# Please help so confused about starting clomid



## rosieposey (Dec 5, 2009)

Hi everyone. I am 28 and my husband and I have been trying for our first baby for the past 5 months. My Gp did some bloods at day 19 and my progesterone level came back at 12.1. She said she was unsure as to whether I ovulated or not but I thought I did as i got an LH surge at day 13. Basically my GP practice were doing nothing to follow up and I went to see a gynaecologist privately. He said he didn't think I had ovulated as that figure was a bit low and he would like to see it at 25 and above and he is checking my progesterone levels at day 14, day 19 and day 22  this month and if they are not good I have to get started on clomid next month. what I am really confused about it is whether I am ovulating or not as I have regular cycles ,26-29 days and get an LH surge every month around mid cycle. Looking at different fertility websites some are are saying at 12.1  I have not ovulated and some say I am probably ovulating but not having a "good" ovulation. I would be so grateful for anyones advice as the confusion is not helping as my husband and I are already really stressed by this. Thanks so much!


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## lesleyr (Jul 26, 2009)

any of them could be true hun, unfortuantly u just ave 2 wait n c if the tests come back wae anyhing. If not then its the clomid journey which will help wae ovulation(fingers crossesd). Clomid is a very successfull drug tho it is a hard drug but worth it 2 get a bfp.


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hi there

Progesterone is usually tested on cd (cycle day) 21 but this assumes you ovulated on cd14. Ideally it should be tested at 7dpo (days past ovulation) as this is when it peaks.

When you're looking at varying levels that say you've ovulated, you need to consider the unit measurement used as otherwise it takes completely out of context. Most clinics/consultants will look for a progesterone level of 30 nmol/l or over at 7dpo to indicate you ovulated. Where you've read that a level lower than this indicates ovulation then the measurement was most probably in ng/ml.....10 ng/ml is approx 30 nmol/l.

If you had a level of 12.1 ng/ml then this would indicate you ovulated, if you had a level of 12.1 nmol/l then this is under what would be good ovulation but it could mean you were just tested on the wrong day...and if you had this level (12.1 nmol/l) on cd19 then I'd say you were tested too early.

You would normally ovulate around 36hrs after an LH surge but it can be anywhere between 12-48hrs.

It's good that you have regular cycles but it's a bit of a myth that luteal phase (from ovulation to period) is always 14 days...it can be anywhere between 10-17/18 days and still be classed as normal. Sperm can live for around 3-5 days inside you but an egg can only survive for around 12-24hrs once released so it's always good idea to have plenty of sex from around cd9/10 onwards for at least a week or more to ensure there is a constant fresh supply of sperm ready and waiting for when the egg pops.

It's really good that your GP is doing these tests for you after only ttc for 5mths....most wouldn't do anything until you'd been ttc for at least a year as it can take up to a year, sometimes longer, for a perfectly healthy couple of conceive. I can completely understand how frustrating and upsetting it is each month but 5mths isn't long in the grand scheme of things, although I'm sure it feels like a lifetime...it doesn't make it any easier I know  ....were you on any hormonal contraception prior to starting ttc ?

I'm assuming you're using OPK (ovulation predictor kits) if you're checking your LH surge but maybe you could consider charting your temperature, cervical mucus (cm) and cervical position (cp)....all used alongside one another can help to give a clearer picture of what's happening.

A couple of good books for when you're starting ttc are:

"Fertility & Conception" by Zita West

"Taking Charge of Your Fertility" by Toni Weschler (and the website www.tcoyf.com )

and some useful websites for charting temps, cm, cp etc...

http://www.fertilityplus.org/faq/bbt/bbtfaq.html

http://www.webwomb.com/checking_cervical_fluid.htm

http://www.webwomb.com/cervical_mucus_page.htm

http://www.webwomb.com/cervical_position_frame_page.htm

http://commons.wikimedia.org/wiki/Image:Cervix_checkup_(no_description).svg

You may also want to look into complementary therapies such as reflexology and acupuncture.

