# What are most people's readings from the Day 21 Blood Test?



## babynumber

HI all,
Just thought I would mention that before I started clomid I had a day 21 progesterone test which read 10. 
Following My first month of clomid  my day 21 blood test has now come back at 83.  So thats a huge increase, and Im assuming the clomid is doing something.  I felt pretty rough on the clomid and had terrible mood swings and felt exhausted.  But whether ive ovulated or not I do not know because I never got a positive on the Ov Pee sticks... Its so confusing.
Does anyone know how to interpret these readings?  I know that below 30 generally means you have not ovulated. But i do not know what the high readings mean.  Id be interested to hear feedback and others experiences.
Donna


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## lesleyr

uve ovulated hun so congrats. opk's arent always reliable so i wouldnt pay attention 2 them in all honesty. My 1st results 4 cd21 were bad but late on in cycle i ovulated i know my cd32 bloods were 34.8 so i ovulated late they reckon about cd23. But yeah as u said anything over 30 is ovulation. If ur clinic/doc were worried that ur results were 2 high then thyed have u in 2 talk so dont worry xx


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## babynumber

Thank you!  I keep reading that people know when they ovulated after they have had their blood test at the docs or clinic - what is this test and HOW can they tell what day  I thought the test just told you the level of progesterone.  Is it a different test to this?  I'd be interested to know.


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## ☼♥ Minxy ♥☼ ©

Hi there

The test done on cycle day 21 is for progesterone. Progesterone levels indicate whether you have ovulated...there are no differerent blood tests to confirm ovulation, although a scan can sometimes show that you've ovulated, depending on when you have it afterwards.

When you ovulate, the area of the follicle that the egg ruptures from, becomes the "corpus luteum" (which literally means "yellow matter" or "yellow body"). The corpus luteum can be seen on a "dildocam" (internal) scan and it is this that releases progesterone.

Progesterone peaks at 7dpo so this is ideally when it should be tested. Having it tested on cd21 assumes you ovulated on cd14 so if you ovulate later (or earlier) than cd14 then try to get progesterone tested accordingly.

A level of 30 nmol/l (or >10ng/ml) indicates that an egg was released ie you ovulated and the corpus luteum is releasing a good level of progesterone. Progesterone is what prepares the womb lining for possible implantation of embryo and then if it does, it sustains early pregnancy until the placenta takes over completely at around 10-12 weeks.

Higher levels of progesterone at 7dpo _may_ indicate that you released more than one egg but not always. Unless you had a follicle tracking scan that showed more than 1 dominant follicle (around 18-26 mm before egg popped out) then no way of knowing for sure.

I ovulate naturally with no problems and my progesterone levels have been between 48 and 81 nmol/l on natural cycles (the 48 nmol/l was first natural cycle following IVF and the lowest I've had). I was prescribed 6mths of clomid 5 years ago (50mg) to "boost" ie to release more eggs (more target practise for the sperm!) I had follicle tracking scans for the first 3mths and progesterone blood tests on 1st and 4th month of being on it. The scans indicated I had 2 or 3 dominant (mature) follicles and my progesterone blood tests came back at 103 and 105 nmol/l. Consultant said this shows I released 2 or 3 eggs each time.

There is nothing wrong with having higher progesterone, it just means that mature egg or eggs were released and good level of progesterone for any possible pregnancy.

If you had a level of 83 nmol/l then this is really good. You could have released 2 eggs or it may just have been a really good mature single egg...unless you had scan then no way to know but certainly nothing to worry about.

Progesterone levels can vary quite a bit between cycles and also between women so I wouldn't try and compare your levels month to month, just know that you ovulated. Because progesterone can vary so much it can't be used to determine pregnancy. Some women may have a level of 31 nmol/l at 7dpo and get pregnant that month, others may have levels of 150 nmol/l (or more) and not conceive that month.

As for OPKs, these only detect the LH surge prior to ovulation...they do not show you've actually ovulated and you may get an LH surge (positive OPK) and still no ovulation or you may get a negative OPK that hasn't picked up the LH surge (maybe using it at the wrong time) and you still go on to ovulate. If you have PCOS then they're not reliable and clomid can effect the results too.

Hope that helps explain things a little for you.

Good luck  
Natasha


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## babynumber

Thank you Natasha.  That was a really good description of the prog test - makes sense now!
Although, do you know how some people seem to know what actual day they have ovulated from a blood test? I keep reading it on some posts?  I'm not sure how the clinics/docs work this out? Is it a different test from the day 21 test?
xx


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## ☼♥ Minxy ♥☼ ©

Hi again

No, as I already mentioned in my previous post, there aren't any different blood tests to indicate ovulation, only progesterone.

