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#1 of 48 Old 12-31-2007, 05:37 PM - Thread Starter
 
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Hi ladies! Just trying to figure out what to do here. I am a late ovulator (CD 20+) and my RE thinks that is responsible for my miscarriages. He wants me to go on Clomid to move up my O date. I am in the process of evaluating my options and was wondering.....

Is there anyone out there who has had (or is having) a successful pregnancy after ovulating late?

TIA! Best wishes to all!

Marine ecologist wife to my kite-boarding soulmate and now a SAHM to Annabelle 8/02, 3 , and finally Willem 12/21/08!
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#2 of 48 Old 12-31-2007, 05:56 PM
 
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I ovulate very late, when I ovulate. I've had this problem for YEARS now. With both ds and this pregnancy, I only got the baby to "stick" by taking progesterone pills. Both times, I had d&c's a few months before conception. I was watching my cycles very carefully and it had gotten past "that point" (35 days) and I wasn't getting af. I called my Dr. and they put me on a 10 day cycle of progesterone to start af. When the progesterone was done, I still didn't have af, but I did have a second line on a pregnancy test.

On months that I didn't take the progesterone, I had a few very faint positives at 35+ days, but then af started. When I took Clomid for a cycle, I got 2 fairly large and very painful cysts on my right ovary.

Best of luck with whatever you decide!

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#3 of 48 Old 12-31-2007, 06:02 PM
 
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I have gotten pregnant twice ovulating around day 22 of 28 day cycles (DD and 1 mc at almost 11 weeks.) I don't know if this out of the norm or not (wasn't trying either time.) With this baby I started taking Vitex and my O day moved all the way up to cd 14 or 15 (it took a few cycles to conceive.) Since Vitex is an herb you will probably have to take it for a few cycles to see the results. Aside from that I would also suggest trying progesterone after O to lengthen your cycle. I am a little leary of jumping straight to Clomid.

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#4 of 48 Old 12-31-2007, 06:03 PM
 
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How long is your luteal phase? I thought that was what mattered most.

With ds1 I o'd on day 70-something. It was day 80-something with ds2. Although with ds2 I had a similar situation as the pp in that I was given a shot of progesterone to jumpstart my cycle so we could start fertility treatments again. When my period never came I found out I was pg.

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#5 of 48 Old 12-31-2007, 06:13 PM
 
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Oh, and for clarification, I have long cycles and what one Dr. called "late luteal defect" (late ovulation, basically) My "normal" cycle (if you could call it that) is about 35-38 days with ovulation around day 25-28. And then if I don't have the progesterone in my system, af takes over and the fertilized egg is swept away.

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#6 of 48 Old 12-31-2007, 06:36 PM
 
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My dd who is 4yo was conceived on CD 30. I had been taking Vitex for irregular cycles and luteal phase defect. My luteal phase had been lengthening but my cycles were still irregular. I was very freaked out and had a progesterone test shortly after I found out and thanfully it was within normal range and I had a healthy pregnancy and baby girl.
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#7 of 48 Old 12-31-2007, 07:06 PM - Thread Starter
 
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Wow! Thank you all so much for the quick responses! I can't tell you how much I appreciate your input.

My RE thinks that my problem is with poor egg quality because my LH:FSH is slightly elevated. This results in less-than-robust eggs and a poor corpus luteum. I think my m/c have more to do with inadequate uterine lining, as my menses have always been light and short (plus I am underweight depite my best efforts). Maybe the two theories are both so related that you can't seperate them?

Well, the RE thinks that Clomid is needed to correct the problem, not just progesterone. He feels that, by inducing ovulation earlier in my cycle, the egg quality will be better. Both of my last pregnancies started to fail 6 days after my first BFP, although the gestational sac with my last one continued to grow when I went on progesterone. Thus I didn't m/c until 8 weeks. Hmmm... what if I had been on progesterone since ovulation??? Could that have made the difference?

Since my last m/c in October, I have attempted to move my O date up with weekly acupuncture. I have not yet seen a difference. I started Vitex last month and I know it may take more time to work. But I am sitting here on CD 33 with no sign of AF in sight. This, and the fact that I don't have all the time and the world to TTC #2 (DH wants to go back to school, DD is already 5, etc), is what is actually making me consider Clomid.... something that I never ever thought I would entertain. I tried to temp this month but you will see from my chart that it doesn't tell me much: http://www.fertilityfriend.com/home/1be3d6 I think the peaks you will see are inaccurate because I took my BBT two hours late on those days or I was sick.

