Vitamins to Lengthen LP?

[shadesofgold]

Let me start by saying that I did try to get in touch with my midwife for an answer, but have not yet heard back. I am doing online research but am looking for a little wisdom from GKU!


I am on the bench since our loss in early March, and have been charting in the meantime. I have noticed that my luteal phase has been 10 days and 9 days, respectively, my last two cycles. (It is supposed to be at least ~11-14 days to support healthy implantation.) From what I've read, a short luteal phase can be caused by progesterone deficiency and can lead to difficulty conceiving or recurrent miscarriage. I don't know for sure if progesterone is the issue, but it seems likely since I'd been on BC for >10 years until last November and/or my hormones were bonkers after my loss. 

I read that Vitamin B6 can aid in progesterone production and lengthening the cycle. I noticed a few ladies were taking it here. Last week I started taking 100 mg of B6 with my multivitamin and fish oil daily. (This is the maximum recommended dose - 50 mg would probably be more ideal if I could split pills.) I have heard that a B-complex is also recommended, but none of the B-Complex I found at my local pharmacy contained over 2 mg of B6, and that seemed way too low. I have also heard that some women use Vitex or Chasteberry to normalize their progesterone levels/menstrual cycle. 

Do you use any supplements to lengthen your LP or encourage/balance your hormones? Any advice for me in this arena?

Thanks in advance!

[joy]

If you have a progesterone problem, then supplemental progesterone is the way to go.

[kellybenelly83]

also shadesofgold after 3 cycles with LP shorter than 10 you have a very good reason to see your Dr and ask for help on that.

[Deleted]

Just lurking...

I had short LP's as well normally around 9-10 days, and I started taking Omega 3's women's formula and it lengthened my LP by a few days. I also would drink green tea in the morning (prenatal at night). I don't know if it is a coincidence or not, but my LP did lengthen after I started taking these vitamins and drinking the green tea.

[joy]

No, really... if you have a progesterone problem, then you need supplemental progesterone. I would not dilly-dally around with vitamins or other stuff. There's a very simple fix if this is the problem.

[shadesofgold]

May 12, 2015 13:44:34 GMT -5 joy said:

No, really... if you have a progesterone problem, then you need supplemental progesterone. I would not dilly-dally around with vitamins or other stuff. There's a very simple fix if this is the problem.

Thanks. I am not sure it is a progesterone problem, but suspect it. I've sent another note to my midwife and asked specifically if testing was possible/necessary. (They are part of a hospital with an online medical record and messaging system, and she has been responsive in the past.) If I don't hear from them in the next few days, I will call and try to set up an appointment so I can ask in-person. Is the testing more involved than bloodwork? Thanks again!

[joy]

May 12, 2015 14:06:20 GMT -5 shadesofgold said:

May 12, 2015 13:44:34 GMT -5 joy said:

No, really... if you have a progesterone problem, then you need supplemental progesterone. I would not dilly-dally around with vitamins or other stuff. There's a very simple fix if this is the problem.

Thanks. I am not sure it is a progesterone problem, but suspect it. I've sent another note to my midwife and asked specifically if testing was possible/necessary. (They are part of a hospital with an online medical record and messaging system, and she has been responsive in the past.) If I don't hear from them in the next few days, I will call and try to set up an appointment so I can ask in-person. Is the testing more involved than bloodwork? Thanks again!

Not that I know of!  I'm just trying to save you some headache over wondering and going down unfruitful roads.  I hope you hear from your doctor soon!!

[shadesofgold]

May 12, 2015 14:42:01 GMT -5 joy said:

May 12, 2015 14:06:20 GMT -5 shadesofgold said:

Thanks. I am not sure it is a progesterone problem, but suspect it. I've sent another note to my midwife and asked specifically if testing was possible/necessary. (They are part of a hospital with an online medical record and messaging system, and she has been responsive in the past.) If I don't hear from them in the next few days, I will call and try to set up an appointment so I can ask in-person. Is the testing more involved than bloodwork? Thanks again!

Not that I know of!  I'm just trying to save you some headache over wondering and going down unfruitful roads.  I hope you hear from your doctor soon!!

I appreciate it! I would certainly love to not waste my time! I did a few searches of "progesterone supplements" on the boards to start getting some more information about it. Thanks again.

[pismoduo]

Can I ask a spin-off question? I've never had 3 LPs in a row shorter than 10 days, but out of 8 cycles I've had 3 with an LP less than 10 and 1 anovulatory cycle. Should I stick it out until the year mark, or is it worth talking to someone about sooner?

