# Can clomid be useful to lengthen my luteal phase?



## Missark80 (Sep 2, 2010)

Hi guys, 
I'm a newbie on here.  I've been ttc for a 18 months now with no luck.  OPK's give me a positive result around day 20, yet my cycles are only the average 28 days.  My blood tests on day 21 (progesterone) are about 25 which is not THAT low but I will only just be ovulating around that time.  It's pretty obvious that I can not conceive and form a baby in just a week before my AF arrives.  
I'm feeling really impatient now and am worried that if my GP refers me it will take another year or so to get any real answers.  I am thinking about taking clomid but want to know if it will correct the problem I have.  All other bloods came back as normal.  Please help...........


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hi there

You would need to be prescribed Clomid by your GP or a fertility consultant.  When you say "you're thinking about taking Clomid", has it been suggested to you by your GP or consultant ?  

If you've had a progesterone blood test on cd21 that was 25 nmol/l then this would be classed as borderline ovulation and probably means you ovulated around cd15/16 (or possibly ovulated cd14 but the egg released was a little immature).  They usually look for a progesterone level of 30 nmol/l or over at 7 days past ovulation as this is when it peaks.  Having progesterone tested on cd21 assumes ovulation on cd14 so if you ovulate a little earlier or later than cd14 then you need to be tested accordingly....if you'd been tested on cd23 for instance, your progesterone level would probably be at least 30 nmol/l.

Personally I wouldn't use OPKs as a definite indicator as they only detect LH surge and they don't show ovulation itself. You'd get LH surge prior to ovulation and then usually ovulate around 36 hours later.  

If you're not getting a definite positive on an OPK until cd20 then you wouldn't have ovulated until about cd22 and yet your progesterone level on cd21 was already at 25 nmol/l....in which case I'd say you're OPKs aren't accurate/reliable because from what you mention, you'd have released progesterone before you'd even ovulated if your OPKs were correct...which I can't see how they can be.

Since your cd21 progesterone blood test indicated borderline ovulation at 25 nmol/l, which would suggest ovulation actually happened cd15/16 then if your cycle is 28 days then that's not a short luteal phase....it would be a luteal phase of around 12/13 days...enough for implantation to happen.

It's a myth that luteal phase is always 14 days...it can be anywhere between 10 -18 days and still be classed as normal.  Only if luteal phase is under 10 days would it be classed as luteal phase defect.

Have you had any other hormone blood tests eg FSH, LH, Thyroid, Prolactin ?  Has your partner had sperm test ?  I can appreciate the feeling of impatience but your GP would need to refer you to a fertility consultant for further investigations if there was a problem.  Some GPs can prescribe clomid but many won't because it is a potent fertility drug that ideally requires some form of monitoring.

What other forms of tracking cycles are you doing ?  How old are you ?  Do you have any known fertility issues ?

Good luck and take care   
Natasha


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## Missark80 (Sep 2, 2010)

Hi there minxy, 
Thank you for your post. It was extremley informative. I have had all the other blood tests which have come back normal.  I don't yet have any known fertility issues other than 'low progesterone'.  I just got a result from my 2nd day 21 progesterone test which came back at just 8!
I have been using opk's for the last 4 months and they have always showed positive on day 20 or 21. My af lasts around 10-11 days and my whole cycle is an average of 28 days.  I am not charting in any other way but I do get the signs if ovulation (disharge) a couple of days after my opk+.  
My partner is waiting for an appointment for his tests however he has children already. For this reason, the first gp I saw met me with a very negative response forcing me into doing my own research.  I've read about clomid and have in fact ordered it in case I was dismissed for further treatment.
Luckily I have seen a different gp today who has referred me to a gynaecologist for scans etc so I will refrain from taking clomid for a while. I am 30 year old but my partner is 43 so we need a resolution.
I hope this makes sense.  Thank you again x x


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hi again 

When you say you've just had your 2nd "day 21" results which were 8...what unit measurement was used ? Was this 8 nmol/l or 8 ng/ml ? Were they actually taken on cd21 and if not, what cycle day were they tested ?

What other hormone bloods have you had and what were the levels ? Is there a chance you have PCOS which can cause annovulation or not ovulation at all ?

Sorry, do you mean you've ordered Clomid over the internet ??

