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Trying to Conceive

by Danielle
(Reno, NV)

First let me say that your website is very helpful. I am 30 years old and have been trying to conceive for 6 months. The first month I just counted about 14 days in, thinking that was the normal ovulation time since I am on about a 28-30 day cycle on average. The next month I started using ovulation predictors and realized I wasn't having my LH surge until about day 16 which meant ovulation was about day 17 or 18 making my luteal phase 10 days or so...way too short.

I went to my OB/GYN who said don't worry about it and that luteal phase defects are still medically unproven. She didn't want to see me until we had tried for 1 year. The old brush off. So, I went to an accupunturist who said my luteal phase was was too short and I needed progesterone. Day 25 of my cycle, 7 days after ovulation it was only 7.1. Day 6 of my cycle it was only 0.2. I started using 100mg compound suppositories last cycle. I ovulated day 18 and started using it day 19. My luteal phase was 18 days making my cycle about 36, longer than normal. My temp stayed up the whole time during the luteal phase, which before it would be up for a few days then do a saw pattern of up and down. I really was getting my hopes up that I was pregnant since I was so late, but I started my period. It was 1 day of thick heavy black gel type discharge. Abnormal for me.

My questions are - does the progesterone change your period consistency? Should my luteal phase lengthen that much? Is 100mg enough? I just want to make sure I am maximizing my conception chances. Thank you for any input.

Comments for Trying to Conceive

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Jan 25, 2011
 Add to discussion
by: Danielle

I forgot to add that after being on the progestrone my levels went to 13.1 which was done 7 days post ovulation. Thank you for any comments.
Jan 26, 2011
 Trying to Conceive
by: Wray

Hi Danielle Thanks for the kind words. I'm finding more and more women are taking matters into their own hands now, as so many get the brush off as you were. It also helps me so much having all the details you've gathered together. Firstly I've found a luteal phase defect has a significant effect on falling pregnant. Back in 1982 they were using the term, see here, here, here, here and here. There's a possibility that thyroid autoantibodies could bind and block LH/CG-R in the corpus luteum, which would imply a defective luteal phase, see here. Another paper mentions 'reduced corpus luteum function', again implying a defective luteal phase, see here. The luteal phase should last 12-14 days, if less, insufficient progesterone has been made to prime the endometrium for a fertilised egg. Making implantation improbable. If it does take place, the low level would not support the embryo and rejection would occur. The discharge you experienced was from oxidised blood, which indicates the lining was not shedding fully each month. This would make implantation difficult and might account for the problems you've encountered. When first using progesterone it can lengthen or shorten a cycle, it usually settles down within 2 to 3 cycles. I do recommend 100-200mg/day, dependant on symptoms. MMP?s are enzymes that break down protein. They play a role in the breakdown of endometrial tissues at the end of the menstrual cycle. Progesterone suppresses MMP's. So it?s only when progesterone levels drop at the end of the cycle that the MMP?s can get to work and break down the lining causing our monthly bleed. If you increase to 200mg/day, and there is still old lining present, the large drop in the progesterone level should 'flush' it away. If you follow this, I suggest you stop the suppositories on day 14 after ovulation, you should bleed within a day or two. It's always best to use progesterone a minimum of twice a day, as levels drop after about 13 hours. We do have a page on Pregnancy, it explains the use of progesterone before and after conception. Finally please have a vitamin D test, this is critical for ovarian function and pregnancy. For more info see the Vitamin D council website. Take care Wray
Feb 07, 2011
 Should I lower my dose?
by: Danielle

Thank you for your reply and yes, my vit d was quite low. I have been on 2000 IU for over two months. My last two cycles have been about 36 days with the phase days equally split 18/18. This far better than before the progesterone when it was 18/10 for a 28 day cycle, but I am wondering if 100 mg is too much. These cycles are too long. Is there anything I can do to help my cycles become more of the normal standard of 14/14 or 15/14? I am passing more of this thick goop and I am wondering how much lining is built up in there from years of low hormones. We have been trying to conceive for awhile and would like to be successful soon.

:-)
Feb 24, 2011
 Should I lower my dose?
by: Wray

Hi Danielle Firstly the vit D, please increase your dose to 5000iu's per day, 2000iu's is not sufficient to bring the level up. You might find this makes all the difference to ovulation. A lack of vit D makes this improbable. Although you don't have PCOS, please read through this page, as it gives advice on why ovulation doesn't occur, and what to take to help the ovaries. You might like to see this video by Carol L. Wagner, M.D. on Pregnancy and vitamin D. I don't believe the 100mg/day is too high, in fact it could be too low. You should be using progesterone twice a day too, as levels drop after about 13 hrs. I'm pleased you're passing more of the 'goop', as it means your uterus is cleaning out. So don't try to fall pregnant until you have clean, red blood coming. 36 days is only slightly long for a cycle, the normal range is 21 to 35 days, making 28 days the average. So don't concern yourself about trying to get it to 28 days, this is no more normal than 21 or 35 days, see our page on How to use progesterone cream. Don't forget that progesterone does increase or decrease a cycle, it does right itself given time. You might find it easier using a mini microscope to check for ovulation, see here. Take care Wray

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