Low P4 but positive OPK? — The Bump
Trouble TTC

Low P4 but positive OPK?

I know I've heard this on here.  I'm asking to be clear.  I did OPK's this month, with a bunch of negatives and I got about 3 days where it looked like all could be positive.  One day (same day I went for my P4 test, Day 21) was a very strong and definite positive. The rest of the tests were negative after that day. 

Yet, P4 test came back at a 1.2 and doc says there was no O.  Does that mean PCOS is a possibility?  Is it worth mentioning? Would treatment change if we were treating annovulatory cycles vs. PCOS? 

I know I'm going out on a limb here, but I'd feel more comfortable asking you crazy questions than my doc thinking I am a nut case.

TTC #1 since October 2010.
Dx with Seminal allergy 4/2010.
Low Progesterone (7/2011)
Hypothalamic disorder/Luteal Phase Defect (7/2011)
HSG normal (8/11)
DH's S/A: Normal
IUI #1 (50 mg Clomid + Noveral)= BFN
IUI # 2 (100 mg Clomid + Noveral) October 2011
PAIF/SAIF Welcome
Daisypath Anniversary tickers

Re: Low P4 but positive OPK?

  • You're supposed to have P4 tested 7 days AFTER you ovulate.  Sounds to me like you just tested too early.

    After more than 2 years of fertility treatments, FET did the trick!
    IVF March 2012 - BFP! - Severe OHSS = 8 days in the hospital in kidney failure
    No heartbeat at 10w6d
    FET August 27,2012 = BFP!
    It's a boy!
    My Blog - 3 Dogs, No Baby

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  • I'm confused. Was CD21 also 7DPO? Because that's when your progesterone matters. If a doctor is assuming O on CD14, your levels are going to be way off. I had to chart to make sure I got P4 done at 7DPO. If I'd gone by my OB's "CD21" orders, I'd have wasted blood and time, since I didn't O until CD22 that cycle.

    Taken at the wrong time in your cycle, low P4 would definitely indicate no O.

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    Invisible Finish Line
    3T's Traveling Ovary Blog
    7DPO Progesterone: low. CD3 BW: normal, HSG: clear
    DX: severe MFI (low all 3) and low T. Undergoing replacement therapy.
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  • I have no idea when 7DPO is, because my charts don't clearly show when I ovulate.  So I think he wanted to test at Day 21 because it was a good guess? I don't know? 

    TTC #1 since October 2010.
    Dx with Seminal allergy 4/2010.
    Low Progesterone (7/2011)
    Hypothalamic disorder/Luteal Phase Defect (7/2011)
    HSG normal (8/11)
    DH's S/A: Normal
    IUI #1 (50 mg Clomid + Noveral)= BFN
    IUI # 2 (100 mg Clomid + Noveral) October 2011
    PAIF/SAIF Welcome
    Daisypath Anniversary tickers
  • Should I call and tell them about the OPK and ask to test on Thursday?  That would be 7 DPO if the OPK is accurate.
    TTC #1 since October 2010.
    Dx with Seminal allergy 4/2010.
    Low Progesterone (7/2011)
    Hypothalamic disorder/Luteal Phase Defect (7/2011)
    HSG normal (8/11)
    DH's S/A: Normal
    IUI #1 (50 mg Clomid + Noveral)= BFN
    IUI # 2 (100 mg Clomid + Noveral) October 2011
    PAIF/SAIF Welcome
    Daisypath Anniversary tickers
  • Are you seeing an OB or an RE?  I would be concerned that they aren't testing you on the correct day.  Also, have you have CD 3 blood work and an internal u/s?  Its usually pretty easy to spot PCOS with both.

    Also, have you considered charting?  Charting can give you a good idea when you O and therefore when to have your 7 dpo bloodwork.


    After more than 2 years of fertility treatments, FET did the trick!
    IVF March 2012 - BFP! - Severe OHSS = 8 days in the hospital in kidney failure
    No heartbeat at 10w6d
    FET August 27,2012 = BFP!
    It's a boy!
    My Blog - 3 Dogs, No Baby

    image
    BabyFruit Ticker
  • If you were still getting a +OPK the day that your progesterone was drawn, it won't be valid. Many docs assume "CD21" to also be "7dpo" which very often is not the case. I would keep charting to see a temp rise, and try to get a progesterone drawn 7 days after the rise.