[shadesofgold]

Update! Heard back from my OB practice. They basically said that while it is uncommon to have a short LP, there is a lot of conflicting evidence about luteal phase defect, how it impacts fertility, and if vitamins can help (but welcomed me to add B6 and B-complex to my regimen). Based on my case history, she wouldn't yet recommend progestins. She recommended continuing trying as we were, and if we don't have a successful pregnancy within a year of trying, they can do additional testing.

[helloerrbody]

May 12, 2015 17:26:35 GMT -5 pismoduo said:

Can I ask a spin-off question? I've never had 3 LPs in a row shorter than 10 days, but out of 8 cycles I've had 3 with an LP less than 10 and 1 anovulatory cycle. Should I stick it out until the year mark, or is it worth talking to someone about sooner?    

I would see someone sooner in that situation.

[helloerrbody]

May 12, 2015 20:35:29 GMT -5 shadesofgold said:

Update! Heard back from my OB practice. They basically said that while it is uncommon to have a short LP, there is a lot of conflicting evidence about luteal phase defect, how it impacts fertility, and if vitamins can help (but welcomed me to add B6 and B-complex to my regimen). Based on my case history, she wouldn't yet recommend progestins. She recommended continuing trying as we were, and if we don't have a successful pregnancy within a year of trying, they can do additional testing.

If your next few cycles also have short LP's, I would ask again about progesterone testing.  It's a simple blood draw at 7 or 8 DPO.  Nothing invasive or (relatively) expensive, and if your progesterone is significantly low, it could make a difference getting it supplemented.

[pismoduo]

May 12, 2015 20:53:51 GMT -5 helloerrbody said:

May 12, 2015 17:26:35 GMT -5 pismoduo said:

Can I ask a spin-off question? I've never had 3 LPs in a row shorter than 10 days, but out of 8 cycles I've had 3 with an LP less than 10 and 1 anovulatory cycle. Should I stick it out until the year mark, or is it worth talking to someone about sooner?    

I would see someone sooner in that situation.

Thanks. I'll see if the OB in my PCP's office has any openings. Hopefully it's something minor. Could even be a lingering effect from the depo.

[helloerrbody]

May 12, 2015 21:08:18 GMT -5 pismoduo said:

May 12, 2015 20:53:51 GMT -5 helloerrbody said:

I would see someone sooner in that situation.

Thanks. I'll see if the OB in my PCP's office has any openings. Hopefully it's something minor. Could even be a lingering effect from the depo.

You could def wait it out, but if it was me, I would want to get things checked out sooner.

[pismoduo]

May 12, 2015 21:23:18 GMT -5 helloerrbody said:

May 12, 2015 21:08:18 GMT -5 pismoduo said:

Thanks. I'll see if the OB in my PCP's office has any openings. Hopefully it's something minor. Could even be a lingering effect from the depo.

You could def wait it out, but if it was me, I would want to get things checked out sooner.

Nah. Waiting it out hasn't really done me any favors so far.

[FDL]

May 12, 2015 20:35:29 GMT -5 shadesofgold said:

Update! Heard back from my OB practice. They basically said that while it is uncommon to have a short LP, there is a lot of conflicting evidence about luteal phase defect, how it impacts fertility, and if vitamins can help (but welcomed me to add B6 and B-complex to my regimen). Based on my case history, she wouldn't yet recommend progestins. She recommended continuing trying as we were, and if we don't have a successful pregnancy within a year of trying, they can do additional testing.

****lurking****

Firstly, I'm very sorry for your loss.

I have to agree with your OB office on this one. You've had two cycles with short LPs following a loss. I wouldn't start supplementing after two cycles following a loss while you're healing. I would however look into testing after repeat losses.

They are correct in that there is conflicting evidence on how a luteal phase defect can effect fertility. Identifying the cause is the most important thing.

Even if you have a progesterone draw done at 7DPO, and it comes back low that is only going to tell you one piece of the puzzle. To get the full picture you would need additional testing. They could give you progesterone but they might be putting a bandaid on the problem when you really need a tourniquet. Luteal phase defects can be caused by the body not naturally producing enough progesterone, which a supplement could help. It could also be that the endometrial lining isn't responding to the progesterone being produced or poor egg quality.

Progesterone supplements aren't going to help with egg quality issues or if the endometrial lining isn't responding to the progesterone already being produced by the body.

