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Post by puddleduck on May 6, 2007 14:45:10 GMT -5
Hi,
I've been charting my basal body temperature for 3 weeks now and have been using the USP natural progesterone, too. I appear to have a short luteal phase (8 days) inspite of using the cream.
(Background: endo on front and back of uterus and significant thick white scarring on uterus and ligaments, plus endo on uterosacral ligaments and on left fallopian tube. Multiple ovarian cysts on left side Adhesions on back of uterus Retroverted uterus Tubes are patent (checked with dye) Two ops Oct 06 and Jan 07 removed all endo & cysts except the dense scar tissue)
I wonder whether this means I'm going to need to have IVF if/when I meet a man I want to have kids with...Is this something I should be aiming to deal with now instead of trying to deal solely with pain control? Does anyone have any words of wisdom?
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Post by ouchy on May 6, 2007 16:55:53 GMT -5
I wonder whether this means I'm going to need to have IVF if/when I meet a man I want to have kids with...Is this something I should be aiming to deal with now instead of trying to deal solely with pain control? Does anyone have any words of wisdom? Many women even WITHOUT endometriosis have low progesterone and LPD. IVF wouldn't have anything to do with helping out LPD, except for the progesterone injections. To sustain a pregnancy, you'd likely need progesterone supplementation, either suppository or shot. It's an easily remedied fix!
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Post by ouchy on May 6, 2007 17:45:34 GMT -5
If this is your first cycle charting and you're also using the progesterone cream, you might try not taking the cream and see what your LP is like without it. I know the cream actually makes some women start their periods (possibly by reducing their progesterone if their progesterone was fine to start with). Also, if it stays wacky, you might talk to you doctor about only taking the cream from ovulation until menses (to better mimic what your body naturally does w/ progesterone. That's how my doctor told me to take it, and I went from anywhere from 5-7 day LP to an average of 13 days...but I could see by my charts before taking the cream that I had LPD.)
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Post by puddleduck on May 7, 2007 5:19:02 GMT -5
Thanks, Ouchy. It does seem common sense to see what the luteal phase of my cycle is like without the nat. progest. and then try using it from ovulation onwards. I'm torn between doing that or using the cream as prescribed to damp down endo & cysts (not to mention pain) because I realise any more active disease can lead to further scarring and compromise my already fragile fertility. I think you're right that I should discuss it with my doctor.
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Post by ouchy on May 7, 2007 12:29:16 GMT -5
If you do have LPD, I'd consider that a bigger fertility hurdle than endo, though it is thankfully easily remedied . MOST of the people w/ endo are fertile, and even people with stage IV have been widely known to conceive (though not all, of course). However, if your LP isn't at least 10 days long, you hardly have any chance of a successful full implantation. BTW, did you have your mirena removed? (Sorry if you have already posted this somewhere.)
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Post by puddleduck on May 7, 2007 13:47:23 GMT -5
Hello Ouchy,
I had a 16-day long period (Mirena removed on CD 12) and ovulated on CD 24. From reading about LPD, in many cases it seems to be related to a problem with the endometrium. It's certainly a complicated business!
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Post by ouchy on May 10, 2007 13:31:53 GMT -5
Hi. I didn't see your reply. Sorry. I'm not sure where you were reading, but LPD is a progesterone issue (nothing to do w/ the lining of the endometrium). Having the corpus luteum break down too quickly (it stops providing progesterone to support the uterine lining/endometrium), would cause your period to start, washing out any potential pregnancy.
Basically, if your progesterone falls, your period should begin, which is where the endometrium gets flushed out. Maybe that is what you were reading. The problem is the endometrium breaks down and gets flushed out too early (but that is a result of the corpus luteum breaking down).
**Edited to add: I did find something about where the uterine lining may not respond to appropriate levels of progesterone produced by the corpus luteum. You'll be able to tell by charting, though, if this is the case.
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Post by ouchy on May 10, 2007 13:39:53 GMT -5
Taken from BabyHopes.com ____________________________________________________
What is a Luteal Phase Defect or LPD? Luteal Phase Defect A luteal phase is the time in a woman's cycle between ovulation and menstruation. In a pregnant woman, during the luteal phase the fertilized egg will travel from the fallopian tube and into the uterus for implantation. The luteal phase is normally 14 days long and on an average it can be anywhere from 10 to 17 days long. If your luteal phase lasts anything under 10 days it is considered a luteal phase defect. But some doctors believe that if the luteal phase falls under 12 days, then it is a problem. If you conceive and you have a luteal phase defect, you will have an early miscarriage.