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#8 of 48 Old 12-31-2007, 07:18 PM
 
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I have had 3 successful (and am in one right now, so 4 total) pg from late O. Mine is always VERY late, somewhere between day 20 and 30. With this pg, I never saw any indication of O, using the Clearplan computer. It was my first pp cycle and I just figured I didn't O at all. I gave up watching for O around day 30 but on day 50 I started feeling nauseated. BFP!I ha d a hard time getting pg the first time because I was assuming O around day 14. Once I started tracking it, I found it was much, much later and not reliably the same day each month.
Good luck with yours!

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#9 of 48 Old 12-31-2007, 11:44 PM
 
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From your chart it doesn't look like you O'd at all in that time period... I'm pg now (due in a few weeks) after a late O - cycle day 24 or so, even though I normally O around day 18-20. I can't see why it would matter what day ovulation happens as long as the luteal phase is good. Good luck to you!!
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#10 of 48 Old 01-01-2008, 12:39 AM
 
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Yep, my DD2. I used maca root and vitex to get pg with her after many wonky cycles.

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#11 of 48 Old 01-01-2008, 12:48 AM - Thread Starter
 
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So do you think I could correct a luteal phase problem by just adding progesterone? Or do you think the correction needs to come higher up in the ovaries with Clomid?

Marine ecologist wife to my kite-boarding soulmate and now a SAHM to Annabelle 8/02, 3 , and finally Willem 12/21/08!
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#12 of 48 Old 01-01-2008, 01:51 AM
 
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Me! Me!

I don't know if this will help you, but I only tracked one cycle... and it turns out that cycle I got pg. I O'd on CD 23, and here I am! :

Prior to this my cycles had been mildly-wonky-on-the-long-side, but I wasn't TTC so I didn't pay too much attention. I was really concerned that my LP would be short once I did the research, though.

http://www.fertilityfriend.com/home/1da109

Here's my chart (if I linked it right.....) HTH!

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#13 of 48 Old 01-01-2008, 02:06 AM
 
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Quote:
Originally Posted by ChesapeakeBorn View Post
So do you think I could correct a luteal phase problem by just adding progesterone? Or do you think the correction needs to come higher up in the ovaries with Clomid?
Well first you need to know if you really do have an LP problem. I would start doing some serious temp/mucous charting. Put your thermometer under your pillow if you have to. Someplace you'll remember it as soon as you wake up. Maybe right on top of your alarm clock. Were you charting your CM for your entire cycle? Right now, based on that, it doesn't look like you've o'd yet.

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#14 of 48 Old 01-01-2008, 06:38 AM
 
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I have PCOS and thus a whacked out LH:FSH ratio plus a luteal phase defect (9 days at most). Most cycles I O on my own, though it's not until later in my cycle (CD 20-24 or so).

It took us a year of trying, but my doc was pretty sure that it was my luteal phase that was the biggest problem, not my late O. He said that egg quality does go down, but he didn't want to correct that until my luteal phase was corrected. He felt pretty strongly that as long as I was Oing before CD 25 or so, I was probably okay.

It turns out he was right. The first month I took progesterone to lengthen my luteal phase I got pg. O'd on CD 20 that month and went on to have my DD.

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#15 of 48 Old 01-01-2008, 10:43 AM
 
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I O'd on CD 23 last cycle and got my BFP 9 days later.

I started charting in August and realized I was having a 10 day LP.. I assumed due to DD still nursing. Worried that this might thwart our chances of TTC I read all about the different things ladies were doing on here to lengthen their LP's and decided to go with Vitamin B6 before trying Vitex or anything like that.

It worked like a charm. The first month I took 50 mg and saw no change. Upped it to 100 mg the second month and I had a 12 day LP.

3rd month I got my BFP
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#16 of 48 Old 01-01-2008, 11:12 AM - Thread Starter
 
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Thank you so much for sharing your stories!!

Quote:
Originally Posted by Shelsi View Post
Well first you need to know if you really do have an LP problem... Right now, based on that, it doesn't look like you've o'd yet.
Yeah, I'm not so sure that I did O. I had some cramping for a few days back around the 15th (I thought it was O, but my temps tell otherwise. Plus I haven't gotten my period), followed a week later by spotting which has let up a little bit. That spotting leads me to think that my progesterone is low. I read in the book Taking Charge of Your Fertility that there are 3 kinds of luteal phase problems. Sounds like I may have the last 2:
1) The luteal phase is too short, which means your uterine lining starts to shed in the form of menstruation before the fertilized egg has had a chance to implant.
2) The luteal phase appears to be a normal length, but the amount of progesterone is not optimal to produce an ideal uterine environment for implantation.
3) The luteal phase appears normal, but the progesterone starts to dramatically drop just a week or so after ovulation, often causing premenstrual spotting. Again the progesterone is not high enough to produce an ideal uterine environment for implantation.

