A blog about babies: the babies I lost, the babies I never had, the baby who made me a Mama.

Tuesday, March 2, 2010

Paging Dr. Google; or, Second Opinions

I've mentioned before on this blog my frustrations with ovulation. In the past year of TTC (okay, almost year, get ready for the big anniversary post in two weeks) I have ovulated on:

March-April: Day 30
April-May: Day 18
May-June: Day 19
June-July: Day 21
August-September: Day 21
September-October: Day 26 (bfp month)
January- February: Day 27
With one anovulatory cycle post miscarriage (November-January) and one anovulatory cycle when I traveled internationally. (July-August)

I think this pattern is quite irregular. I think it falls outside the realm of normal and problem-free, but I'm willing to accept that it's just acceptable variation and nothing to worry about (that seems to be my doctor's opinion).

I also think it's pretty late. And while I haven't had one of those 60 day cycles that I know some women have (at least not yet), I'm worried that delayed ovulation might have been the reason behind my miscarriage. It's something I've see mentioned as a possible cause (though I have not read any of the research referenced). Again, my doctor said she wasn't concerned when I tentatively raised that issue at our post-d&c follow up appointment.

My husband says I should trust my doctor. He said I'm making up problems where none exist. He hates when I consult Dr Google and make my own diagnoses.

But I can't shake the feeling that something is wrong here.

So I'm asking you guys, what do you think? Is this all fine? Do I have a slightly irregular, slightly delayed cycle, but nothing to stress over?

When do you decide if there's a problem?


  1. I'm one of those people who believes in gut feelings. If you think there's something wrong, you have a right to get it checked out...that being said, a friend of mine just went 93 days without ovulating and once she finally did, she got a BFN on DPO 10 and a BFP on DPO 13. That leads me to believe that no cycle is really "too long", it's possible, but that doesn't mean that you shouldn't seek a dr's opinion on getting yourself regulated if it's possible.

    But you know, I'm just Gidget, I'm not a doctor. ;)

  2. This looks pretty normal to me. Did you post before on the length of your luteal phase? That's what counts, apparently (as I'm sure you've also read online, ad nauseum).

    Last month I o'd on day 19 and then got my period on day 28 (or I guess it's 29 if you count the first day of your period as both day 1 and as day 29 of the same cycle-- but basically I have been getting my period regularly every 4th Wednesday). That's too short of a luteal phase! So I wonder if that explains my miscarriage. I'll track a couple more cycles before I contact my ob about it.

    My ectopic pregnancy, however, WOULD NOT DIE without assistance... so I'm wondering, how is it that my TUBE represents a more hospitable place to implant than my UTERUS, luteal phase defect or no??? It is all very confusing.

    You were going through the 2ww around the same time as me- I am expecting my period tomorrow or Thursday (since it came at 11:30 Wed. night last time). How's yours going?

    I am half insane with the final day or 2. Cried this morning-- I think it's PMS. Am now drinking coffee. So THERE, mind fetus!

  3. Yeah, despite the mind-boggling amount of time I've spent on Google toward that M.D. in reproductive endocrinology, I have no idea. I agree with trusting your doctor, but those cycle lengths are a teenie bit wacky...would a second opinion hurt? (On the other hand, you ARE ovulating, and that is GOOD!) At least if another doctor concurred that everything's fine, you could get some extra peace of mind.

    PS I will keep you posted on our spring NYC travel sked as soon as I have it. It will be awesome to catch up in real life!

  4. Honestly, I don't have much insight to offer either. But I did ovulate around 17/18 days...and always wondered about my luteah phase being long enough which was like 9 or 10 days. My regular dr. even did a progesterone which came back normal, and that was the end of that. But I always wondered if the egg had enough time to implant?

    I also tell myself that is something is bothering me, than you just gotta ask. I do trust my dr, but also realize he doesn't go to bed at night thinking about the ins and outs of my cycle (like I usually do). A second opinion certainly couldn't hurt, and like egg said if anything you'll get some peace of mind!!