A luteal phase defect cannot sustain a pregnancy because the uterine lining in these women begins to break down, bringing on the menstrual bleeding and causing an early miscarriage. There could be more than one reason for the luteal phase defect which can be found out after medical analysis. Going by statistics, the number one reason for a luteal phase defect is low progesterone levels. Your doctor can do a progesterone test on you 7 days past ovulation to determine exactly how deficient you are. Once you know that there are several ways of correcting this defect.
Causes of Luteal Phase Defect The three main causes of luteal phase defect include poor follicle production, premature demise of the corpus luteum, and failure of the uterine lining to respond to normal levels of progesterone. These problems occur at different times during the cycle but can also be found in conjunction with each other.
Poor follicle production occurs in the first half of the cycle. In this case, the woman may not produce a normal level of FSH, or her ovaries do not respond strongly to the FSH, leading to inadequate follicle development. Because the follicle ultimately becomes the corpus luteum, poor follicle formation leads to poor corpus luteum quality. In turn, a poor corpus luteum will produce inadequate progesterone, causing the uterine lining to be adequately prepared for the implantation of a fertilized embryo. Ultimately progesterone levels may drop early and menses will arrive sooner than expected resulting in luteal phase defect.
Premature failure of the corpus luteum can occur even when the initial quality of the follicle/corpus luteum is adequate. In some women the corpus luteum sometimes does not persist as long as it should. Here, initial progesterone levels at five to seven days past ovulation may be low; even if they are adequate, the levels drop precipitously soon thereafter, again leading to early onset of menses and hence a luteal phase defect.
Failure of the uterine lining to respond can occur even in the presence of adequate follicle development and a corpus luteum that persists for the appropriate length of time. In this condition, the uterine lining does not respond to normal levels of progesterone. Therefore, if an embryo arrives and tries to implant in the uterus, the uterine lining will not be adequately prepared, and the implantation will most likely fail.
Correction of Luteal Phase Defect Fertility charting is an easy way of detecting whether you have luteal phase defect. If you do, don't worry because luteal phase defect can be easily corrected. Immediately seek the advice of your physician first before starting any treatments to correct it. In most case, luteal phase defect can be corrected through over-the-counter remedies and/or with prescription drugs.
Over the counter remedies for luteal phase defect: The two main over the counter remedies for luteal phase defect are vitamin B6 and progesterone cream. Vitamin B6 is perfectly safe and can be taken daily in dosages from 50 mg to 200 mg. Taking vitamin B6 every day during the entire month will help to lengthen the luteal phase.
A progesterone cream is usually targeted for menopausal women; however this cream is also useful in lengthening the luteal phase. A cream with natural progesterone works best. Use about 1/4 to 1/2 a teaspoon of progesterone cream spread on the inner arm, inner thigh, neck, and chest - alternating places - twice a day from ovulation to menstruation or until the 10th week of pregnancy.
Prescription drugs for luteal phase defect: The most common prescription drugs for luteal phase defect patients are Clomid or progesterone suppositories. Clomid is taken orally as prescribed by the doctor. The suppositories are taken through the vagina after ovulation has occurred and until either day 14 post ovulation or at some point weeks later during a pregnancy, if pregnancy occurred.
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Post by ouchy on May 10, 2007 13:42:08 GMT -5
So, I'd say chart your cycles a couple more months before you're sure you have LPD. Sometimes it can take a couple months after going off of hormonal treatments to establish "normal" cycles again. Then, if you see you do have LPD, try to get it treated with the most common remedies--for poor progesterone production or corpus luteum failure. If you don't respond to these treatments, then I'd start to wonder about the uterus not responding. It doesn't seem to be the most common cause of LPD, so try not to worry about it until you have a better understanding of what is going on with your body.
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Post by puddleduck on May 11, 2007 3:55:35 GMT -5
Thanks for such comprehensive information and advice.
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Post by ouchy on May 11, 2007 10:27:59 GMT -5
No prob! Hope it all sorts itself out and you're really fine! If not, it's pretty simple to remedy!
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