Obviously I'm not medically qualified but I would seriously urge you not to take unprescribed clomid. Sorry for saying this and I certainly don't mean to offend but you could be taking unnecessary risks by self medicating, if that is what you'd intended to do. I'm please you've decided to not take it for now but seriously, I wouldn't take it at all without it being properly prescribed.

Firstly, many of these online "pharmacies" are not registered and there is no way of knowing that what you are taking is actually clomid. http://www.drugstory.org/feature/mailorderdanger.asp

"Clomid: Because fertility treatments are pricey and generally not covered by insurance, women go to great lengths to get drugs without paying to see a doctor, says Pamela Madsen, executive director of the American Infertility Association in New York City. The price was right on this batch of Clomid, a synthetic hormone that stimulates ovulation and is one of the cheaper fertility drugs. But "access to infertility medications without physician supervision is a really bad idea," says Madsen. Taking Clomid unmonitored may decrease the odds of getting pregnant while increasing the chance of risky multiple births and even cancer if the drug is overused, she adds. "The risk is very real."

Secondly, if it is clomid, it is a very potent fertility drug and definitely should not be taken without the knowledge of your GP/consultant. You have no idea what dose you should be taking or what cycle days to take it on, you have no idea whether you should be taking it in the first place, there's no way of knowing what your response will be and in turn this could lead to OHSS (ovarian hyperstimulation syndome) which is something you do not want to get !

Please do not consider taking clomid without proper guidance and monitoring as it may do you more harm than good.

I can honestly understand your frustration when it comes to ttc  but at 30, without sounding patronising (definitely not my intention), you do have some time on your side, especially if you have no known fertility issues. Sometimes it can take even the healthiest couple up to 2 years to conceive. It's not easy and every month that goes by feels like forever...I can empathise. We didn't start ttc until I was 34 (with known fertility issues of endometriosis and septate uterus...I do ovulate fine so that was one less hurdle)....I'm now heading quickly for 42, having been on 6mths of Clomid to boost (release more eggs) and 7 IVF cycles with 5 early miscarriages (3 naturally conceived, 2 through treatment)....so I'm not just blowing hot air when I say I understand, I honestly do.

It is difficult when your partner already has children and unfortunately in the UK this means that you wouldn't be entitled to NHS funding for treatment, although you may be entitled to Clomid on NHS, I'm not sure....but you should get it prescribed, not just take it self-medicated.

As for your question about will it lengthen your luteal phase, not necessarily...clomid can lengthen or shorten your cycles...and you may not always ovulate on cd14.

Fingers crossed the consultant you're being referred to will be able to advise your next steps....if you do have ovulation problems then usually their first port of call is to prescribe Clomid anyway so much better to do it the "proper" route with all the monitoring etc needed.

Good luck
Natasha 

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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Just to add....

What cycle day are you starting to use the OPKs ?  If your cycles are on average 28 days and you're not getting a definite positive OPK until cd20/21 then that would indicate no ovulation until cd22/23....and then that would mean a luteal phase of 5/6 days which would be very short.  However, you mention your period is 10/11 days long....how are you calculating cd1 ?  You should only count cd1 as the first day of full flow red bleeding, ignoring any spotting and/or old brown blood...and if full flow red bleed starts after 3pm then the following day is cd1.  

What is the longest cycle you've had ie do you get some that are longer than 28 days ?

You mention you've been ttc for 18mths...is that actively ttc ?  Were you on any hormonal meds prior to ttc such as the pill ?

Take care
Natasha


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## Missark80 (Sep 2, 2010)

Hi yes I was on the pill until 18 months ago when we actively started ttc. I have actually been counting cd1 as the first sign of any blood at all.  The longest cycle I have had had been 30 days but the rest are just 28. I know I am young at 30 but my partner will be a grandfather before he's a dad again at this rate x


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hello  

Your partner is only a year older than me...that is definitely not old !!!!!!  I'm sure he won't be a grandad before you conceive   

As for the pill, it can sometimes take a while for your body to settle down and find it's own natural rhythm after coming off it although I would've expected it to have sorted itself out after 18mths !

If you've been counting cd1 as the first sign of any spotting then you may have been calculating your cycle lengths wrong.

This could mean that yes, you do ovulate later in your cycle but if you count the first day of full flow red bleed, you may find that your luteal phase is actually longer than you thought...as long as not under 10 day luteal phase then although shorter than average, would still be within normal length.

