How do you know if you ovulate from drugs ?

mskeenan

I know this may seem like a silly question but it has been on my mind and figured yall would know the answer . So - I don't ovulate on my own . I have 1-2 periods a year , if that , naturally . I've been doing medicated ovulation induction cycles with femara , gonal f and ovidrel followed by progesterone after ovulation and TI/IUI. How do I know if I have ovulated as I should from the drugs - aside from OPKs and symptoms . Is there a way a doctor would know after the cycle that I never ovulated ??

KidShrink

They can see it from your bloodwork and ultrasound. The corpus luteum (the envelope of the eggs) stays there for a bit and produces progesterone. Most people will ovulate when taking the trigger though although some seem to ovulate later.

Drove2u

My doc can tell I ovulated a week after my iui with my progesterone test.

AdorkablePixie

I wasn't sure the trigger shot would make me ovulate either, because I don't ovulate on my own and rarely get periods. I temp though and my temperature yesterday and today confirmed that I O'd on the day of my IUI. Do you temp? If so, that may help. Otherwise probably the only way you will know is by a blood test or an ultrasound. If you're concerned you didn't O, you could have your doctor check. I had no signs I Od except for cramps, which I assume are from the IUI since it was the same night.

bsckgb7

Your doctor should be doing a Progesterone draw 7dpo and that level will confirm O.  Are you seeing an RE?

mskeenan

Thanks yall for the responses . I am seeing an RE- but after my IUI (day following trigger ) they don't have me come back until I come in for my blood pregnancy test . I'm wondering if they can tell from that test or if they are only testing for pregnancy ? I haven't tried checking temp - maybe I should next month ? I know I'm paranoid but I just don't feel like I ovulated this month . I'm going crazy !!

Drove2u

That's a bit strange that they're not testing you 7dpiui. It's to tell if you ovulate and if your progesterone levels are ok. If they're not ok then they give you meds in case you are pregnant and to have a healthy pregnancy. If you're not ovulating then that's a problem obviously so no point of continuing treatment if docs aren't testing this.

mskeenan

Yah now I'm starting to worry . They do put me on progesterone because my levels are really low (they tested them months ago though ). I wonder if I need to switch docs or advocate to have my blood work down before my beta .

HBamama2B

My RE doesn't test either which annoys me. They can tell from my day 2 BW though based on progesterone levels. It just confirms that ovulation did occur but not when. I temp BC I felt like you and saw that I ovulate late, 4 days after trigger. Ask your RE to add a CD21 progesterone level or confirm with US. They will if you ask.

Drove2u

I would maybe just ask them why they aren't testing you 7dpiui. Maybe there is a good reason for it? Keep us updated. I would be curious what their answer is.

rachlee2010

My re hadn't had me come in for a progesterone check but both months they put me on progesterone after my iui. I think the blood test wouldn't be accurate when you are on progesterone anyway

bsckgb7

mskeenan - Have they EVER done a progesterone draw on 7dpo?  Mine only does the Progesterone draw ONLY if the protocol changed this month.  In other words, I do a Letrozole cycle with trigger, they do a 7dpo draw.  I do the same exact protocol but if my progesterone was good last month (on the same meds), they won't do another one with the next round. 

mskeenan

No they have never done the progesterone draw - but like @rachlee2010 mentioned maybe it wouldn't accurate since I'm doing the progesterone suppositories right after I ovulate ? Ah I don't know . I'm going in to see the doc next Monday (Labor Day ) and if I get a BFN I will ask him about it ! Thanks again for yalls input !!

pmnf26

@mskeenan my RE checked progesterone last month on cd 21 , but he isn't checking this month until pregnancy check. I am also on progesterone supplements this month.. Maybe that is why? Hopefully!

mskeenan

@pmnf26 yah I'm wondering if he has been looking at my precious pregnancy tests . He never mentioned it . Ah I hope I am !!

mskeenan

Actually just checked my lab results from my tests the last two months they don't say anything about progesterone levels . Ugh !

Drove2u

Why are you taking progesterone then if they never checked your levels?

bsckgb7

Progesterone suppositories were added for me this month.  Had a 7dpo Progesterone draw today (so don't think it's the supplemental progesterone making your doc not check). 

But if your progesterone is too low, you won't be able to sustain a pregnancy, so seems very odd. 

riveridgional

My RE automatically picked a day to begin progesterone after my trigger shot. I had no testing later to confirm O. The vast majority, like 99%, of people ovulate within a certain time frame after the shot (I'm blanking on the number of hours but I want to say 42 or 46), so I imagine the REs don't see the need to do a confirmation. And, from what I've been told, additional progesterone can't hurt.