So, if I am not Oing until this late (now that I think of it, that happened with my first m/c) AND I have a luteal phase problem, does that mean that both Clomid and progesterone are in order? (If it turns out that I am not responding to holistic methods?)

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#17 of 48 Old 01-01-2008, 12:00 PM
 
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I don't know that we have the same problems but I always have longer cycles, 32-36 days and O is usually day 22-26. What helped me move it up and extend my LP (it was very short) was B6. I took 100mg daily with my normal prenatal and fish oil and I saw results in the second cycle on it. My DD was concieved on day 24 I believe, and this baby was concieved on day 21. I was able to move O day to day 20/21 and LP to 12 days. There is hope! Hopefully you can get things resolved quickly!

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#18 of 48 Old 01-01-2008, 12:23 PM
 
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With my daughter, I hadn't had menses since November, and conceived January 25.

I have PCOS and had irregular, annovulatory cycles. I had started taking Metformin in October, had one 28 day cycle, one drawn out cycle and that is when I conceived. It can be done!
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#19 of 48 Old 01-01-2008, 01:00 PM
 
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Have you had an endometrial biopsy done for luteal phasing yet? if not do one! That is the ultimate test to see whether the problem is your progesterone or not.

Yes, I do think it can be fixed with JUST progesterone but it needs to be enough/right format (such as compounded vaginal suppositories or PIO) and some people need HCG support as well (HCG injections to support the luteal phase).

Have you ever tried Vitex to regulate your cycles?
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#20 of 48 Old 01-01-2008, 01:54 PM
 
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Quote:
Originally Posted by ChesapeakeBorn View Post
Wow! Thank you all so much for the quick responses! I can't tell you how much I appreciate your input.

My RE thinks that my problem is with poor egg quality because my LH:FSH is slightly elevated. This results in less-than-robust eggs and a poor corpus luteum. I think my m/c have more to do with inadequate uterine lining, as my menses have always been light and short (plus I am underweight depite my best efforts). Maybe the two theories are both so related that you can't seperate them?

Well, the RE thinks that Clomid is needed to correct the problem, not just progesterone. He feels that, by inducing ovulation earlier in my cycle, the egg quality will be better. Both of my last pregnancies started to fail 6 days after my first BFP, although the gestational sac with my last one continued to grow when I went on progesterone. Thus I didn't m/c until 8 weeks. Hmmm... what if I had been on progesterone since ovulation??? Could that have made the difference?

Since my last m/c in October, I have attempted to move my O date up with weekly acupuncture. I have not yet seen a difference. I started Vitex last month and I know it may take more time to work. But I am sitting here on CD 33 with no sign of AF in sight. This, and the fact that I don't have all the time and the world to TTC #2 (DH wants to go back to school, DD is already 5, etc), is what is actually making me consider Clomid.... something that I never ever thought I would entertain. I tried to temp this month but you will see from my chart that it doesn't tell me much: http://www.fertilityfriend.com/home/1be3d6 I think the peaks you will see are inaccurate because I took my BBT two hours late on those days or I was sick.
This is the thing I wonder about though: you say you suspect a problem with the endometrium, and your RE wants to start Clomid, which is an estrogen antagonist. This will not encourage a nice fertile endometrium, unless I'm missing something.

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
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#21 of 48 Old 01-01-2008, 02:06 PM
 
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WHen you ovulate shouldn't have anytime to do with getting pregnant (as long as you are able to know when you ovulate). The luteal phase is what is important. My cycles are long and irregular and I ovulate anywhere from CD20to CD32! I've gotten pregnant twice, both times on our first try and both times have been successful (well, the first one resulted in a healthy baby boy and this one I am currently 21 weeks along and doing well). My luteal phases though are consistenly around 13-14 days long, so they are long enough to sustain a pregnancy. That's the key, and having low levels of progesterone is a big reason for shorter luteal phases. I'd try temping and checking cervical mucus. That'll tell you when you ovulated and then you can see how long your temps are up and how high they get (if they aren't high enough that could indicate a problem wiht progesterone or it could also indicate the possibility of a thyroid problem). Good luck!
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#22 of 48 Old 01-01-2008, 02:11 PM
 