If you're getting progesterone tested on cd21 but not ovulating until later than cd14 then you need to try and get progesterone tested accordingly...so if you don't ovulate until cd22 then get progesterone tested on cd29 which would be 7dpo, the day progesterone should ideally be checked as it peaks at this point.

Without knowing more about your actual levels for the other hormone blood tests and how long your actual cycles are when cd1 is first day red bleed, it's hard to give any guessimate of what's happening.

Hopefully things will get sorted once you see the consultant but maybe worth trying to work out your cycles based on cd1 being first day of red full flow bleed.

Take care
Natasha x


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## Missark80 (Sep 2, 2010)

Aw thank you for your advice, you have been very helpful.  This is all very complicated and frustrating . I hope you're well x


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## Missark80 (Sep 2, 2010)

Btw minxy, now that I have been referred to the gynae, what will happen? Will it involve some dye and a camera do you know? Or will that come later on? I have an appointment at the end of this month x


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hi again

Sorry for late reply.

In answer to your question about initial appointment with consultant, are you being referred to a fertility specialist or are you being referred to a gynae consultant ?

If you're seeing a fertility specialist then your partner should ideally go along with you. The first appointment they will just take your medical history and your partners. You'll then need to get some hormone blood tests done. Even though you've had these with your GP, the consultant will usually want to do their own...obviously these will be done on certain days through your cycle and not necessarily on the day of appointment. Your partner will also need to provide a sperm sample, again, will need to abstain from sex for a few days so probably won't be done on the day of appointment.

Sometimes they will do an internal vaginal scan ("affectionately" known as a "dildo cam" by many of us !!)....some consultants will do that there and then, some will require you to come back for this at another appointment.

Depending on what your medical history, your blood tests and results of scan show, they may suggest you have an HSG or HyCosy to check the patency of your tubes (ie whether fluid flows through them freely) and can also check for any possible abnormalities in your womb such as fibroids, polyps etc. Both HSG or HyCosy are fairly quick procedures as an out-patient and don't require any anaesthetic although you may want to take a couple of painkillers beforehand as they can be uncomfortable.

An HSG and a HyCoSy are similar in that they involve injecting a dye up through the cervix into the uterus and watch to see it spill out the ends of the tubes. An HSG can show obstructions in the tubes & sometimes abnormalities in womb but a HyCoSy is far clearer...an HSG is like having an xray dye and uses radio contrast dye, whereas a HyCosy uses dye but with similar equipment to having a "dildo cam" internal scan ie sonography rather than xray.

http://www.ivf.com/fert_hysterosalpingogram.html

http://www.nufw.com.au/hycosy.htm

If the consutlant feels you need to, then they may advise a laparoscopy and dye.

A laparoscopy is where they look directly inside the pelvic cavity...so see the outside of the womb, as well as the tubes, ovaries etc etc. They can check for adhesions, endometriosis, fibroids etc. This is where they pass a fine scope with camera through an incision in or just below the belly button (and possibly other small incisions around ovary and low pelvic/pubis area). They can then perform micro surgery if required and sometimes they may do this there and then, sometimes they will just perform a diagnostic laparoscopy and if you require any further surgery then another appointment is made for another lap/dye.

With a laparoscopy they can also inject a dye up through your cervix and see if it spills out the ends of your tubes into the pelvic cavity...however, they wouldn't be able to see exactly where any possible obstruction was.

http://www.netdoctor.co.uk/health_advice/examinations/laparoscopy.htm

....and there's a possibility that if you have to have a laparoscopy and dye, they may also perform a hysteroscopy at the same time, whilst your under general anaesthetic....

A hysteroscopy is where they check directly inside your womb for any abnormalities by inserting a fine scope with a camera, via the cervix into the womb (doesn't involve any dye). They can then see inside your womb on a screen (like when having a laparoscopy) and can also perform any surgery if needed eg removal of polyps, fibroids, uterine adhesions, correction to abormal shaped womb such as septate.

http://hcd2.bupa.co.uk/fact_sheets/html/hysteroscopy.html

I wouldn't worry too much about all these further investigations at this stage. Wait to see what consultant advises at your initial appointment and take it from there. I've only ever had 1 HSG which was 22 years ago, following my 1st lap/dye....I've since had 6 more lap/dyes and 7 hysteroscopies but I have endometriosis & septate uterus amongst other things, so unfortunately keep requiring further surgery.

Let us know how your appointment goes.

Take care
Natasha

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