FSH, LH and Progestrone - 21 days blood Tests

[chocci]

Hi

I hope someone can help explain things as I am totally confused

My husband and I have been trying for a baby for over a year now. My periods were always regular i.e. between 25-28 days. I came off the pill last year and have been regular since then. I was slightly concerned I do not bleed much only for 1-2 days max, but was told not to worry about that.

Everything was fine and I knew it can take 2 years to conceive for some couples but as time goes on I am starting to get a little more concerned.

Last few months my periods suddenly came at 23 days, 21 days then 17 days, I decided I best go to see doctors. They asked me to come in for 21 day blood tests to check various things. I have just got the results but am slightly confused and am hoping someone has had the same and can explain.
Thyroid tested OK
Cholesterol great very low at 3.1
FSH 2.1
LH 1.6

The nurse had a nightmare getting my blood and unfortunately did not managed to get enough for progesterone test on day 21, I had it taken on day 25 when they again also checked diabetes, iron blood count everything. All apparently came back "normal". I felt relieved then thought well why on day 25 is my progesterone measured as normal. I thought this had to be taken at a certain time of the cycle? On day 25 when it was taken I started my period, so how has my progesterone level been calculated?

I also don't understand what the significance of LH and FSH is at day 21? I thought this should be taken in early cycle such as day 3? Can anyone tell me what the FSH and LH level should be on day 21? and if they are at all relevant?

The nurse has said all my results are normal, which I am utterly greatful for but am bemused as to how they can all be normal when they were taken at strange times in my cycle? I am so puzzled

Oh and just to add my cycle went back to 25 days this month??? I had started using Valerian a herbal calming table and drinking chamomile tea too and think that my "wonky" periods may have been due to this? I stopped them all this month and low and behold periods returned to normal. Anyone any experience of this too?

Thanks in advance for any advice

 

[happy mum]

it all sounds very confusing, sorry i can't help. i've got my 21day bloods on tue next week, think i'll be taking a pen and paper for some info. if you don't find out before i'll ask.maybe you should make an appointment with dr to explain things better??? good luck!! i have a similar prob !!!

 

[chocci]

If I find out I will let you know. I have asked for the nurse / doctor to ring me for an explanation, told hubby might be time for him to go get checked because apparently thus far tests have found nothing wrong with me

Will keep you posted would be good if you could let me know how you get on and if you find out anything interesting to shed any light on the topic?

 

[meisha]

hello there, i have just had these tests done BUT LH and FSH were done on day 3 as they should always be done. I really cant tell you what these levels should be on day 21 as I dont know what the reason for having them taken on this day would be.
Boook in and go see your doc.
Progesterone can be take late. Min should have been on 26 but I had it on 27 because of the weekend. My last test result was 84 which shows a huge increase following ovulation so if you manage to get your bloods done look for large surges.

 

[chocci]

Apparently one of the first test they do if you are at all concerned about fertility, is to do day 21 blood tests. The theory is based on the most common cycle being 28 days. Therefore day 21 would be 7 days after you had ovulated on day 14. this is apparently the best time to check progesterone. They also say that FSH and LH can be taken at this time as they can compare levels of the FSH and LH to the progesterone level, apparently that relationship is the most important part of the tests and FHS and LH and progesterone levels in isolation dont mean that much it is the correlation between the 2. Apparently if there is a mismatch in the readings they would investigate further and then order FSH and LH level test on day 3. That is what i have found out so far anyway! It appears all docs are different tho and people get told all sorts of different things. I have been told the correlation between my results is good. That doesn't help me tho. I have really light periods which surely is not normal. Its like i don't build up enough womb lining which leads me to think i have a lutal phase defect and don't have high enough progesterone levels at end of cycle. No one seems to be able to offer any answers which is frustrating. I have booked to talk to nurse to see what the next steps are an I will be asking lots of questions now as i don't want to be fobbed off!!

Has anyone else had experience of these 21 day test, can you shed any light on them. And meisha, does the large surge mean good or bad? ids that good news for you or not?

I will come back after seeing the nurse and give update too as surely someone else may find this useful.

 

[loopylew]

Apparently one of the first test they do if you are at all concerned about fertility, is to do day 21 blood tests. The theory is based on the most common cycle being 28 days. Therefore day 21 would be 7 days after you had ovulated on day 14. this is apparently the best time to check progesterone. They also say that FSH and LH can be taken at this time as they can compare levels of the FSH and LH to the progesterone level, apparently that relationship is the most important part of the tests and FHS and LH and progesterone levels in isolation dont mean that much it is the correlation between the 2. Apparently if there is a mismatch in the readings they would investigate further and then order FSH and LH level test on day 3. That is what i have found out so far anyway! It appears all docs are different tho and people get told all sorts of different things. I have been told the correlation between my results is good. That doesn't help me tho. I have really light periods which surely is not normal. Its like i don't build up enough womb lining which leads me to think i have a lutal phase defect and don't have high enough progesterone levels at end of cycle. No one seems to be able to offer any answers which is frustrating. I have booked to talk to nurse to see what the next steps are an I will be asking lots of questions now as i don't want to be fobbed off!!