    Started TTC 2/2009
    Started fertility treatments 11/2010
    Ovarian dysfunction, LPD, male factor
    6 failed medicated IUI's
    Pregnant 5/2011 - Miscarriage at 6 weeks due to triploidy
    Decided to adopt - 6/2012
    SURPRISE! Pregnant without intervention - 7/2012 
    Sweet Baby James Born 3/2013
    Decided to be "One and Done"

    ....OR NOT.
    Pregnant 12/2018 despite birth control pills
    Here we go again...
    Due 8/26/19!
  • The OPK just shows the surge.  You would usually ovulate about a day or so after.  I would defintely want to have the bloodwork done again.

     


    After more than 2 years of fertility treatments, FET did the trick!
    IVF March 2012 - BFP! - Severe OHSS = 8 days in the hospital in kidney failure
    No heartbeat at 10w6d
    FET August 27,2012 = BFP!
    It's a boy!
    My Blog - 3 Dogs, No Baby

    image
    BabyFruit Ticker
  • image linzy5677:
    Should I call and tell them about the OPK and ask to test on Thursday?  That would be 7 DPO if the OPK is accurate.

    Yes, if you are not temping. I know you said your charts aren't very clear. A temp rise might be more accurate than a +OPK.

    Started TTC 2/2009
    Started fertility treatments 11/2010
    Ovarian dysfunction, LPD, male factor
    6 failed medicated IUI's
    Pregnant 5/2011 - Miscarriage at 6 weeks due to triploidy
    Decided to adopt - 6/2012
    SURPRISE! Pregnant without intervention - 7/2012 
    Sweet Baby James Born 3/2013
    Decided to be "One and Done"

    ....OR NOT.
    Pregnant 12/2018 despite birth control pills
    Here we go again...
    Due 8/26/19!
  • I am temping and I had a rise, but it fell again. I will call tomorrow and see what the doc says.
    TTC #1 since October 2010.
    Dx with Seminal allergy 4/2010.
    Low Progesterone (7/2011)
    Hypothalamic disorder/Luteal Phase Defect (7/2011)
    HSG normal (8/11)
    DH's S/A: Normal
    IUI #1 (50 mg Clomid + Noveral)= BFN
    IUI # 2 (100 mg Clomid + Noveral) October 2011
    PAIF/SAIF Welcome
    Daisypath Anniversary tickers
  • I don't have a link, but I think it might be helpful.  I'll work on that tonight and see if you ladies can help me decipher my temps.  

     You are all beyond helpful.  I really don't know what I would do without you.  Thank you so much =) 

    TTC #1 since October 2010.
    Dx with Seminal allergy 4/2010.
    Low Progesterone (7/2011)
    Hypothalamic disorder/Luteal Phase Defect (7/2011)
    HSG normal (8/11)
    DH's S/A: Normal
    IUI #1 (50 mg Clomid + Noveral)= BFN
    IUI # 2 (100 mg Clomid + Noveral) October 2011
    PAIF/SAIF Welcome
    Daisypath Anniversary tickers
  • image linzy5677:

    You are all beyond helpful.  I really don't know what I would do without you.  Thank you so much =) 

    I'm with you on this.  These ladies are what keeps me sane some days!


    After more than 2 years of fertility treatments, FET did the trick!
    IVF March 2012 - BFP! - Severe OHSS = 8 days in the hospital in kidney failure
    No heartbeat at 10w6d
    FET August 27,2012 = BFP!
    It's a boy!
    My Blog - 3 Dogs, No Baby

    image
    BabyFruit Ticker
  • Honestly, I'd be asking for a referral to an RE. My progesterone was 2.1 at 7DPO (it should be at least 10 for an unmedicated cycle), but my OB/gyn said it was normal. OB/gyn's should, in theory, know about hormone levels, but many don't seem to know what pre-pregnancy levels should be, because they mainly only work with women who are pregnant (or routine care for women TTC with no known issues). An RE is skilled an knowledgeable in the hormones and their fluctuations in your cycle, as well as how to manipulate them to achieve pregnancy. Clearly, your OB/gyn is going by the assumption that you have a 28 day cycle with O on CD14, which doesn't seem to be the case.

    Moral of the story: get thee to an RE who knows what he's doing and looking for with your levels. Also, I'd work at charting until you see the RE so that you have some data to show.

    ETA: and I'd really encourage you to do your Clomid cycle with the RE as well. Again, it's their area of expertise, not the OB/gyn's.