I would continue to chart and try again once you are off the bench. If you do continue to have a short luteal phase then I would look into further testing.

Here is some information on the diagnosis and treatment of LPD from resolve.
www.resolve.org/about-infertility/medical-conditions/luteal-phase-defect.html

I hope this information helps!

[ghostmonkey]

May 12, 2015 20:56:16 GMT -5 helloerrbody said:

May 12, 2015 20:35:29 GMT -5 shadesofgold said:

Update! Heard back from my OB practice. They basically said that while it is uncommon to have a short LP, there is a lot of conflicting evidence about luteal phase defect, how it impacts fertility, and if vitamins can help (but welcomed me to add B6 and B-complex to my regimen). Based on my case history, she wouldn't yet recommend progestins. She recommended continuing trying as we were, and if we don't have a successful pregnancy within a year of trying, they can do additional testing.

If your next few cycles also have short LP's, I would ask again about progesterone testing.  It's a simple blood draw at 7 or 8 DPO.  Nothing invasive or (relatively) expensive, and if your progesterone is significantly low, it could make a difference getting it supplemented.

Progesterone testing is not how you test for a LPD. You have to do an endo biopsy. 

And those fuckers SUCK.

[shadesofgold]

Thanks so much for the info, FDL and ghostmonkey. Super helpful to understand the issue and the potential tests ahead. I am hoping my cycles balance themselves out as I recover from the loss and take better care of myself which is also part of the healing process, I suppose. Good to know what could be ahead should the not balance themselves. (And I'm really glad I am charting and catching that my LP is short. I usually O on CD 17, so my cycle is still 27 days - a seemingly normal length.)

[helloerrbody]

May 12, 2015 22:55:13 GMT -5 ghostmonkey said:

May 12, 2015 20:56:16 GMT -5 helloerrbody said:

If your next few cycles also have short LP's, I would ask again about progesterone testing.  It's a simple blood draw at 7 or 8 DPO.  Nothing invasive or (relatively) expensive, and if your progesterone is significantly low, it could make a difference getting it supplemented.

Progesterone testing is not how you test for a LPD. You have to do an endo biopsy. 

And those fuckers SUCK.

My RE tests progesterone first for a short LP. If there is a deficiency, she will prescribe supplements. If those do not help lengthen the LP, then she will do further testing. Maybe she's doing it wrong ? but I know progesterone supplements alone have helped some lengthen their LPs and get pregnant.

[FDL]

May 13, 2015 10:22:32 GMT -5 @underdog25 said:

This is totally unrelated, but I just saw your siggy FDL. Oh my goodness, congrats!!!!!!

Thank you!

[wannabmama]

Everyone here may already know this but I had an "aha!" moment when I met with my RE, I told her I'd had some short-ish LPs and she asked how I was calculating them, I said off temping/O date...she told me the LP is actually based on the LH surge, so usually a day or two before O (I haven't been able to make OPKs work for me), but so what I thought was a 10 day LP (based on O) was really 11 or 12 days, if that makes sense. Just thought it was a interesting point.

[shadesofgold]

May 13, 2015 13:09:10 GMT -5 wannabmama said:

Everyone here may already know this but I had an "aha!" moment when I met with my RE, I told her I'd had some short-ish LPs and she asked how I was calculating them, I said off temping/O date...she told me the LP is actually based on the LH surge, so usually a day or two before O (I haven't been able to make OPKs work for me), but so what I thought was a 10 day LP (based on O) was really 11 or 12 days, if that makes sense. Just thought it was a interesting point.

Hmmm... If this is true, why would FF tell me my LP length based on O date? (In the Cycles History box, to the right of the Fertility Analyzer.) In the education section it also defines the luteal phase as "the time between ovulation and menstruation." 

[joy]

May 13, 2015 9:33:34 GMT -5 helloerrbody said:

My RE tests progesterone first for a short LP. If there is a deficiency, she will prescribe supplements. If those do not help lengthen the LP, then she will do further testing. Maybe she's doing it wrong ? but I know progesterone supplements alone have helped some lengthen their LPs and get pregnant.

So, this is where I'm starting to get confused.

My progesterone was tested at 7 DPO and it was 4.5.  To me, this seems low.  To my doctor, he said it was fine.  He said progesterone testing was more of a yes/no if ovulation occurred and not a quantitative measure of how good that ovulation was (ie. high progesterone indicating strong ovulation, etc).  He also said that if we had pulled my blood at a different time of day, then my progesterone level would've been a different number.

