Any advice/opinions?

[RossieH]

Just posted this on TTC - just realised it should probably be here!!!
Hi all,

I'm new to this forum so would like to say Hi!
My story is:
Have a gorgeous little DD who's 21 months old. She was conceived easily - 4 months off BCPs, 2nd month using OPKs.
Have been TTC #2 for almost a year. Have been using OPKs since we started and noticed after a while that I have a short luteal phase - 8 or 9 days max. Went to my OB who said that while I might read a lot about luteal phase defect, there is a large school of thought that does not believe a short luteal phase is linked to infertility and to keep trying and he ordered some tests (Day 3 bloods, HSG for me, SA for DH). All tests were normal.
Had a follow up session with him yesterday and he's referring us to a fertility clinic.
Appointment with the clinic is next Wednesday.
While I know in the overall scheme of things a year TTC is not that long, I really feel the short lp is not helping. Gut instinct I suppose. At times I feel positive about it all - other times I'm down - a lot of my friends who had babies the same time as me are pregnant with the second - and they all seem to fall pregnant at the drop of a hat!! It's hard!
So - has anyone out there been treated successfully for lpd or even heard much about it??!

Rossie

[Seedlings]

Hi, and welcome. I really do not know much about lutal phase defects. Do you think there is to short of a time between o and af?

I can say you will learn a lot about your cycle from your re or fertility specialist. It is amazing how much I have learned about my cycle. They will monitor you from day 3 up until af shows. Good luck with your appointment and let us know how it goes.

[RossieH]

Hi Seedlings!
Yes - the general consensus is that the length of time between O and AF needs to be at least 10 days so that a fertilised egg has time to implant. Some doctors think it's causes by low progesterone, others think it's more complicated than that, some don't think it's a big issue!
It's all a bit complicated!!!!
Hopefully the RE will have some answers!
Rossie

[RunnerDuck]

A short luteal phase IS a problem when it comes to TTC... but it's kind of a chicken or egg type thing.

Are you unable to get pregnant because of your short luteal phase? Or is the short luteal phase due to poor egg quality which is the more important underlying cause of infertility?

You can treat the problem a few different ways... the best way, of course, will depend on the source of the problem. If you are making good quality eggs and just, for some reason, your corpus luteum is not living as long as it ought to, progesterone supplements can help with this problem. It's a cheap, easy, can't-hurt-to-try-it fix.

The problem with this is it won't address poor egg quality, if that is what is making your luteal phase short, and if your eggs are no good, you won't get/stay pregnant. Sometimes different medications can be used to induce ovulation in the hopes that a better ovulation (better quality egg) means a better luteal phase and a better chance at pregnancy. Usually clomid is the place to start...

Often progesterone supplements are used when fertility treatments are used "just in case."

Hope the fertility doctor is able to come up with a plan for you that will work soon!

[RossieH]

Thanks Runnerduck!
Do you know if "egg quality" would have been measured by the Day 3 bloods I had done or if they just tell whether or not I had egg reserves - my OB told me my "ovarian reserves" were good - think this is based on FSH and LH levels?
Do you know if egg quality can be measured?
Thanks!

[RunnerDuck]

Well the only real measure of egg quality is a successful pregnancy...

Egg quality is not exactly set in stone. You have your eggs... and that accounts for part of it... but the hormonal conditions in your body while they develop/ripen in a particular cycle matter, too.

Day 3 blood draws are usually going to be LH, FSH, and estradiol. You don't want LH that is too high as that indicates PCOS (and maybe other problems, I don't know, PCOS is my problem so I know too much about it). If your LH is high and out of whack - you're probably just not likely to ovulate. You don't want estradiol to be too high and you don't want FSH to be too high because these things indicate diminishing ovarian reserve. We are born with all the eggs we will ever have, each resting in a little follicle in our ovaries. Our brains put out FSH to stimulate the follicles. As the reserves drop, the brain puts out more FSH - and if the brain is having to work harder to make the ovaries listen, then it likely means the egg situation isn't looking so hot.

So... you want low FSH. But it's not the whole picture. It means you have a good chance, though.

Now another test you can have done is a day 21 progesterone draw... which should probably be 7 days past ovulation, not day 21 as a hard and fast rule. If you don't ovulate until day 22, than a day 21 progesterone level isn't going to tell you much. A nice number at this blood draw - lab normal is over 10, real life normal I'd say you want more than 15-20 - the higher the better - indicates a nice quality ovulation. If it is low you can supplement with progesterone IF you are sure ovulation has occurred - and this may or may not save a pregnancy - again it comes back to whether or not the egg was a good quality.