The only reason some women know when they've ovulated is because they may have had follicle tracking scans which have shown a dominant follicle and from there can be given a rough idea of when to expect ovulation eg if have scan on cd12 which shows follicle of 15/16mm then it's likely that ovulation will be around cd14/15 as they like a follicle to be minimum 18mm before rupturing and they grow around 1-2mm per day.

Some women also track their basal temperatures which can give an idea of what's happening in cycle...looking back over cycle you can see a temp dip just before ovulation and a continuous temp rise after ovulation so can help pinpoint when ovulation happened.  Some women may also check their cervical mucus and cervical position which both vary throughout the cycle and change following ovulation.  And some women get lots of tell-tale pain and symptoms of ovulation.

I know I ovulate on cd14 because I get lots of pain and symptoms plus my cd21 progesterone blood tests have indicated this.  Over the years, I've also done temp charts, checking cm and cp plus had follie tracking scans whilst on clomid and during natural FET.

The blood tests don't tell anyone exactly what day they ovulated, all the progesterone blood test does is give an indication of when it may have happened because if it's 30 nmol/l or above on cd21 then this would point to ovulation being on or around cd14 but it's not exact.

The only way that you could say exactly what day you ovulated was if you had follicle tracking scans every single day, watching the growing follicle until you had a scan on the day which showed corpus luteum ie egg popped out !

Try not to over analyse it all.  You've ovulated, that's the main thing !!!!  You just want to try and ensure you have as much sex from around cd10 onwards, for at least a week-2 weeks to cover all the bases in case of late ovulation.  Sperm can live for around 3-5 days whereas an egg only survives for about 12-24 hours once released so you want plenty of fresh sperm ready and waiting for when egg released.

Good luck   
Natasha


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## babynumber

Ahhhhh... the monitoring scans!  DOH!  I see.  That must be what everyone is talking about. (NOT a different blood test)
I'm not having these scans myself.  But as you say, at least I know i've ovulated on the clomid which is great!. thank you xx


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## Heluerto

normally the top limit is around 90, I've had higher than that, but normally when I've had more than one egg being released.


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## slabberkoekje

babynumber2 said:


> HI all,
> Just thought I would mention that before I started clomid I had a day 21 progesterone test which read 10.
> Following My first month of clomid my day 21 blood test has now come back at 83. So thats a huge increase, and Im assuming the clomid is doing something. I felt pretty rough on the clomid and had terrible mood swings and felt exhausted. But whether ive ovulated or not I do not know because I never got a positive on the Ov Pee sticks... Its so confusing.
> Does anyone know how to interpret these readings? I know that below 30 generally means you have not ovulated. But i do not know what the high readings mean. Id be interested to hear feedback and others experiences.
> Donna


Yes Clomid is exhausting, I also have the mood swings and weepiness. I had a blood test early this month - miscalculated my dates as I ovulated a bit later than usual and my cycle day was in fact 18. My results this time around were 500 oestradiol and 9.8 Progesterone. My Gynae who is wonderful btw said I have definitely ovulated - so u see this was under 30 for the progesterone - but she says anything over 12 on day 21 is good.


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## babynumber

Thank you for that, and good luck to you too. How long are your cycles usually if you ovulate on day 18?  Its amazing how much it varies from person to person.
BTW, please can you tell me what they Pregnyl medication does and when do you take it?  I'm only on clomid, but Ive often wondered how people use the pregnyl?
xx


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## ☼♥ Minxy ♥☼ ©

slabberkoekje said:


> babynumber2 said:
> 
> 
> 
> HI all,
> Just thought I would mention that before I started clomid I had a day 21 progesterone test which read 10.
> Following My first month of clomid my day 21 blood test has now come back at 83. So thats a huge increase, and Im assuming the clomid is doing something. I felt pretty rough on the clomid and had terrible mood swings and felt exhausted. But whether ive ovulated or not I do not know because I never got a positive on the Ov Pee sticks... Its so confusing.
> Does anyone know how to interpret these readings? I know that below 30 generally means you have not ovulated. But i do not know what the high readings mean. Id be interested to hear feedback and others experiences.
> Donna
> 
> 
> 
> Yes Clomid is exhausting, I also have the mood swings and weepiness. I had a blood test early this month - miscalculated my dates as I ovulated a bit later than usual and my cycle day was in fact 18. My results this time around were 500 oestradiol and 9.8 Progesterone. My Gynae who is wonderful btw said I have definitely ovulated - so u see this was under 30 for the progesterone - but she says anything over 12 on day 21 is good.
Click to expand...