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When I ovulate, it is late in the cycle, 25-30 days. With dd I o'ed about cd 28, I think. I did use clomid with this pg because I wasn't o'ing at all on my own. With each round of clomid, my o moved later in the cycle. The first round it was cd 20, the second round it was cd 23, and the third round (successful) was cd 26.
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#23 of 48 Old 01-01-2008, 02:22 PM
 
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RE wants to start Clomid, which is an estrogen antagonist. This will not encourage a nice fertile endometrium, unless I'm missing something.
correct. So unless he also plans on supplementing with estrogen after the clomid is done, then he's probably just creating another problem.
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#24 of 48 Old 01-01-2008, 02:53 PM - Thread Starter
 
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Yes, I argued with my RE about this. I asked "Won't Clomid make the lining worse? Isn't that my problem?" He said that he feels my problem is weak ovulation resulting in poor egg quality and poor corpus luteum and this is why he thinks Clomid will fix it. And he said that thining and hardening of the lining is sometimes a side effect, especially if you are on the slender side (which I am). He said he would monitor the lining to see how I am responding and add something to counteract this effect if necessary.

I am a little confused because I thought the endometrial lining was really built up in the secretory or luteal phase, when progesterone dominates. At least that is what those hormonal rhythm charts show. And in addition, a luteal phase deficiency is caused by progesterone deficiency and this results in a less than ideal uterine environment. I know that my estrodial is okay, as I had that tested on CD 3. But I don't think my progesterone is okay, as it was on the low end of "normal" before my last pregnancy failed. Plus my breasts NEVER get sore and I never have PMS.

kelly, that is interesting that it moved your O day back. My RE wants to use it to move my O date up!!:

NatureMama3, I started taking vitex at the beginning of the cycle. I know it takes awhile to work, but the only change I have seen so far is some spotting that began before Christmas. I am now on CD 34.

As far as the B vitamins, I guess what is in the prenatals isn't enough? I have been on them since July.

Thank you e/o for helping me think through this. This is a wonderful discussion!

Marine ecologist wife to my kite-boarding soulmate and now a SAHM to Annabelle 8/02, 3 , and finally Willem 12/21/08!
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#25 of 48 Old 01-01-2008, 03:02 PM
 
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FWIW, my breasts get VERY sore, etc, but I have low progesterone. I'm just very sensitive to what small amounts ARE there.

The lining is a 2 part process with the estrogen building it up in the 1st half of the cyce and the progesterone joining it in the 2nd half to finish the job. The progesterone can't finish what the estrogen can't start, which is why many REs use something estrogen-wise after the clomid to help boost the lining.

What dose and form of vitex are you using? If you aren't breastfeeding you could use a higher dose for quicker results (don't go too high though) and if you are using an infusion or tincture it will work better than the powdered herb in a pill.

Extra b vitamins (I usually took a B-100 complex) really do help with LPD, it's a harmless enough addition.
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#26 of 48 Old 01-01-2008, 10:06 PM - Thread Starter
 
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Hmmm, maybe the lack-of-sore-breasts thing isn't something to worry about. They used to get sore, but they kinda stopped somewhere along the way.

I take one 400 mg capsule of Vitex fruit twice a day. I tried to increase the dosage, but I would get awful headaches when I tried.

So many RE's back up Clomid with estrogen. For those people, would they add progesterone too? I know that my RE has a strict schedule of bloodwork and ultrasounds to monitor the situation, so I guess he would know how I was responding...

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#27 of 48 Old 01-01-2008, 10:09 PM
 
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I think any RE worth his money would back up with progesterone too!

You might try vitex tincture or using the whole berries in an infusion instead of the pills. They really are more effective that way and with less unsavory side effects.
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#28 of 48 Old 01-02-2008, 10:49 AM
 
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For both of the pg I charted, I got pg after day 20+. I'm pretty sure my first was similar, since my cycles then averaged 37 days. I've never had a m/c. It did take me awhile to get pg with my first, but ds2 and #3 were both conceived on the first try. I think the probs with #1 were more due to general health (I was at my heaviest) and not timing things correctly.

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#29 of 48 Old 01-02-2008, 01:14 PM
 
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Hi there, I usually had "regular" 28 day cycles, but on the cycle when I got pregnant with DD I randomly ovulated on CD21.
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#30 of 48 Old 01-02-2008, 01:47 PM
 
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currently 9 weeks into a healthy pregnancy (knock on wood)... and I ovulated around CD 21. I ovulated later with my DD too.
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