Has anyone else had experience of these 21 day test, can you shed any light on them. And meisha, does the large surge mean good or bad? ids that good news for you or not?

I will come back after seeing the nurse and give update too as surely someone else may find this useful.

I have a short luteal phase and have never had cd 21 tests done, my GP looked at my chart and referred us stright away to a fertility consultant, im going back next Tues to insist on a cd21 test, to think that if she'dve done the tests i might just need progesterone tablets and saved months of heartache. How do you know you have a LPD? are you charting?

 

[magicvw]

Hiya! I had cd 3 and cd 21 tests - I had the cd3 first, because I went to arrange the tests on cd1 so there was time. CD3 they did lh and fsh and full bloods including glucose, and cd21 was only progesterone. There is a good link with the "normal" levels on :

https://www.fertilityplus.org/faq/hormonelevels.html

(thanks krissi!)

 

[Trying4ever]

Hey Chocci,

Did you find out what your levels meant? You said you would get back after seeing the nurse last month. I also had a blood test done on day 2 and then the GP asked to have one on day 21 before she could refer me (which I did on 29th Sept 2008). My results on day 21 were:

FSH=5.1iu/L
LH=14.2iu/L
Progesterone=3.5nmol/L

My doctor just said the results are normal then referred me. I can't get hold of my day 2 tests. I'm still waiting for my referral letter. But I know there is something wrong with me cos my periods have been longer than 35 days since I have been monitoring them in Jan 2008. Once it was nearly 80 days before I had a period.

I've tried to look up the results on the net but I get confused with the units as they are mg then nmol sometimes.

Can anyone help me interpret them?

 

[DebsHopeful]

Hi Chocci,

Take a look at this website it is super handy for interpretting your results.

fertilityplus.org/faq/hormonelevels.html

I had my 21 day blood test last Sunday and have done all the research, but unfortunately from everything I have read so far, I think your progesterone is too low and you probably aren't ovulating at the moment.
This isn't a big problem, if you go see your gynea he will help you to regulate your hormone levels and you will have your baby.

All the sites vary but the majority of them say your Progesterone has to be above 10 for ovulation but there are a couple that say you can ovulate if it is above 6.5.

Best of luck

 

[Loo]

Well this is what my research has told me:

Chocci - Ideally FSH and LH should be taken early in the cycle. This is because both of them should be quite low at that time and so are easy to interpret.

If one or both of them are high then it is worrying. However, the levels of them rise naturally at midcycle time and so this could be confused with abnormal if they were taken at midcycle.

However, if they are taken later in the cycle and are low, then its ok to say they are normal, as it must have been after they had settled back down after their midcycle peak.

Yours was almost on CD1 as you started your AF that day, so really they were only a day or two early.

Trying4ever, I agree with Debshopeful about the progesterone. But did you have a period a week after your bloods? If not, then it may be that the test was not at the right time anyway. If your periods are 35 days, you should have had the progesterone on CD 28. So they may have missed your peak.

Sometimes the other thing is that if your LH is higher than your FSH (this is based on day 2 bloods though) then it may be a sign of pcos. And that would fit with your long cycles too.

Anyway, good luck to you all when you see the specialists x

 

[Trying4ever]

Well I don't know if I have PCOS or just PCO. Apparently there is a difference. But doesn't make a difference to me! Still doesn't help me conceive. I had a scan in August some time and the sanographer said there was 'a little cyst but nothing to worry about 'and that I have to discuss with my GP as he can't say anything. GP useless and discussed nothing with me sending me for a CD2 blood test. When those results came GP said the FSH was slightly high. Then I was referred but haven't got appointment through yet!

I agree with you both that I am not ovulating. My last period was 7th Sept 2008. I had my CD21 test on day 22 actually on 29th Sept 2008. I still haven't had a period meaning its now CD41. There is definitely something wrong with my cycles. My husband and I have been religiously trying 2-3 times a week as I really don't know when I am ovulating but who am I trying to kid? It looks like I am not ovulating at all.

I've done a pregnancy test and its neg.

 

[DebsHopeful]

Well I don't know if I have PCOS or just PCO. Apparently there is a difference. But doesn't make a difference to me! Still doesn't help me conceive. I had a scan in August some time and the sanographer said there was 'a little cyst but nothing to worry about 'and that I have to discuss with my GP as he can't say anything. GP useless and discussed nothing with me sending me for a CD2 blood test. When those results came GP said the FSH was slightly high. Then I was referred but haven't got appointment through yet!

I agree with you both that I am not ovulating. My last period was 7th Sept 2008. I had my CD21 test on day 22 actually on 29th Sept 2008. I still haven't had a period meaning its now CD41. There is definitely something wrong with my cycles. My husband and I have been religiously trying 2-3 times a week as I really don't know when I am ovulating but who am I trying to kid? It looks like I am not ovulating at all.