Hi there

I would imagine that your progesterone was measured in ng/ml rather than nmol/l. 30 nmol/l is approx 10 ng/ml. When comparing any hormone levels then you need to consider the unit measurements used otherwise takes it out of context.

If you were tested on the wrong day then 9.8 ng/ml would be just under 30 nmol/l........progesterone needs to be 30 nmol/l (or 10 ng/ml) or over to indicate ovulation. Progesterone also needs to be tested at 7 days past ovulation (dpo) as this is when it peaks. Having it tested on cd21 assumes you ovulated on cd14 so if you ovulate earlier or later than cd14 then ideally need to get progesterone tested accordingly eg if you ovulate cd16 then get progesterone tested cd23 etc etc.



babynumber2 said:


> Thank you for that, and good luck to you too. How long are your cycles usually if you ovulate on day 18? Its amazing how much it varies from person to person.
> *BTW, please can you tell me what they Pregnyl medication does and when do you take it? I'm only on clomid, but Ive often wondered how people use the pregnyl?*
> xx


Hi there

Pregnyl and Ovitrelle are an HCG injection. They are given to trigger ovulation. You'd normally ovulate around 36 hours following the injection. It's basically the same hormone as released from an implanted embryo and it stay in your body for up to 14 days. Because it's the same hormone as released from embryo it can cause false positive results on a pregnancy test (and OPKs) if you test too early so always best to wait at least 14 days following the HCG injection before you test to ensure that it's completely out of your body.

Hope that helps

Good luck
Natasha


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## babynumber

Thank you, but why do you need the pregnyl if you are on clomid too?  x


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## ☼♥ Minxy ♥☼ ©

babynumber2 said:


> Thank you, but why do you need the pregnyl if you are on clomid too? x


Because clomid encourages your ovaries to produce follicles but doesn't always mean will ovulate....it's the LH surge that triggers ovulation in natural cycle......some women (like with PCOS) don't get the LH surge because they have naturally high LH levels anyway....so by having the HCG trigger injection, this kicks the follicles into final maturation and then triggers ovulation around 36 hours after the injection.

With IVF, because it's not a natural cycle, women have the HCG injection to prepare all those follicles prior to egg collection (not ovulation).

Even when I've had FET (frozen embryo transfer), on natural cycles, on one FET cycle I had the HCG injection so clinic could exactly time my "natural" ovulation in preparation for doing the embryo transfer.

....and some women have the HCG injection as additional support during the 2ww. Because HCG injection tricks your body into thinking it's already pregnant, it tells your ovaries to keep producing producing which sustains early pregnancy.....if not enough progesterone released ie no implantation of embryo, then the corpus luteum (area of follicle where egg popped out and which releases progesterone) breaks down....this breaking down of corpus luteum causes the womb lining to break down and shed ie period arrives.

If you're ovulating fine ie releasing the egg ok on your own, whilst on clomid, then you may not need the HCG injection...however, some consultants will prescribe it to ensure ovulation/release of egg happens within a certain timeframe, rather than waiting for follicle to rupture of it's own accord as for some women this may not happen.

Hope that helps explain a bit more...

Good luck
Natasha


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## Heluerto

Ok, so this is FAR from normal, but I had my day 21 results back today and they were >190 - apparently they dont test higher than that.  I guess this confirms that all 4 eggs have popped this month.  No wonder I feel so tired!


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## babynumber

WOW! I DIDNT KNOW YOU COULD HAVE FOUR EGGS RELEASED! I HOPE THAT IT WORKS FOR YOU THIS MONTH X


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## slabberkoekje

Hi Baby#2, I'm interested in your case as I am also on Clomid and hav now just finished my 5th cycle of clomid - but no BFP. I was given Clomid 50mg days 3-7 of my cycle then on days 8 and 10 went in to check out my follicle growth. If there were any mature ones (Which there were every time) then I would get the Pregnyl shot - to make sure I released them. I started taking Progynova (For the endometrium lining) around day 7/8 - not before, and this has generally worked every time to build up the lining - as Clomid saps your endometrium a lot. Then we BD from the time of the shot - and for four days - and then I start taking Utrogestan - (Progesterone) to make sure my levels are maintained - and to help keep the lining nice and thick. So from 3/4dpo I am taking - Progynova, Utrogestan and Folic Acid plus a booster shot of Pregnyl 5 days after the first one.

Every time had two to three eggs - this month I tried 3 days at 100mg and 2 at 50 but it still didn't work - got more eggs though - (4) and ovulated alone without the pregnyl. However had booked the nurse to come and give me the shot - as my Doctor had said if u don't ovulate within the next two days you'd better call a nurse to give u the Pregnyl. Well 2 days and nothing on the OPK and then not five mins after the nurse had left - did the OPK just to see if I was ovulating alone and ...big smiley face!!!