    Image and video hosting by TinyPic
    P/SAIF Welcome
    Invisible Finish Line
    3T's Traveling Ovary Blog
    7DPO Progesterone: low. CD3 BW: normal, HSG: clear
    DX: severe MFI (low all 3) and low T. Undergoing replacement therapy.
  • I totally agree with PPs and get a P4 test done about 8 days after your + OPK.  But also looking at your temps would def. help. 

    Plus, hasn't your doc done u/s & b/w to rule out or in PCOS vs just annov.?  Since I don't deal with that Dx, I'm not sure just how much is changes your treatment but still - a clear Dx is a good place to start!


    TTC since July 2009. Dx MFI & LPD. 
    IUI#1&2&3 (2011 & 2012) BFN
    IUI#4 1/23/13 on 75iu x9 Follistim = BFP then chem preg m/c (Feb 2013)
    IUI#5 BFN (April 2013)
    IVF w/ICSI Oct. 2, 2012 - 13R, 11M, 7F, 1 frozen blast 4BB grade - - - FET Nov 15, 2013
    BFP! Beta 1:104 @ 10dp6dt, Beta 2:178 @ 12dp6dt,  beta 3:366 @ 14dp6dt
    Saw heartbeat twice before missed M/C at 8w3d on 12/27/13, missing my little angel boy
    JUNE 2014 IVF#2;  5R, 2M, 1F Three day transfer 6/7.  Beta 6/18 - BFN
    Child Free Now?
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    My Blog

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  • I've had more u/s done than I can count (due to all of the problems I have had since I was 14), all u/s have been normal. My last u/s about, which was about 1 year ago, doc saw a follicle. As far as b/w, here is what I've had done:

    P4: <0.5 (CD3) 

    TSH: 1.83 (Normal)

    Prolactin: 5.8 (Normal) 

    P4 again (CD 21): 1.2 

    Would I have additional b/w done to test for PCOS? 

    TTC #1 since October 2010.
    Dx with Seminal allergy 4/2010.
    Low Progesterone (7/2011)
    Hypothalamic disorder/Luteal Phase Defect (7/2011)
    HSG normal (8/11)
    DH's S/A: Normal
    IUI #1 (50 mg Clomid + Noveral)= BFN
    IUI # 2 (100 mg Clomid + Noveral) October 2011
    PAIF/SAIF Welcome
    Daisypath Anniversary tickers
  • image linzy5677:

    I've had more u/s done than I can count (due to all of the problems I have had since I was 14), all u/s have been normal. My last u/s about, which was about 1 year ago, doc saw a follicle. As far as b/w, here is what I've had done:

    P4: <0.5 (CD3) 

    TSH: 1.83 (Normal)

    Prolactin: 5.8 (Normal) 

    P4 again (CD 21): 1.2 

    Would I have additional b/w done to test for PCOS? 

    Did you have your FSH tested?  That is an important one.

    For PCOS they usually look at testosterone and LH from your CD 3 blood work. 

    There are 3 things that can show PCOS and to have PCOS you have to any combination of 2 of the symptoms.  Annovulation, elevated testeosterone, and poly-cystic ovaries.  For me, I don't ovulate and I have poly-cystic ovaries.  I just went to a seminar about it a month ago.  Its pretty easy to diagnose. 

     


    After more than 2 years of fertility treatments, FET did the trick!
    IVF March 2012 - BFP! - Severe OHSS = 8 days in the hospital in kidney failure
    No heartbeat at 10w6d
    FET August 27,2012 = BFP!
    It's a boy!
    My Blog - 3 Dogs, No Baby

    image
    BabyFruit Ticker
  • They tested FSH.  It was normal.  I just don't have the number because I can't find my results online anymore.  They were there just the other day.  I'll ask for them next time I'm at the doc's.  

    LH was not tested. So if I asked them to test testosterone, that might help clear things up?  I don't have the other symptoms (hair, overweight). 

     

    TTC #1 since October 2010.
    Dx with Seminal allergy 4/2010.
    Low Progesterone (7/2011)
    Hypothalamic disorder/Luteal Phase Defect (7/2011)
    HSG normal (8/11)
    DH's S/A: Normal
    IUI #1 (50 mg Clomid + Noveral)= BFN
    IUI # 2 (100 mg Clomid + Noveral) October 2011
    PAIF/SAIF Welcome
    Daisypath Anniversary tickers
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