I've also heard women say that their REs will not prescribe progesterone because they can't tell if you really need it and it's a waste of time.  But then you hear of women getting it prescribed because "it can't hurt anything."

Progesterone is a pile of insanity. 

And I think mine is low.

But my luteal phases average over 13 days.

I'm so confused.

[wannabmama]

May 13, 2015 14:22:06 GMT -5 shadesofgold said:

May 13, 2015 13:09:10 GMT -5 wannabmama said:

Everyone here may already know this but I had an "aha!" moment when I met with my RE, I told her I'd had some short-ish LPs and she asked how I was calculating them, I said off temping/O date...she told me the LP is actually based on the LH surge, so usually a day or two before O (I haven't been able to make OPKs work for me), but so what I thought was a 10 day LP (based on O) was really 11 or 12 days, if that makes sense. Just thought it was a interesting point.

Hmmm... If this is true, why would FF tell me my LP length based on O date? (In the Cycles History box, to the right of the Fertility Analyzer.) In the education section it also defines the luteal phase as "the time between ovulation and menstruation." 

I don't know, that's what I thought, too. Maybe there's some difference between what docs "count" as the LP? I'm no doctor obviously, just sharing what she told me. Maybe she was just less concerned overall bc my LP hasn't been shorter than 10 days (based on O) and she just explained it poorly. Obviously if you're close to the "line" at 10 days or less it's worth looking into and getting info from your doc.

[shadesofgold]

May 13, 2015 14:29:43 GMT -5 joy said:

May 13, 2015 9:33:34 GMT -5 helloerrbody said:

My RE tests progesterone first for a short LP. If there is a deficiency, she will prescribe supplements. If those do not help lengthen the LP, then she will do further testing. Maybe she's doing it wrong ? but I know progesterone supplements alone have helped some lengthen their LPs and get pregnant.

So, this is where I'm starting to get confused.

My progesterone was tested at 7 DPO and it was 4.5.  To me, this seems low.  To my doctor, he said it was fine.  He said progesterone testing was more of a yes/no if ovulation occurred and not a quantitative measure of how good that ovulation was (ie. high progesterone indicating strong ovulation, etc).  He also said that if we had pulled my blood at a different time of day, then my progesterone level would've been a different number.

I've also heard women say that their REs will not prescribe progesterone because they can't tell if you really need it and it's a waste of time.  But then you hear of women getting it prescribed because "it can't hurt anything."

Progesterone is a pile of insanity. 

And I think mine is low.

But my luteal phases average over 13 days.

I'm so confused.

You and me both, sister.

[mugster]

May 13, 2015 14:29:43 GMT -5 joy said:

May 13, 2015 9:33:34 GMT -5 helloerrbody said:

My RE tests progesterone first for a short LP. If there is a deficiency, she will prescribe supplements. If those do not help lengthen the LP, then she will do further testing. Maybe she's doing it wrong ? but I know progesterone supplements alone have helped some lengthen their LPs and get pregnant.

So, this is where I'm starting to get confused.

My progesterone was tested at 7 DPO and it was 4.5.  To me, this seems low.  To my doctor, he said it was fine.  He said progesterone testing was more of a yes/no if ovulation occurred and not a quantitative measure of how good that ovulation was (ie. high progesterone indicating strong ovulation, etc).  He also said that if we had pulled my blood at a different time of day, then my progesterone level would've been a different number.

I've also heard women say that their REs will not prescribe progesterone because they can't tell if you really need it and it's a waste of time.  But then you hear of women getting it prescribed because "it can't hurt anything."

Progesterone is a pile of insanity. 

And I think mine is low.

But my luteal phases average over 13 days.

I'm so confused.

My RE said that since it surges, not to worry too much if a number was not quite what was desired. She said they want to see 10, but wouldn't worry about an 8. But she said if it was a 6 it would be meaningfully low.... which is to say, your RE seems very different from mine. However, just because it is meaningfully low does not necessarily mean progesterone supplements. Clomid, Femara, etc. help with progesterone too by making a stronger ovulation... so, since your RE wants to do medicated cycles, he might just mean, he doesn't think you would need extra treatment on top of what the medication would provide? I don't know joy, I'm new to all of this.