My BFN this time was undoubtedly negative (<1 hcg but my Progesterone was good proving that maybe it was just a bad egg that had tried to implant or something.

I am going to try and forget abt all these scans etc - for one month - tempted to try alone this month - maybe just taking clomid......or maybe just taking the Utrogestan etc and no Clomid. I will let you know what the outcome is. Let me know how u feel about your treatment - will you be going onto IVF after? Unfortunately, here in Belgium if you are my age it's not reimbursed anymore -plus I have two children already. Paying ourselves is not an option unfortunately. How long have you been trying for? Did u get preggers quickly with your first child?

Big hugs

Louisexx


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## slabberkoekje

[size=14pt]Hi there baby#2

Sorry it has taken me so long - couldn't find the thread and had forgotten your name!!!!!! I am also in the same case as you - we cannot afford IVF - so not an option - I also got preggers really really quickly with my two - and now it's becoming increasingly elusive this egg that wants to meet sperm and actually implant itself!!!!!

As for your question regarding Pregnyl - is it dangerous if u take it if u have ovulated already? - the answer is no. My doc told me it is perfectly fine -as this hcg jab just stimulates the body to make more progesterone and nourishes the endometrium plus induces ovulation. It also is used (as with me) five days after the first jab - to support the body and keep the hormones at good levels - especally good for those who have had recurrent miscarriages. This last month - I ovulated myself - I know cos I did the test - Clearblue digital - I had never done the OPK test for the other cycles - thinking i wasn't ovulating alone - and needing the Pregnyl to do so. It was my gynae who suggested I test and see if I could actually ovulate alone - and to test over the following two days afer seeing I had four follicles - 11mm,13, 17, 21. She reckoned I had enough oestragen to make my LH peak - without the shot. She did say though - if u don't have a positve in two days then call the nurse to come and give u your jab. Well i got two negatives - and then I called the nurse - and the minute she left I thought I will just check again - and I had a positive smiley face - my gynae told me later that I had in fact ovulated alone.

It must be hard not having the scans - but this month I am also tempted to do without and maybe to try just the clomid to see if three or four follicles can make me ovulate alone. I have a sneaky feeling the follicles being forced to develop quickly - doesn't allow them the time to develop properly. I take my Clomid days 3-7. And you? Aparently if you take the Clomid on the days I do u get more eggs, and I heard that if u take it on days 5-9 the you get better quality eggs but fewer.

I agree - see through bodies would be much easier 

Let's just hope this month letting nature back into the room - will help me produce a perfect egg - we can but try!!!!! 

Hugs - and let's keep in touch - it's really nice us being similar in age and history a little. [/size]


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## babynumber

Hi Louise,

I have some of the Pregnyl at home too.. but I have never used it.

I wonder if you have a 21 day blood test with high progesterone levels (i.e.  80 approx which I had) does this mean that you ovulated for sure?  or just maybe that the follicles developed but maybe the egg didnt ripen?

Also, what days did you ovulate and how long was they cycle in each case.  I'm always interested to know about peoples cycles... because my ovulation is so elusive!  (I think I will try the temperature charting next time).
Great to hear someone with similar experiences to myself.  Yes, Definitely keep in touch.
Good luck xxx


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## slabberkoekje

Hi baby#2 - yes you definitely ovulated having 80 as your progesterone level - The pregnyl you have at home is it for you to give it yourself or your partner/hubby??  My cycle is around 28 days - and I usually ovulate after clomid quite early - it as been around Day 12 of cycle - and once around day 10 - (she said this was rare).  I am also considering the temp charting - sounds quite good - those figures don't lie at least there is no room for interpretation.  If you get the mittelscmerz pain then you are ovulating and you should be having sex around that time....alo fo aout three days after too - to make sure.  I also read something strange the other day - and I am going to try it - a wman said that after three years she ouldn't get pregnant and a friend of hers told her to raise her pelvis for 45 mins-1hr after sex - (not just the 20-30 mins everyone says) and she did it - and she got pregnant.  It's worth a try!!!!!!  Remember my gynae told me that those OPK tests ae pretty reliable and if my friend who was using them and kept getting negatives - then this was most likely because she was simply NOT ovulating.  THEN you need the pregnyl.  She also said to me try the tests for two days if still nothing - then have the shot.  Otherwise it's a wasted month....and follies!!!  Your progesterone level is good - so in my opinion it was a good egg!!! (or 2/3)

Keep me posted!!

Louise xx


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