Weak ovulation

[WishnandHopn]

What exactly is this and how is it diagnosed? Would you be able to tell from your chart if you had a weak ovulation? Like maybe not a huge temp shift or a shorter luteal phase with spotting before AF?

I'm pretty sure I'm ovulating every month...wondering if it's weak though

 

[BunnyN]

Im not an expert but I think it is either when you have a mature folicle and it doesnt release the egg propperly or you are releasing eggs that are not mature enough. It is diagnosed by testing progesterone at the time of ovulation. Low progesterone can mean weak ovulation and is treated with some combination of progesterone supliments, clomid and trigger shots. Some women have unusual cycles or charts, like long cycles or OPKs that stay positive for longer than normal. Often they everything seems normal until the blood test and maybe a scan to see ovulation.

 

[lesondemavie]

I thought that I might have weak ovulation. My cycles are short but regular. I always have super clear opks and super clear temp shifts. I requested a progesterone test because my LP was only 10 days and my first and only pregnancy ended in an MMC at 8 weeks. It came back super low, but still high enough that my ob said I did ovulate. She said I wouldn't O if the egg wasn't mature enough, and that it was likely due to early failure of the corpus luteum. She has me on progesterone after ovulation for now, but wants me to come back in if I'm still not pregnant after several cycles with the progesterone.

 

[lesondemavie]

The corpus luteum is what remains of the follicle after the egg is released, so progesterone levels really have nothing to do with the egg. It is the follicle from which the egg bursts that matters.

 

[WishnandHopn]

I'm seeing my doctor next week, likely only a day or two after O, so I think it will be good timing to ask him to send me for CD21 (or 7 dpo) progesterone blood work.

I do wonder if an immature or poor quality egg being released could also have a poor quality corpus luteum left behind?

 

[lesondemavie]

My ob was very certain that I wouldn't have O'd if the egg itself was immature. As I understand it, you only ovulate once a follicle matures to a certain size, and the follicle only reaches that size if the egg it its wall is also mature enough to be released. Egg quality is a different matter. I have read that if the egg is not healthy, the resulting corpus luteal cyst (responsible for progesterone) is more likely to produce inadequate levels of progesterone. I think you would have to have cd3 bloodwork to check that. Checking progesterone for egg quality is rather indirect for that matter.

 

[sarah2211]

I'm pretty sure I'm in this position. I'm seeing the fertility clinic later this month so I'll give you all an update. My GP has put me on Metformin which is meant to help create a stronger O.

 

[Candilou22]

I have issues with a short luteal phase and spotting from just past ovulation to the start of my period. I am now taking vitex twice daily as well as metformin due to my high insulin resistance. Vitex is supposed to help with progesterone and almost all aspects of your cycle. Only just started taking vitex but feeling hopeful.

 

[mara16jade]

Just curious, would it help or be at all beneficial to test progesterone the day of or day after you O? Or is the 21 day progesterone the only one thats useful?

 

[lesondemavie]

Progesterone is supposed to peak at 7-8 DPO, so that's the best time to test. Right after ovulation your levels may not be high enough to indicate ovulation. Progesterone pulses so it has highs and lows throughout the day. It's best to test at its peak bc then even the low might be high enough to indicate ovulation and enough progesterone to support a pregnancy. I wonder if my peak is just earlier. I get such a clear spike in bbt right after my +opk but then my temp starts to drop early, but I doubt the doctor would test earlier or be interested in those results. Some say instead of 7 DPO you should go in half way through your LP, so if your LP is 10 days go in at 5 DPO etc. but if your levels start to drop before 7 DPO your lining might not be thick enough and implantation might then be unlikely.

 

[WishnandHopn]

Well it may be awhile until I find out what my progesterone levels are. I brought it up with my doc, he said no, all your other hormone levels are fine, it's not necessary, then I asked to be referred to a fertility specialist and he said no again, come back in 6 months! I gently reminded him that I am 37 and pulled out the referral form I had pre-filled out for him (!) and he was like ok, sure I will refer you. I waited while he sent the fax. I seriously hate my doctor...as scared as I am to see the fertility specialist, at least I will be able to talk to a doctor who knows what they're talking about for a change and cares!

 

[lesondemavie]

You definitely deserve that referral after 6 months at 37. I'm 34 and my PCP and the first ob I saw thought 6 was plenty before getting help. This new ob is sticking to 12 months from my MMC, but I think with the low level on P I can get her down to 6 months since my MMC and 12 months total.

Hope the specialist listens to you better