Day 21 Results - Progesterone Low - what can I do

[Beena]

Hi there


I just had my day 21 results back ad it was 22.9 on exactly day 21 (7 days after OV) which I know as am using a clearblue fertility monitor. Is this too low to get pg and maintain a healthy pg? Can I do anything to make my progesterone higher like progesterone creams or suppositories or anything? Can't talk to my consultant about the results until Monday as he is away so just hopeing to find out some info before then as I'll go mad with worry otherwise.

Been ttc for 15 months now, had hycosy and tubes fine but some little cysts on my ovaries. Day 3 results normal.

Any help or advice would be wonderful as am worrying myself sat here now.

[AttilaTheMeerkat]

Hi

At 15 months ttc there is likely to be a problem preventing conception.

Do you have a diagnosis of the underlying problem?.

Did they comment re the little cysts on the ovaries?. I ask this because these could be perhaps seen as polycystic ovaries. These are ovaries which have multiple cystic follicles on them. Some of these follicles contain eggs, others are dormant and yet more release hormones. These can cause problems with ovulation (they can give rise to irregular periods for starters) and may be the root cause as to why ttc is a problem.
BTW PCO can be treated if this is the underlying problem but you need specialist help from the gynae.

Would suggest you lay off using the opk's - if PCO is a factor here the kit will just read the level of LH (which in many cases of PCO is higher than it should otherwise be). Therefore they are a waste of time and effort.

Interesting to see that your Day 3 results are "normal" - did they check both LH and FSH and if so did they compare LH against that of FSH?. If they did not do this the test is meaningless.

If your progesterone is awry then LH and FSH are doubtless out of sync as well. LH and FSH are important as these two hormones kickstart the whole ovulation process.

Hope it goes well on Monday. Do ask lots of questions - write them down before you get in there.

HTH, any other questions just ask.

[Beena]

Thanks Attila. My day 3 test results were looked at to see if indicative of PCOS and they weren't at all.

Not had a diagnosis of the underlying problem at all and not sure if we will get one. When we last saw our private consultant before my day 21 test he said that assuming the day 21 results were normal and indicated OV he would recommend starting IUI in January if we don't have any luck naturally by then. He said if day 21 results were below normal then he would recommend starting IUI sooner rather than later.

What do you think of this as a way forward? I would kind of like to know what the underlying problem is if it can be pin pointed but I guess it may just be very mild PCOS and a result of fairly invasive surgery on my cervix 3 years ago for CIN3 pre-cancerous cells.

LH and FSH levels were normal so surely if my clearblue monitor is showing OV eah month then I am actually OV - do you know if that is right?

Final thing is that I start spotting 8 days after OV and get period 10-11 days after OV which to me seems like a problem with progesterone levels which are therefore causing a luteal phase defect but consultant said there is no such thing as a luteal phase defect as when I do get pg my body will automaticaly produce more progesterone and I won't start spotting or get my period -What do you think of that?

So sorry for the million and one questions but you know what you are talking about and all I know is from what research and googling I have done myself.

[AttilaTheMeerkat]

Hi Beena,

Re your comments:-
"My day 3 test results were looked at to see if indicative of PCOS and they weren't at all".

My first question is was LH compared against that of FSH?. If not, why not?. Results that can appear okay when only looked at separately may hide a problem.

"Not had a diagnosis of the underlying problem at all and not sure if we will get one. When we last saw our private consultant before my day 21 test he said that assuming the day 21 results were normal and indicated OV he would recommend starting IUI in January if we don't have any luck naturally by then. He said if day 21 results were below normal then he would recommend starting IUI sooner rather than later"

I would try and get to the root cause(s) of the underlying problem. I cannot see why a cons would push a regimen of treatment forward without a diagnosis. He's offering IUI I think because there is nothing concrete. From your latest result of 22.9 this would not necessarily indicate ovulation so I am wondering what he will now propose treatment wise. It may be worth a second opinion.

Initially at least you are far safer going under the NHS. Some private treatment (generally speaking) is poor as well as expensive. I sincerely hope you visited a few clinics and asked lots of questions before going ahead.

"What do you think of this as a way forward? I would kind of like to know what the underlying problem is if it can be pin pointed"

I think you need to have a firm diagnosis.

"but I guess it may just be very mild PCOS and a result of fairly invasive surgery on my cervix 3 years ago for CIN3 pre-cancerous cells".

Or a condition called polycystic ovaries whereby the patient presents only with the cystic follicles. The commonality between PCO and PCOS is the cystic follicles and I note that little cysts (these are really cystic follicles rather than cysts in the usual sense of the word) were found on the ovaries previously. The cervical surgery may not have any bearing on your current ttc problem at all but I think you should talk to a specialist regarding this specific point.

"LH and FSH levels were normal so surely if my clearblue monitor is showing OV eah month then I am actually OV - do you know if that is right?"

What exactly were your LH and FSH levels and have these been checked more than once?. Sometimes hormonal abnormalities are seen only over a period of time. OPK's are beset with problems in their own right; first off these assume that women only have one rise in LH every month and that such a rise is immediately followed by ovulation. Both of these are simply not true. Also if you are one of many women producing higher than average levels of LH (a common problem with PCO for instance) the kit just reads that excess.

"Final thing is that I start spotting 8 days after OV and get period 10-11 days after OV which to me seems like a problem with progesterone levels which are therefore causing a luteal phase defect but consultant said there is no such thing as a luteal phase defect as when I do get pg my body will automaticaly produce more progesterone and I won't start spotting or get my period -What do you think of that?"

Any spotting between periods should be checked out to ascertain the cause - I note you had cervical surgery previously. It probably is nothing serious (sometimes cervical erosions can cause spotting) but it certainly needs looking into further. Do raise this issue with the cons. LPD is controversial; some gynaes certainly do not believe it exists. If your progesterone level is out chances are your LH and FSH levels are awry too. All these hormones are connected.

Let us know how you get on.

HTH

Attila x

[Beena]

Hi Attila

Thanks for all of that info - you certainly do seem to know what you are talking about.

My LH and FSH levels were compared and both GP and consultant said they were normal and didn;t indicate PCOS. FSH was 7.8 and LH was 4.4. These levels ahve only been checked once and that was in May this year. I think I might ask for these tests to be repeated as well as another day 21 test during my next cycle as it wuold be useful to compare.

I feel at such a loss as to what to do. I guess I'll just have to wait until Monday when I'll hopefully be able to talk to the consultant again about what the next ove forward should be.