  5. I think anything after day 21 is considered "late", though that doesn't mean late = bad. The things I've read (and recall that until a week or so ago I was under the misconception that people alternate sides in ovulation, so I know nothing and should not be trusted) suggested that late ovulation can lead to perfectly successful pregnancies, but that your chances might be slightly reduced. (In part just 'cause the longer your cycle, the fewer cycles you have.) You might be interested in this mildly relevant paper. (I actually have a bibliography of IF literature!). I think you should ask your doctor to explain why this is not a problem. Because while trusting one's doctor is a nice goal (and I'm sure she is trustworthy), it's hard not to be anxious until one gets a logical explanation.

  6. My doctor (RE) was fixated on my late ovulation. I usually ovulated on clomid around CD24. Then with femera it was CD17. She thought that indicated poor egg quality. I never asked for more info as my gut thought she was right given the outcomes cycle after cycle. So I moved my femera up to CD1 and ovulated CD15...and am pregnant now. Sample size of one, of course.

  7. I don't think it's an issue that you're ovulating on different days each cycle, but I do think that it's an issue when you ovulate after day 21-- at least, that's what my RE said. She was absolutely not ok with me ovulating on CD40-45.

    Just as you did ovulated late with your BFP cycle, so did I. I think it was CD24. So, it's not impossible b/c egg quality is not at its best by then (they've been sitting around a little too long) and hormone levels are not as healthy as they would have been the week before.

    Here's the thing-- my ob/gyn didn't seem concerned with this either. It was frustrating. My RE was very concerned about it. Additionally, she wasn't concerned with my TSH levels. The RE was also concerned about this-- I truly believe that's what was keeping me from getting pregnant.

    Have you thought about moving on to an RE? I know that you're starting over after the m/c, so you're in a different place as your one year TTC anniversary rolls around, but I definitely think it's worth considering, if this is a move you want to make.

  8. Wow. So many typing errors, so little time. :)

  9. I am also a late ovulator. My OB/GYN seemed to think it was fine and that I wasn't having sex at the right time each month (she was wrong). Prior to Clomid, I ovulated day 21-23 and my cycles were always 29-30 days. Even if my progesterone was ok on 7 dpo, I would still get my period a few days later. Clomid definitely helped and moved ovulation up to day 17. My cycles were still 29 days, so the luteal phase was improved as well.
    To echo the other ladies, I think the concern with ovulating late is egg quality b/c the egg hangs around too long, but as I said earlier, my OB/GYN didn't seem to think there was a problem. Have you thought about seeking a second opinion or seeing an RE?

  10. I know that I felt very ignored by my OB when it came to my reproductive issues. It wasn't until I got to my RE that I felt that things were looked into. There are lots of simple blood tests that can test hormone levels that can indicate if your egg quality is an issue, midcycle progesterone, etc. You can either ask your OB to run those tests or ask for a referral to a RE. I think the bottom line is that if you are concerned about it, it's an issue. If your doctor brushes your concerns off, they aren't the doctor for you. You need to feel listened to and validated.

  11. Keep in mind that I have PCOS and can have cycles at well over 100 days so my “normal” isn’t everyone else’s normal. However, I do think your ov days look pretty normal and certain life stresses affect and delay ovulation all the time.

    I do not think that having a delayed ovulation is a problem in and of itself. (However, I’d love to know if you get any contrary information.) My only concern with a delayed ovulation is if (and only if) you have “breakthrough” bleeding before ovulation. I doubt that occurs if you are ov’ing around cd 20, but where I’ve had the marathon cycles, I’ve had breakthrough bleeding before ovulation. In my (non-medically educated) mind, that is a problem because that breakthrough bleeding is my uterine lining shedding . . . and I need that lining to be thick or implantation to occur. Does that make sense?

    If your luteal phase is short (less than 12-14 days), then that is definite more of a problem in my book because there is not enough time for implantation to successfully occur. I do know several women who suffer from the luteal phase defect, but are on progesterone to correct.