CD 21 Testing Quesiton and Intro - Child Mentioned

TeAmoMiAmor · May 2013

I was going to ask this on TTC, but thought I might get more from TTTC...here's a little of my background: DH and I have hit the 12 month mark this month of TTC, but due to the length of my cycles I have had 14 unsuccessful cycles in that time period. I appear to have all signs of ovulation - postive OPKs, regular cycles, have been charting/temping for the past 9months, etc. Last week (after reaching CD1 of month 12) I called my OB GYN and went in for a consultation. She recommended CD 21 bloodwork (along with HSG and SA for DH), but based on my O days (usually between CD 11 and 13) that I get the bloodwork done earlier somewhere around CD 18 or 19. My question is this, this cycle I O'd late - still waiting to confirm with temps, but looks like CD 15. Friday is CD 19 and I'm not sure if I should go ahead and go in for the bloodwork or wait until CD 23 - which would be Tuesday (lab is closed Monday for Memorial day). The Dr. told me to make sure to go in no later than CD 21, but would CD 19 be too early based on my O date?

She also basically told me that she doesn't think they are going to find anything wrong and that our likely dx will be unexplained infertility since DH and I were able to successful concieve DS on our own 4 yrs ago and everything appears as though I'm ovulating every month. So it makes me question whether I want to get all these test done in the first place, so I just feel all around confused and frustrated.

katib77 · May 2013

Your OB is wrong, the test needs to be done at 7dpo - doesn't matter if 7dpo is cd18 or cd24. If you think you ovulated on cd15, then you should get it done on cd22 ie Monday. If they are closed on Monday then I'd personally skip getting the test done this month.

As for "Unexplained IF" because you had DS? That is also wrong. There is a whole board called secondary infertility. And while they probably have 30% unexplained Dx (like much of the population), I'm sure many still have a Dx.

Like you, in a 12 month period I would have 14 and a half cycles because my average cycle is only 25 days long. I do have LPD with very low progesterone AND we also have MFI. Don't skip over the testing phase, you never know what issues you might be dealing with even with the miracle of your DS. Do yourself a favor, go see an RE because OB's are not trained in IF.

lin681 · May 2013

katib77:
Your OB is wrong, the test needs to be done at 7dpo doesn't matter if 7dpo is cd18 or cd24. nbsp;If you think you ovulated on cd15, then you should get it done on cd22 ie Monday. nbsp;If they are closed on Monday then I'd personally skip getting the test done this month. nbsp;As for "Unexplained IF" because you had DS? nbsp;That is also wrong. nbsp;There is a whole board called secondary infertility. nbsp;And while they probably have 30 unexplained Dx like much of the population, I'm sure many still have a Dx. nbsp;nbsp;Like you, in a 12 month period I would have 14 and a half cycles because my average cycle is only 25 days long. I do have LPD with very low progesterone AND we also have MFI. nbsp;Don't skip over the testing phase, you never know what issues you might be dealing with even with the miracle of your DS. nbsp;Do yourself a favor, go see an RE because OB's are not trained in IF. nbsp;

Agree with all of this! I strongly recommend going to an RE as well.

TeAmoMiAmor · May 2013

Thanks for the comments. Based on my insurance I need a referral in order to see an RE, my OB wanted to completed those 3 tests (bloodwork, HSG, SA) prior to giving me a referral. She did say she does clomid in her office, but would send me to RE if I was more comfortable doing it there.

She didn't mention anything about a hard and fast 7dpo rule, just that they want the bloodwork about a week after ovulation and no later than CD21 (she might have said that because of the length of my cycles usually 25 days). Are the levels only accurate if it is 7dpo?

Thanks again! I feel like all of this is scary and difficult to take this step and I've felt like something was wrong/not working correctly, but she made me feel a bit silly basically saying we know everything works it's jut not working as fast as you want.

katib77 · May 2013

TeAmoMiAmor:
Thanks for the comments. Based on my insurance I need a referral in order to see an RE, my OB wanted to completed those 3 tests (bloodwork, HSG, SA) prior to giving me a referral. She did say she does clomid in her office, but would send me to RE if I was more comfortable doing it there.

She didn't mention anything about a hard and fast 7dpo rule, just that they want the bloodwork about a week after ovulation and no later than CD21 (she might have said that because of the length of my cycles usually 25 days). Are the levels only accurate if it is 7dpo?

Thanks again! I feel like all of this is scary and difficult to take this step and I've felt like something was wrong/not working correctly, but she made me feel a bit silly basically saying we know everything works it's jut not working as fast as you want.

While we often say "impatience is not infertility" it sounds like you have been patient. You've tried for a year. For 14 cycles. And your son is clearly old enough that the 14 cycles were after getting your period back and probably after stopping breast feeding (but don't want to assume since there are those the BF older children).

Your OB at least knows the main tests to run, and admittedly I had my HSG and Dh's S/A before moving on so I can see how that's fairly common. AND because of your cycle length, I can see how she figured 7dpo for you doesn't fall after cd21 but the test is hard to interpret if not done on that day. Yes, you could say "well, adjust a day or two here", but you're then still just guessing.

Example: If you get it done Friday but you are only 4dpo, then your P4 reading might only be 3, making it clear you ovulated - but not sure if by Monday it would raise to over 10. ((Your follicle that releases the egg, releases the progesterone they are testing and the peak day if you don't end up PG is 7dpo. If your P4 is too low, you are not able to support an embryo to implant even if the sperm did meet the egg.)) If you have it done at 7dpo and the reading is 3, then you really know there is an issue. No guessing. You could get it done at 8dpo, and it's a 9 and there it's closer to guess that "OK, it *might* have been 10 yesterday. Or it could come back at 13, and think "OK, then I *know* it was over 10 yesterday. See how one day either side of 7dpo the guessing is a lot easier? But three days ahead of time, the only thing it will tell you is if indeed you did ovulate (any number above a 2 is considered ovulating).

TeAmoMiAmor · May 2013

Thank that was a very helfpul!!! It makes a lot more sense now as to why to test on 7dpo. Right now I am just guessing O date based on OPK and previous cycles, but waiting to confirm with temps. I feel like a I have a lot better direction now.

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