[joy]

May 13, 2015 14:53:29 GMT -5 mugster said:

My RE said that since it surges, not to worry too much if a number was not quite what was desired. She said they want to see 10, but wouldn't worry about an 8. But she said if it was a 6 it would be meaningfully low.... which is to say, your RE seems very different from mine. However, just because it is meaningfully low does not necessarily mean progesterone supplements. Clomid, Femara, etc. help with progesterone too by making a stronger ovulation... so, since your RE wants to do medicated cycles, he might just mean, he doesn't think you would need extra treatment on top of what the medication would provide? I don't know joy, I'm new to all of this.

This was an unmedicated cycle and I specifically asked if 4.5 meant that I was having "weak" ovulation.  He said he couldn't say - this was just a qualitative way of looking at ovulation.

We actually almost didn't even test progesterone because my luteal phases were so good in length.  He assumed that there was no way I could have a progesterone problem. 

So, yeah. 

[helloerrbody]

May 13, 2015 14:29:43 GMT -5 joy said:

May 13, 2015 9:33:34 GMT -5 helloerrbody said:

My RE tests progesterone first for a short LP. If there is a deficiency, she will prescribe supplements. If those do not help lengthen the LP, then she will do further testing. Maybe she's doing it wrong ? but I know progesterone supplements alone have helped some lengthen their LPs and get pregnant.

So, this is where I'm starting to get confused.

My progesterone was tested at 7 DPO and it was 4.5.  To me, this seems low.  To my doctor, he said it was fine.  He said progesterone testing was more of a yes/no if ovulation occurred and not a quantitative measure of how good that ovulation was (ie. high progesterone indicating strong ovulation, etc).  He also said that if we had pulled my blood at a different time of day, then my progesterone level would've been a different number.

I've also heard women say that their REs will not prescribe progesterone because they can't tell if you really need it and it's a waste of time.  But then you hear of women getting it prescribed because "it can't hurt anything."

Progesterone is a pile of insanity. 

And I think mine is low.

But my luteal phases average over 13 days.

I'm so confused.

It definitely seems like there is no certain or definitive answer when it comes to this, as the RE's don't agree and vary in their opinion.  I do know that there is a lot of recent research that questions the use of your progesterone level to determine if/how well you ovulated.

My RE told me that progesterone of 4 or higher at 7DPO shows ovulation, and 10 or higher shows "strong ovulation."  (Whatever the fuck that means.)  I have also heard others say that their doctors prescribed progesterone because "it wont hurt anything" and could potentially help.

So I'm just adding to the confusion.  Sorry Joy.

[joy]

May 13, 2015 15:19:23 GMT -5 helloerrbody said:

May 13, 2015 14:29:43 GMT -5 joy said:

So, this is where I'm starting to get confused.

My progesterone was tested at 7 DPO and it was 4.5.  To me, this seems low.  To my doctor, he said it was fine.  He said progesterone testing was more of a yes/no if ovulation occurred and not a quantitative measure of how good that ovulation was (ie. high progesterone indicating strong ovulation, etc).  He also said that if we had pulled my blood at a different time of day, then my progesterone level would've been a different number.

I've also heard women say that their REs will not prescribe progesterone because they can't tell if you really need it and it's a waste of time.  But then you hear of women getting it prescribed because "it can't hurt anything."

Progesterone is a pile of insanity. 

And I think mine is low.

But my luteal phases average over 13 days.

I'm so confused.

It definitely seems like there is no certain or definitive answer when it comes to this, as the RE's don't agree and vary in their opinion.  I do know that there is a lot of recent research that questions the use of your progesterone level to determine if/how well you ovulated.

My RE told me that progesterone of 4 or higher at 7DPO shows ovulation, and 10 or higher shows "strong ovulation."  (Whatever the fuck that means.)  I have also heard others say that their doctors prescribed progesterone because "it wont hurt anything" and could potentially help.

So I'm just adding to the confusion.  Sorry Joy.

Nope, you're just confirming what I feel like I've already heard.  That alone is very helpful!

[shadesofgold]

It seems like a lot could depend on what the science was when our doctors went to school. (It wouldn't be the only issue in medicine for which this is the case.) My MD (who said the evidence is mixed and that I probably wasn't a candidate for progesterone supplement yet) is in her 30s. I recall that she performed my D&C using newer methods and also had quoted research from England on Rh factors, so I get the strong indication she is keeping up with the latest science. (Then again, she may not be immersed in conception and infertility science.) So basically, each health expert could be giving us all different answers based on different research and different experiences. [Paging RajahMD!]