If I'm remembering correctly, I triggered on a Saturday morning and started progesterone the following Monday night.

bsckgb7

36 hours after trigger is the average O time.  I started progesterone about 36 hours after IUI.  IUI on Friday morning, Progesterone on Sat night. 

riveridgional

Also, I'm pretty sure the trigger shot will disrupt your temps, so that may just stress and confuse you more. My RE told me he hates temp charting as he finds it only adds stress at this stage in the game. You would have already obtained any helpful information from the chart to assist with diagnosis and treatment. Additionally, you'll be waking up in the morning and automatically be telling yourself you're infertile and that's why you need to temp. So, from a postivity and affirmation standpoint, it's probably not the best. Personally, I feel liberated by throwing my thermometer out (aka in the bathroom vanity drawer).

bsckgb7

The trigger shot induces ovulation, which would show a rise in temperature (which is what is supposed to happen).  There is nothing wrong with temping to confirm O.  I know lots of ladies continue to temp, because it gives them peace of mind. 

mskeenan

Hmm... yah I am so confused. I feel silly for not asking my doctor why he was putting me on the progesterone before confirming I needed it with a blood test. I have a lot of questions for him next week. I have stayed away from taking temp in the past just because I saw it as an added stress. But could be of good use in the future if the doctor isn't recommending additional blood work

Whiggrrl65

My RE told me that the progesterone suppositories will not effect blood levels because the hormone goes right into uterus.  So for all of us on the suppositories, maybe the 7 day blood test is to check ovulation rather than progesterone?  I'm taking a total guess here as they always have told me it is to check progesterone.

Also, I have not tempted at all but based on everything I have read, I think I am going to start if I don't get my BFP this month--even with taking the trigger shot every cycle. 

AdorkablePixie

@Drove2u Most REs prescribe progesterone just to be safe. It thickens the lining of the uterus so it makes it "easier" to get pregnant and sustain the pregnancy. I feel like 9 out of 10 doctors prescribe it. I started on it the nig of my IUI even though my last follicle check before my IUI my lining was great.

@riveridrional I love to temp. It doesn't make me feel like you said at all, it makes me feel slightly in control. The trigger shot didn't mess with my temps. I was actually able to confirm O, which happened the night of my IUI, so my IUI was good timing! I think everyone feels differently about temping, to me it's helpful and doesn't stress me out, but I could see how it might stress some people out.

@mskeenan My doctor doesn't do a blood test to see if I O'd either. I guess they figure they don't need to because most people who take the trigger shot O. I'm not sure the thinking on that.

Drove2u

Interesting about the progesterone. My doc has given me the suppositories as a just in case but so far I have not needed them as my levels have been a-ok. Although I will find out tomorrow if it's still ok.

bsckgb7

My levels have always been great on Leztrozole and never recommended progesterone.  Now with follisitim he added Progesterone (even though it doesn't look like I needed it on previous cycles).  My progesterone draw yesterday was almost 40. 

I have also heard the suppositories don't show up in the bloodwork either, but that's more than double what mine normally runs.  So some of has to be showing up.    

I agree with AdorkablePixie about temping.  I like it. 

agriffin92013

@mskeenan My RE has me come in for progesterone blood work.  We must be on the same time frame. I had my first IUI Aug 24th.  We tried TI first. I test Monday except he has me do a HPT then come in if I get a positive or call when AF makes her appearance. 

HBamama2B

I got a similar dismissal in temping from my RE. But I agree with pp above. Mine has been really good at showing that I don't ovulate with in 36 hours of the trigger and made me feel better because it corresponding with other O symptoms and made me feel less like I was imagining things. My charts are very clear in pattern despite meds.

AdorkablePixie

@Drove2u I wish I didn't have to take the suppositories! But I will do what I need to do if it might help me get pregnant!

@kgbbsc7 I don't see how it wouldn't shot up in the bloodwork, at least a little bit. I mean, if it is going into our bodies and increasing our progesterone, shouldn't is show up? I don't know.. I'm not a doctor. Just my thinking. lol Or maybe it was just really high because you had a strong O?

@HBamama2B My temps didn't seem to be too affected by my meds either, not a lot anyway. I could still see a pattern as well. Plus my temps were always all over before meds anyway. lol

bsckgb7

AdorkablePixie - what Dr. Google says, is that because we shove up there, it's not getting directly in the blood stream (like a shot would).  So that's why they say it doesn't "show up".  That being said, I think logic tells up some has to get in the blood stream through absorption. 

I take it to mean that MOST of it stays where it's suppose to but there will be some "leakage" into the blood stream. 

Also, if it doesn't get into the bloodstream and stays in the uterus/cervix, then why on earth does it might make me feel like shit!!  So, all that to stay, I think a majority stays where it's supposed to, but some leaks into the bloodstream giving you the crazy pregnancy symptoms. 

But it could be strong O, but I still say logic says some of the blood-work is Progesterone. 

AdorkablePixie

@kgbbsc7 That's a good way to look at it. You're right about the symptoms. So far all I have are slightly sore nipples. Hopefully it stays that way but who knows, I am only on day three of the suppositories!