When to see an RE (TTC #2/possible LPD)

[Anonymous]

A penny for your thoughts, ladies:

DH and I are TTC #2 (DD is 18 months; I weaned at 10.5 months). My cycle returned quickly (and I had a paragard inserted PP), but what had been a "short-ish" LP pre-DD has become a really short window since -- like, 10-11 days, usually including a few days of spotting at 8-9 DPO before AF shows at 10/11/12 DPO. This has been consistent since DD was about 5 months, and while it seemed normal while I was nursing, it seems less so thereafter. Also totally TMI, but I've had way, way less CF since DD's birth than I used to (when I was a fairly prolific producer). I had my IUD removed in November, so we've only been "actively trying" for a few months, but I wondered when you'd seek a consultation under these circumstances (e.g., we haven't been "actively trying" without success for that long, but what seems like it could be a hormonal problem has been going on much longer than that). I have age on my side (for now), but I don't want to let something linger that would benefit from an RE's assistance unnecessarily.

TIA....

[Anonymous]

Did you need an RE for #1? I would talk to your GYN first to see if she would give you progesterone if you can show her your BBT charts indicating ovulation, BD'ing, spotting. You can also ask her to check progesterone levels at 7DPO via blood work. Some GYN's do this and others balk an send you to an RE.

Have you tried B6, vitex, or any other supplements?

[Anonymous]

OP here... we conceived immediately with #1 (I had a paragard before, so I had been off BCPs for 2 years before we had it removed to TTC). I've tried B6, which hasn't seemed to do much. My OBGYN was willing to prescribe Prometrium, but also suggested that the science behind it wasn't great and that I'd have to stay on it through the first trimester if I conceived, so I haven't gone that route yet.

[Anonymous]

How old are you? This would affect how much time I was willing to wait pre RE visit.

[Anonymous]

30.

[Anonymous]

Go with the Prometrium. Staying on it for the first trimester is no big deal. if you got pregnant the first month using it Im sure you would be happy to use it for a few more weeks. You will be prescribed it if you need IUI or IVF anyway. I would wait another 4-6 mos with timing intercourse correctly- get some OPK's, the clear blue easy fertility monitor, basal thermometer, Taking Charge of Your Fertility book.

You will need to have a battery of tests completed before beginning a protocol with an RE. You can always start these early and have your obgyn prescribe them- day 3 blood work, transvaginal ultrasound to look at your uterus, HSG to make sure no blockage in fallopian tubes, sperm analysis, recent PAP. Also begin looking at your insurance to see what's covered.

[Anonymous]

Anonymous wrote:30.

At 30, I'd give myself more time and work with an OB to see about progesterone supplements.

[Anonymous]

Wow, I could have literally written your post in the fall, OP, except that I am 37. I had the pre-period spotting (which I never had before DC #1), the shorter luteal phase, and much less cervical mucus than I used to. I asked my OB and she told me that a 10-day luteal phase is long enough and that the spotting doesn't count for when your period starts. Mine was brown spotting -- I don't know if it's different for red spotting. Anyway we actively tried for six months, using the fertility monitor, and no results. The OB had given me an order for testing and I was just about to do it, and it turned out I was pregnant.

I know how impatient you must be and I know the feeling that if there is a problem you want to deal with it, but as my grandma would say, "don't borrow trouble." From what you have said it doesn't necessarily sound like you have a problem. It's normal for your cycle and fertility signs to change over time, with age-related hormone fluctuations, giving birth, etc. Even if you are temping, using fertility monitors, etc., it can still take several months or a yearAt 30 you have plenty of time, and the fact that you have already had one successful pregnancy is great. I would give it at least a full 6 months of directed trying before starting down the long unpleasant rabbit hole of REs, fertility testing/treatments, etc., and at your age maybe even longer.

[Anonymous]

The RE would likely just prescribe a progesterone supplement if there is a luteal phase issue. Save yourself the stress of all the testing required by clinics and stick with your OB for this. If you find it unsuccessful, consider an RE.

[Anonymous]

Totally agree with 11:46. Seems that lots of people on this forum have a harder time conceiving #2 than they did with #1, just by sheer virtue of bodies changing and being older. My OB doesn't consider anyone "challenged by conception" until it's been 1 year of consistent trying within the right range of time each month. Have you tried temping so you know for sure when you've ovulated?

[Anonymous]

OP here -- thanks, everyone, for your thoughtful and kind responses. I have been temping and charting CM, though I've had no success with OPKs (never gotten a positive, even when we were trying with DD) -- I don't know if that's a time-of-day problem or a sign there's something else weird going on (could be linked to my slow post-O rise?). Obviously, I'm not in a hurry to head "down the rabbit hole," and I'm trying not to be my usual nervous-nelly self, but it's unnerving to feel like, "oh, my body was doing normal things! not all that long ago!...and now it isn't," and the many days of LP spotting make the TWW even worse than I thought it could be. This month I'm on my fourth day of spotting (never all that much) with still-elevated temps, so I have no idea what the story is.

[Anonymous]

Oof...officially out for the month. Hope springs eternal. In a way, there's something like relief here, too....maybe?

[Anonymous]

Anonymous wrote:Oof...officially out for the month. Hope springs eternal. In a way, there's something like relief here, too....maybe?

Sorry to hear that. I think you should invest in the clearblue fertility monitor. I never got clear/consistent results on regular OPKs but the monitor worked great, and I credit it with getting me pregnant. The monitor is $$$ and the refills are as well, but it's certainly worth trying for a few months before you consider invasive testing.