Question
Hello- I am writing from Nashville.
I am following up on a question that I sent to you on Friday regarding cramping after ovulation. I have not received a response yet but wanted to update the info.
I am 32 years old with a 2 1/2 year old boy. We conceived in 2 months with him. We have been trying to conceive for 7 months and each month I am having cramps 7 days past ovulation. My period usually starts around day 26 or 27 but my temperature is dropping around day 20.I have been checking my BBT and my temperature dropped today. Based on my chart I am only 20 days into my cycle and 8 days past ovulation. I have been having extreme menstrual cramps since Thursday. I went to the obgyn because of the cramping on Thursday. This was 5 days past ovulation. They did vaginal, pelvic ultrasounds and a progesterone test. My level came back at 17.5. and the ultrasounds looked perfect. I believe that this progesterone test was done too early and now my levels have dropped. What should my next step be? On Friday the Dr. called and said that everything was great and that I should just be patient. I do not believe that everything is great. It seems that based on my fertility charting there is a luteal phase defect but I am not sure what to do to get this diagnosed especially after my progesterone tests came back in the normal range.
I also wanted to get your opinion on natural fertility aids such as FertileAid and Vitex. Do you think these are worth trying? Thank you so much. I appreciate your thoughts.
AnswerHi Carrie,
Sorry for the delay in getting back to you. I just answered your question.
A luteal phase defect is diagnosed by a pre-menstrual (just before menstrual like cD#27) endometrial biopsy and not necessarily by a luteal phase progesterone level. If you had a luteal phase defect, your luteal phase would be less than 14 days, but it sounds like your luteal phase is appropriate. The cramping would not be a symptom of a luteal phase defect.
One thing that I would worry about, which the ultrasound or blood tests cannot show, is endometriosis. Endometriosis causes inflammation in the pelvis and increases as the menses approaches. This cannot be seen on ultrasound and the only way to diagnose it is through a laparoscopy, which is an outpatient surgery. You might want to consider this procedure if the pain is worsening.
The fertility aids such as FertililityAid, are just vitamin supplements. I usually do not recommend them, but if you plan to use then, plan on the cost (because you will have to use them several times per day for several months) and don't expect that they are a miraculous drug that leads to pregnancy (because they are not).
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf
