CD1 - now I need lots of help and advice please!!!

[chocolate]

Hi, so here is the link to my fertility friend chart (hopefully) My Ovulation Chart (http://www.fertilityfriend.com/home/168edb)


I stopped bfeeding my son before the start of this cycle, the cycle before my lp was about 9 days, I thought it would lengthen this cycle but again its about 9 days. I have PCOS and tend to have delayed ovulation, and ovulate about cd17 to 19 ish.

I am seeing my doctor on Wednesday on cd3, I need lots of info please about lp defects and what to ask for, what to expect, and what not to get fobbed off on!
Ideally I dont want to go down the clomid route, and want something to take this cycle as ttc this cycle. I am UK based too so sure that makes a difference.

Any replied would be really appreciated as I dont know much about lp defects, and Im the sort of person who just leaves it in the drs hands and they are good at persuading me to just see what happens, I had a miscarriage at 12 weeks before, reason un-known but dont want to go through that again if it can be avoided by fixing the lp defect.

[rainbowflower]

do you know your doctor? does your doctor already know about this type of thing?

you might have seen my topic last week when I went to the doctor for the same reason (longest LP has been 8 days), she knew NOTHING about luteal phases/LPD, even though I know a lot about it I still got fobbed off.

hope you have better luck than I do! If they ask, I'd not advise you to tell them that you have researched it online... and make sure you print off all your charts showing it's 9 days and take them with you.

[chocolate]

Thanks for your reply. Last time I went in armed with a folder of loads of info and asked to be referred back to the fertility clinic after my miscarriage and she looked at the folder and said yes straight away lol.

This doctor doesnt know me, she is knew which may be beneficial. She did prescribe me metformin to take but I decided against it as found they lowered my levels too much so thought Id see what happenned naturally.
I will print off my charts and some info. so far I have seen the treatments are : vitamin B6 (can take myself if necessary) clomid (want to avoid this at all costs) and progesterone cream/suppositories until 12 weeks ish which is the method I would choose.

Anyone have opinions on the cream? I will def. be pushing to try the cream, we also want to ttc this cycle and not wait to be referred to the fertility clinic again etc.

Sorry you didnt have much luck with yours, may be worth seeing someone new and take a folder lol

[rainbowflower]

yes it was the progesterone cream/supps that I was asking for too... it seems to be the most sensible option. Clomid would be good too I expect but I don't think it directly alters LP in the same way as the progesterone and it seems to have other associated health risks.

I've actually asked GD's fertility expert what she recommends although I think she hasn't answered so far. Here's the link in case she does reply in time for your appointment: http://genderdreaming.com/forum/showthread.php?6579-Babydoctor-luteal-phase-defect-when-breastfeeding&goto=newpost

thanks for the folder tip ;) I'm very tempted to make another appointment with someone else and give it a try!

[chocolate]

This is the info I found: What is a Luteal Phase Defect or LPD?
Luteal Phase Defect

A luteal phase is the time in a woman’s cycle between ovulation and menstruation. In a pregnant woman, during the luteal phase the fertilized egg will travel from the fallopian tube and into the uterus for implantation. The luteal phase is normally 14 days long and on an average it can be anywhere from 10 to 17 days long. If your luteal phase lasts anything under 10 days it is considered a luteal phase defect. But some doctors believe that if the luteal phase falls under 12 days, then it is a problem. If you conceive and you have a luteal phase defect, you will have an early miscarriage.

A luteal phase defect cannot sustain a pregnancy because the uterine lining in these women begins to break down, bringing on the menstrual bleeding and causing an early miscarriage. There could be more than one reason for the luteal phase defect which can be found out after medical analysis. Going by statistics, the number one reason for a luteal phase defect is low progesterone levels. Your doctor can do a progesterone test on you 7 days past ovulation to determine exactly how deficient you are. Once you know that there are several ways of correcting this defect.
Causes of Luteal Phase Defect

The three main causes of luteal phase defect include poor follicle production, premature demise of the corpus luteum, and failure of the uterine lining to respond to normal levels of progesterone. These problems occur at different times during the cycle but can also be found in conjunction with each other.

1. Poor follicle production occurs in the first half of the cycle. In this case, the woman may not produce a normal level of FSH, or her ovaries do not respond strongly to the FSH, leading to inadequate follicle development. Because the follicle ultimately becomes the corpus luteum, poor follicle formation leads to poor corpus luteum quality. In turn, a poor corpus luteum will produce inadequate progesterone, causing the uterine lining to be adequately prepared for the implantation of a fertilized embryo. Ultimately progesterone levels may drop early and menses will arrive sooner than expected resulting in luteal phase defect.
2. Premature failure of the corpus luteum can occur even when the initial quality of the follicle/corpus luteum is adequate. In some women the corpus luteum sometimes does not persist as long as it should. Here, initial progesterone levels at five to seven days past ovulation may be low; even if they are adequate, the levels drop precipitously soon thereafter, again leading to early onset of menses and hence a luteal phase defect.
3. Failure of the uterine lining to respond can occur even in the presence of adequate follicle development and a corpus luteum that persists for the appropriate length of time. In this condition, the uterine lining does not respond to normal levels of progesterone. Therefore, if an embryo arrives and tries to implant in the uterus, the uterine lining will not be adequately prepared, and the implantation will most likely fail.

Correction of Luteal Phase Defect

Fertility charting is an easy way of detecting whether you have luteal phase defect. If you do, don’t worry because luteal phase defect can be easily corrected. Immediately seek the advice of your physician first before starting any treatments to correct it. In most case, luteal phase defect can be corrected through over-the-counter remedies and/or with prescription drugs.

1. Over the counter remedies for luteal phase defect:
The two main over the counter remedies for luteal phase defect are vitamin B6 and progesterone cream. Vitamin B6 is perfectly safe and can be taken daily in dosages from 50 mg to 200 mg. Taking vitamin B6 every day during the entire month will help to lengthen the luteal phase.

A progesterone cream is usually targeted for menopausal women; however this cream is also useful in lengthening the luteal phase. A cream with natural progesterone works best. Use about 1/4 to 1/2 a teaspoon of progesterone cream spread on the inner arm, inner thigh, neck, and chest - alternating places - twice a day from ovulation to menstruation or until the 10th week of pregnancy.

2. Prescription drugs for luteal phase defect:
The most common prescription drugs for luteal phase defect patients are Clomid or progesterone suppositories. Clomid is taken orally as prescribed by the doctor. The suppositories are taken through the vagina after ovulation has occurred and until either day 14 post ovulation or at some point weeks later during a pregnancy, if pregnancy occurred.


Thanks for the link to your post. I actually had clomid before DS1 and still had an odd first cycle, lp of 3 days! So the clomid didnt fix that ....... so next cycle I had a trigger shot and progesterone, but only once which made me nervous.

I would ring your surgery, explain your situation to the receptionist and ask the head doctor who is the best person to see regarding to knowledge about fertility and lp defects. Someone there may have done extra training or even just has more knowledge or interest in that are.

[chocolate]

PS - would any supps I would take, like saw palmetto, zinc, asprin effect me taking any progesterone etc. or worst case clomid? I wont be mentioning swaying or taking the mentioned above.

Should I take any of them tonight?

[rainbowflower]

that is definitely worth printing off!

I don't know about those supps - never researched them, will be interested to hear others opinions on those

when I did book my appointment I did actually ask to see someone who knew about fertility but the receptionist doing the booking said there were no specialists in that area and that they should all know about it. Maybe it was bad luck I got the only one who didn;t!

[chocolate]

Yeah thats sods law, can you maybe go about something else and then say, also I wanted your opinion on the lp defect as the last doctor had to ask what one was so dont feel too confident Im on the right path.

[chocolate]

Just realised you are in Hampshire - where abouts? Im from Berkshire and used to live in Hampshire :-)

[rainbowflower]

ok, you've convinced me to book another appointment then :)

I live near Southampton, neither DH or I are from this area but it's where the work is (for me anyway) so it's where I think we'll end up settling! where did you used to live?

[chocolate]

Ha Ha, def. worth a go if its something simple that could really help!
Ill pm you where I used to live just incase someone I know stumbles across this lol - am not telling anyone about swaying

[atomic sagebrush]

Gosh I'm so sorry that I did not see this last week. Always feel free to bump up any post that doesn't get answered in a timely manner (esp. when other posts from the same day are getting replies.)

To address a few things from this page:

1)Clomid may take more than one month to correct the LPD so even though it didn't work for you the last time, don't be scared to try it again. It may help you conceive and also sway pink.

2)Metformin sways pink and will also help you conceive, so again, it may be something to reconsider.

3)Agree totally about never letting doctors know that you know anything at all. If you're a sneaky sort, sometimes you can lead them along with leading questions...so you could just be very innocent and say, "I'm having spotting for several days before I get my period, is that normal??"

4)If you do decide to go with the progesterone cream, I really think it's best to go with prescription strenght if you can get it.

5)Saw palmetto cannot be taken with Clomid, Vitex, and Pep Tea but you can take them the month(s) before you do the Clomid and it will still work for you.

6)Aspirin will only help you conceive with Clomid and is actually often prescribed to women on Clomid. Aspirin may help to correct the #3 problem in that essay you posted...may make it easier for a fertilized egg to implant in less-than-optimal conditions.