Hopefully the further tests this month will give a better idea of whether you're ovulating and hopefully you won't need to move onto fertility treatments and drugs such as clomid....but if you do then you'll find lots of support and advise from the ladies on here 

Fingers crossed that your ttc journey is a short and fruitful one 
Take care
Natasha

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## rosieposey (Dec 5, 2009)

Thanks to both of you. I came off the pill about 8 months ago and have had a period every month since. The lab results didn't say what they measured the progesterone in ( I am a nurse so I can see my lab results at work) but my GP says the lab normally put a note beside progesterone if they think ovulation has occurred. 
The gynaecologist works for my trust so I presume he knows what units the labs measure in and if that reading is a bit too low.

He seemed really positive and said he was testing me over 3 periods to make sure he covered the likelyhood of the progesterone being high, but he seemed to be of the opinion that there was no point not going on clomid if I am not ovulating as he said "there is no point". I am a bit nervous to get these results back as I always assumed everything would be ok and naively thought because I was still quite young to start trying everything would be ok. I just went to my GP because my period went a bit erratic after the death of a loved one and didn't expect to get told there is a chance I may have problems. 
Thanks so much for explaining things better to me, hopefully everything will be ok.


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## mandinka (Oct 19, 2009)

Hi there,


I was interested to read your post as I have just been prescribed clomid. I am anxious about starting this course of medication and I too am looking for any information or advice.

Your post caught my eye as I have just had a very similar progesterone result. My Day 6 blood test was fine but the day 21 was low. On the one hand I am quite pleased to have this result as this may be the answer for me after trying to conceive for 3 years. (After an op I now have one tube and one ovary - a chance of adhesions/blocked tubes??) Perhaps this will mean that I don't need to go through any investigations such as the dye test or laporoscopy (which is the next course of action).

On the other hand, I have been prescribed clomid after only one test and it wasn't within the same cycle as the other blood test. Also, looking back, I think my period started quite soon after - is this blood test reliable? Is it OK to take clomid if you are ovulating?/ovulating sometimes? Oh yeah, and what does a 'good' ovulation actually mean... biology-wise? 

I was confused to know that I may not be ovulating as I have a period every month.  Is my biology wrong? I thought that if you hadn't ovulated, you wouldn't have a period??

I picked up the tablets and they're here waiting for day 2 of my cycle. I go back to the hospital after trying clomid for 4 months in order to have my progesterone tested again. I hope I don't get any of the notorious side-effects!!

Good luck to you.


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hi mandinka

If you don't ovulate then you can still have a period....your womb lining will still have thickened up during the first part of your cycle because of oestrogen.....but it's progesterone, released from the ruptured follicle (corpus luteum) following ovulation that prepares womb lining for possible implantation and sustains the womb lining.....if no fertilisation/implantation then the womb lining breaks down and sheds......if no ovulation then there is no progesterone released so your womb lining would still shed.

Good ovulation means a progesterone level of 30 nmol/l or over at 7dpo.  This indicates that the egg released was mature (if too immature or too old/mature then may mean no or poor fertilisation).  Also, as I mentioned, progesterone is what prepares womb lining for implantation and if get pg then it sustains early pregnancy until the placenta takes over completely....so you need a good level of progesterone to sustain/support the implanting embryo and early pregnancy.  If the progesterone level is in the mid-high 20's then this could mean that the egg wasn't mature enough when the follicle ruptured (they like to see the follicle at around 18mm minimum and maximum of around 25/26mm).......or it could mean that you were tested at the wrong time.  Progesterone peaks at 7dpo so this is ideally when you should be tested.  Testing on cd21 assumes ovulation on cd14.

It is perfectly fine to be prescribed clomid even if you ovulate naturally....it could just mean that you release more than one egg and ideally you should have some sort of follicle tracking scans to check how many follicles you have developing and how many are dominant/mature.

I ovulate fine naturally and have really good progesterone levels but following 2 naturally conceived early miscarriages in 2005, alternate months decided to go abit erratic so I'd have one month of 28 day cycle, another would be something like 32, then 28, then 29 etc.....but I was still ovulating cd14.  Consultant decided to prescribe me 50mg clomid to help regulate my cycles but also to boost ie release more eggs so more target practise for the sperm !  I responded well and released 2 or 3 eggs each month I was on clomid (6mths total) and my cycles regulated to 30/31 days with ovulation on cd14/15.  

What blood test did you have on cd6 as you wouldn't usually have progesterone tested then....was it your FSH and LH you had tested on cd6 ?

Good luck & take care
Natasha


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## mandinka (Oct 19, 2009)

Thank you for all your help


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