late (day 20-25) and get AF 9 days later (with spotting 4 days before that) so am hoping I can try Clomid to ovulate much nearer day 14 (but I'll settle for anything up to day 20!) with a longer luteal phase afterwards. I'm seeing the specialist on Tuesday so I'll let you know how I get on. Hopefully your gyane will also have some more answers for you x

Cloclo15 Sun 17-Apr-11 20:35:07

Thanks for the welcome I'm a little confused actually, today is 13dpo and af not started properly yet (this is third day of spotting). I am positive I did ovulate last month, I think the blood test was taken on the wrong day and though I might not have reached 30, I think I would have been much nearer that total.

What I don't understand is how I had a 9 day luteal phase last month and (at least) a 13 day luteal phase this month. I thought the luteal phase has to stay pretty much the same?

joycep Mon 18-Apr-11 11:29:26

Greengrassy, that's good. She sounds really helpful and quite reassuring to know that she is looking after your ovaries. Has it given you confidence? I hope she can help plus give me a boost of reassurance as well. I will let you know how I get on. I phoned my insurance today - no chance of getting this on insurance. I was skirting around the issue and they just said, 'are you trying for a baby?'. I could hardly lie! Thanks for prepping me on the costs-if it works, I don't care but when there are no guarantees , it's a lot of cash!

Cloclo - luteal phases are normally the same every month, bar 1 or 2 days. However, some people ovulate every other month and so it could differ and if you are just using OPKs to tell you when you ovulate, these can be very inaccurate as you can get more than one LH surge. You should take your temps alongside opks to get a more accurate picture.

MrsHY1 - I hope your appt goes ok tomorrow. Let us know!

greenygrassy Tue 19-Apr-11 18:38:37

Welcome cloclo. I have similar cycles to you, sometimes longer sometimes shorter, always with spotting. The consultant I'm seeing told me that spotting was a problem, especially when it lasts a few days.

Mrs HY1 When are you starting the Clomid? I'm starting this week right after AF gets me.

joy Looking forward to hearing how it goes. Insurance asked me the same, and I also decided there was no point in pretending. Will defo be worth it if it helps.

I'm on 12dpo which is quite exciting for me! I've taken some internet cheapies and looked at them in soft light, in hard daylight, forwards, and backwards, and occasionally I imagine a line (I think I want it so much I'm actually seeing things), but actually they are white as snow, so I'm going to give myself a biscuit. biscuit

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