Opinion: 21 day test question

sailorgal · January 2014

So I've had the 21 day progesterone always on day 21. But my charting indicates I ovulate later than day 14. So my (uneducated) opinion would be that shouldn't the 21 day test be later than day 21? The last cycle that they tested I ovulated on day 17, so the test was 4 days after ovulation and not 6-8 that I've read about online. Would that not potentially give skewed results?

I'm sure that when we get booked for the cycle monitoring, this will be addressed and looked at but I'm over-analyzing and self-diagnosing stage while I await our next appointment with our new RE so last night I couldn't stop wondering about it after some lightbulb turned on after something the ND I met with said. Every doctor I've seen has guessed low progesterone immediately based on my symptoms, and then after the test they say it's normal. And heck, maybe it is, but given that progesterone drops later, it just had me wondering. Thoughts?

Momarazzi007 · January 2014

That makes sense to me... I hate how they scream at us that everyone is different about everything but then test us on a standardized time table... Doesn't that totally contradict? I would ask why

CheesyPeas · January 2014

I'm by no means an expert on 21 day testing but if you ovulate late, your "21 day test" should be after CD 21, so you're right that results might be a little misleading. Progesterone is a tricky thing to test though from what I've read. It's supposed to peak about a week after O on average but that isn't true for everyone. I've read online that for LP issues, some doctors like to test about 7dpo and then a few days after to make sure it's not a case of prematurely dropping progesterone (which is what I think I have based on my charts and a little experiment I conducted last cycle). Unless you peak early, I think that a 4dpo progesterone test would actually underestimate your progesterone rather than overestimate it.

sailorgal · January 2014

Hmm very good point about underestimating - so maybe not. I just went and researched the pattern. I'm wondering then if my progesterone is dropping too soon.

I read that progesterone peaks at 5-9DPO. Such a range!

I just found out that my tests are available online which does not help my self-diagnosing obsession today.

So I ovulated on day 17, progesterone test was 10.2 4DPO and I started spotting on day 24 (7DPO). Total cycle length 27 days (so 10 day luteal phase). My luteal phase ranges from 9-10 days but she doesn't seem bothered by that or thinks I'm potentially confusing spotting with my period (I'm not).

Most things were normal, only two things were borderline high (MCV/MCH)...when I google reasons, it suggests things like alcoholism or B12 deficiency. Well since I'm not a heavy drinker, I'm wondering B12....we eat primarily a primarily vegan diet so this would make sense and hasn't been tested specifically.

I probably need to stop googling

jaminjeff · January 2014

I hate that it's even called the 21 day test. It should be the 7dpo test. My RE never called it the 21 day test. My OB (who treated Clomid like it was candy) insisted on doing a "21 day test" and was shocked that my levels were 1.1, even though I hadn't even O'd that cycle.

Jen071407 · January 2014

According to my RE it should be 7 dpo that it's done. However, he doesn't put too much stock into it because it can vary so much even throughout the day.

sailorgal said:
So I ovulated on day 17, progesterone test was 10.2 4DPO and I started spotting on day 24 (7DPO). Total cycle length 27 days (so 10 day luteal phase). My luteal phase ranges from 9-10 days but she doesn't seem bothered by that or thinks I'm potentially confusing spotting with my period (I'm not).

Most things were normal, only two things were borderline high (MCV/MCH)...when I google reasons, it suggests things like alcoholism or B12 deficiency. Well since I'm not a heavy drinker, I'm wondering B12....we eat primarily a primarily vegan diet so this would make sense and hasn't been tested specifically.

I probably need to stop googling

Your example here sounds a lot like my natural cycles - normal timing of ovulation, then BAM spotting waaay too soon (as early as 3dpo in my wacky body), however progesterone #'s look ok. My RE says that it's not a progesterone deficiency per se, but a weak ovulation/crappy follicle which results in a wimpy corpus luteum, which equals progesterone issues/spotting. The ONLY time I don't spot is on clomid and a gonal f booster on cd9 - results in much better follicles/eggs.

edit to clarify

sailorgal · January 2014

Your example here sounds a lot like my natural cycles - normal timing of ovulation, then BAM spotting waaay too soon (as early as 3dpo in my wacky body), however progesterone #'s look ok. My RE says that it's not a progesterone deficiency per se, but a weak ovulation/crappy follicle which results in a wimpy corpus luteum, which equals progesterone issues/spotting. The ONLY time I don't spot is on clomid and a gonal f booster on cd9 - results in much better follicles/eggs.

Ugh Day 3. That's so crappy and frustrating. My spotting typically starts anywhere from 4DPO-6DPO.
At what stage/test did your RE determine it was weak ovulation/crappy follicle/wimpy corpus lutem?

Literally the other day I was at the point where I don't care about a baby anymore, I was ready to say I'm content as a family of 3, I just want this freaking spotting to stop! Then a few hours later I went back to wanting both.

Jen071407 · January 2014

sailorgal said:

Your example here sounds a lot like my natural cycles - normal timing of ovulation, then BAM spotting waaay too soon (as early as 3dpo in my wacky body), however progesterone #'s look ok. My RE says that it's not a progesterone deficiency per se, but a weak ovulation/crappy follicle which results in a wimpy corpus luteum, which equals progesterone issues/spotting. The ONLY time I don't spot is on clomid and a gonal f booster on cd9 - results in much better follicles/eggs.
Ugh Day 3. That's so crappy and frustrating. My spotting typically starts anywhere from 4DPO-6DPO.
At what stage/test did your RE determine it was weak ovulation/crappy follicle/wimpy corpus lutem?

Literally the other day I was at the point where I don't care about a baby anymore, I was ready to say I'm content as a family of 3, I just want this freaking spotting to stop! Then a few hours later I went back to wanting both.

I feel like that all the time! If this cycle is a bust I'm actually really looking forward to the 3-4 weeks of BCP for ivf. It was after testing progesterone levels and trying just the suppositories (which did nothing but get nurses to tell me it was the "suppositories irritating my cervix and thus the continued spotting"). Also, the simple fact I DON'T spot with the clomid/gonal f/suppositories combined indicates I need the boost with ovulation. I also usually get 2 decent follicles with this combo, so even double the corpus luteum, etc.

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