Sunday, April 20, 2008

Luteal Phase Problem?

I have weird issues about doctors. I was raised to believe that you only go to the doctor when you're in dire straits. So, unless I have an actual, real, tangible problem (ie, I've got a broken bone that's protruding through the skin), I'm reluctant to go. Unfortunately, I will admit that I'm neurotic on the best of days, and sometimes I can't decide whether something is worthy of going to the doctor about. I waffle about whether I have an actual problem, or I am making a mole hill into a mountain because I am crazy. . .I mean, neurotic.

My most recent issue is whether I have a luteal phase problem. I have been both temping and using the CBEFM, so I am quite certain of the ovulation days. Here are my stat's:

1st cycle off BCP: 33 day cycle; O'd on day 21; 11 day LP
2nd cycle: O'd on day 22; Pregnant; miscarriage at 8 weeks; D&C 8/07

I didn't get my period for three months after the D&C, until 11/13/07.

3rd cycle: 29 day cycle; O'd on day 21, 8 day LP
4th cycle: 41 day cycle; O'd on day 28; 13 day LP
5th cycle: 27 day cycle; O'd on day 16; 11 day LP
6th cycle: 31 day cycle: O'd on day 21; 10 day LP
7th cycle: 33 day cycle; O'd on day 23; 10 day LP

I guess if I'm thinking this much about it, I should talk to my doctor about it. If anyone out there has any thoughts in the meantime, I'd love to hear them.


Jen said...

Your fluctuating, somewhat short luteal phase would raise some questions with me. Even with a reasonably consistent LP of about 11-13 days, I had one OB suggest I might have luteal phase defect.

Another thing about your cycles that raises some questions with me is that you ovulate so late in each cycle (although it's great that you do ovulate). I know that some docs equate late ovulation with diminished egg quality, meaning that by that time the egg you finally do ovulate has started to degrade, since it's been brewing since day 1. I don't know that I've ever put much stock in this -- after all, there are a lot of women that ovulate late and get pregnant just fine -- but it can't hurt looking into. Maybe something simple like taking a low dose of Clomid to move your ovulation day up would be all it would take. And adding some progesterone for your LP might help, too.

When you're talking about the fertility of a woman in her mid-30s, I think time is of the essence. But you don't really need an RE just yet. A regular OB can do the early testing and prescribe the things I just mentioned. That gives you some time to look and find a specialist without wasting valuable cycles.

By the way, I know Borneo isn't really the vacation prize that you have your eyes set on, but it's what caught my eye and brought me here from Lost and Found when you started your blog. My uncle used to live/work in Indonesia in the late 70s and he and a friend crossed Borneo with Dayak tribesmen as their guides. Having read the book they wrote about it (never published), I'd vote for another location.

Good luck!

Anonymous said...

I'm with Jen. I think you should make an appointment and tell your OB your concerns. Go in there with notes on when you ovulate and how long your LP is. If your doc doesn't show any kind of concern or doesn't want to do anything about it, find an RE. Your insurance will probably cover it (mine did), and I think you'll feel better knowing that you're in the hands of an RE.

Queenie. . . said...

Thanks, Jen & Manda!

JamieD said...

I tend to lean toward neurotic (spacefuck crazy) myself. When I miscarried, I got the whole spill from my doctor about the frequency of miscarriages and how normal they really are, more than likely it was just bad luck, etc. But that wasn't good enough for me - I wanted ANSWERS. After hundreds of hours with Dr. Google, I also decided I have a luteal phase problem.

Before my D&C, I would O on CD 18-ish, then have a 10-12 day LP. After my D&C I would still O on CD 18-20, but my LP was anywhere from 6-10 days long. For the cycle I concieved, I O'd on day 19, but didn't have implantation bleeding until 12 DPO. From the statisics I found, my pregnancy was doomed from the start.

So last cycle I went and talked to my OB. She started me on Femara (I took CD3 - CD7) and progesterone supplements after O. I O'd on CD 16 and had a 13 day LP - it was the earliest I have ever ovulated and my longest LP to date. Pretty much the perfect cycle, except for the BFN at the end. But I felt like a champ completing a cycle in less than 30 days.

Hope this helps!