I've done a pregnancy test and its neg.

Don't be discourage. You just need some professional help.
I wouldn't suggest going to a GP about these matters since they don't specialise in this field.

You need to look for a gynea who practices as a fertility specialist and specifically one who knows how to diagnose and handle PCOS.

I myself am with a fertility specialist and concieved my last baby with AI. Sadly it wan't meant to be, unfortunately the first time around for any women often doesn't result in a successful pregnancy but the process was really easy. The gynea has to do all the hard work, like ensuring that you ovulate by giving you the right hormones to make sure you are in balance and then it is up to them to get the timing right.

I did the CD21 test and got a result of 30 which is a really nice high figure but having used 10 OPKs, I didn't pick up a surge, not even once.
Take a look on the internet or ask your GP for a reffering fertility specialist and get the help you need. Once you are being managed properly, it won't be too long before you get your

 

[Loo]

I agree. Check out some of the others on here with PCOS - they have used clomid or metformin, so there is plenty of things to try. You just need a gynaecologist to help you!! Good luck x

 

[honey08]

if ur guna need fertility drugs,dont feel down about havin a little extra help hun as these drugs r very good and lots get pg first 3-6mth with clomid !! best of luck hun x

 

[Trying4ever]

I heard you can't have clomid if you have ovarian cysts? Also metformin doesn't help if your not overweight or have hirtuism as its not a pituitary gland problem?AAAAAAAAAAArgh WTF?

 

[Loo]

It is true that metformin is particularly useful if overweight. I don't know whether they use it in normal weight people or not. POssibly the folk on LTTC forum may be able to tell you that.

I don't know about clomid. It is definitely used in ladies with PCO(S) though.....so some types of cysts must be ok. I am not sure of the rules on that. Perhaps its a 'caution' rather than a defeinite 'contraindication'?? I am not sure....

Suppose the O+G consultant can advise you properly when you get to see them. Have you got an appointment yet?

Sorry if we suggested things that won't work for you. It's all so blooming frustrating isn't it?xx

 

[chocci]

Hey

Sorry I dissapeared for a while but I did not get much response from the thread at first and forgot all about it. Basically I have not really had much to report. I have been refered to the Reproductive Medicine Unit and have been told i need a HSG and follicle tracking. I went for my first follicle tracking on day 3 a few days ago which has shown a cyst on my right ovary.

I am a little confused as the nurse / person doing the scan did not really tell me much she said she saw follicles on the left ovary but that the right had a cyst. Does anyone know how many follicles i should have as early as day 3 too as there are so many conflicting things on the internet? She said it looked like i had ovulated from the right ovary last month and the cyst is debri from ovulation......though how she could tell that she did not explain, so if anyone can shed any light?

I am feeling a bit down about it all in all honesty, worrying myself sick that I cant have children.

Does anyone know what the course of treatment is when a cyst is discovered? Is a cyst all that bad?

My husband is due to give a sample in jan. I have my HSG next month too. We have a followup appointment end of jan with the specialist.

Oh and i never found out why they do 21 day blood tests, all i was told was it looks like i am not ovulating?

I feel like just not bothering all the stress of this is making me feel worse and cant help anything can it?

 

[honey08]

hiya hun, can i say i learned its very very important to av cd21 done at 7dpo, if u chart then u will know when u are 7dpo.....BUT this doesnt mean it will b cd21, but from wot i learned for me anyways u defo need to be 7dpo, in oct i went on cd21 but just 3dpo,and got told i didnt O, i was checked for estrogen tho aswell,and it werent far off the lowest we need to O, i asked the doc,wud it make a difference that im 3dpo not 7dpo? no he said it wud b fine !! well it turned out that mth i did O cos we conceived just a bit of advise hun, and i wish u the best of luck

 

[honey08]

i didnt relise i replied to this thread so long ago aswell ! ! also can i say, i was all ready to be referred to FS in oct after been told i hadnt O, OH and i were both very upset by this, if i hadnt of got pg in oct, its scary to think id be getting clomid....but not really needing it !
make sure ur happy with the treatment ur getting and the care ur getting aswell

 

[Loo]

I think what happens with a functional cyst is that the egg pops out of the follicle, but then instead of disappearing, the follicle's outsides re-seal and become a cyst.

Commonly these cysts are 2cm or so and then go away after a while by themselves. Occasionally they get bigger (I had an orange size one) and so take longer to go away.

There are some things that can happen to cysts and there is quite an interesting info leaflet on patient.co.uk

Mine just caused me a few twinges now and again and some pressure symptoms (I initially thought i had a uti) and then went away on its own accord.

day 21 bloods are to check progesterone (should be taken 7 dpo, so called day 21 prog for all those 'normal' 28 day cyles people out there) and if its high, it shows you ovulated. if its low, you havent ovulated or it was taken at the wrong time in the cycle.

btw i havent gone back to read all my own posts on here, so apologies if i have just repeated myself!!