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Fertility Network UK
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Sensitive post - success with pre-period spotting and luteal phase defect

I've um'd and arghed about writing this post for a while, but I see so many posts about pre-period spotting and luteal phase defects and it makes me so mad that this isn't an area understood or treated. Sorry for the essay!

My journey began over 4 years ago. I came off the pill and immediately began experiencing spotting about 3 days before my period. I thought this was just my body adapting to coming off the pill. And anyway, it was great as it was a sign my period was coming and I never got "caught out". We began trying. I was 31, fit and healthy with a very good diet. It would be easy, right? After only a few months of trying I started to worry. Why hadn't it happened yet? It was then I became concerned about the spotting. It was also at this time that the spotting began 5 days before my period.

I did all of the usual ovulation checking, ovulation sticks, CM tracking, temperature charting. My luteal phase was 15 days, with spotting starting from 10dpo.

We went to my GP and I said I thought I needed a progesterone supplement to help me get pregnant. My GP, whilst sympathetic, had to refer me to the fertility clinic. Cue all of the usual tests. These all came back fine. I was diagnosed as unexplained. One doctor even suggested my spotting would go if I gained some weight! My spotting actually increased when I did this. I was now spotting from 5dpo, 10 days pre-period.

At one of my appointments I demanded my spotting be looked into. Instead, I was thrown a prescription for provera. Not really understanding, I got the provera and tried it. First month, bfp followed by immediate chemical. The provera was the wrong type of progesterone and nowhere near strong enough.

I asked my GP for a second NHS opinion while simultaneously seeking a private opinion. The private clinic advised that it sounded like my progesterone levels were dropping throughout my luteal phase, but only scans and regular blood tests would prove this. NHS wanted to re-run some tests, but interestingly not my progesterone levels.

After crying in my last NHS appointment, the senior consultant decided to prescribe me with Cyclogest as I'd had a chemical on a very low dose of progesterone 6 months previously. I suspect some of this was just to shut me up and get me out as my appointment had already taken 2 hours!

First month, no spotting, bfn, heavy period. Second month, tiny amount of spotting 7dpo, none after, bfp. My little girl is 15 weeks old tomorrow. After a year of asking for progesterone I got it and it did what I suspected.

I had tried all of the supplements and nothing helped my spotting. If you feel that there is a problem and that you are not being listened to, keep pushing. Not enough is known about luteal phase defects yet they can be easily, and inexpensively, treated. Good luck to everyone on here, I hope you all get your miracle babies, be them your own, through a donor or surrogate, or through adoption. Keep on fighting!

24 Replies
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Huge congratulations on having your daughter so delighted for you. What a tough journey you had but so glad you got there & you’re so right we know when something isn’t right and must back it 👍

Thank you for sharing your story , it could really help someone else.

I had pre period spotting which was ignored by some medics, until my gynae symptoms became worse & was eventually diagnosed with endometriosis ( which caused it) after 5 years 10 months of TTC. It’s the time you lose that is so frustrating.

Sorry about your chemical pregnancy, I had one last year. But am now 15 weeks pregnant. 🙂

It’s a difficult journey but one that can be won 😘 xoxo

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Thank you Jess. I've been following your story in the background and am so pleased for you, congratulations.

You're right, it is the time lost. My journey was relatively short but was still so frustrating as I knew exactly what was needed but it still took a year to get there.

Good luck with the rest of your pregnancy xx

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Well done on your tenacity to keep persuing your gut feeling, unfortunately sometimes we have to guide our own treatment when the professionals dont listen. Glad it all worked out for you!xx

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Thank you. And good luck for your FET, I'll be keeping my fingers crossed for you xx

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Thank you for this! And congratulations !

I feel exactly the same thing- my progesterone support was far too low and the clinic would not listen and I feel have wasted 2 of our best chances simply for something that could easily have been treated. Surprise surprise they are loading me up with it this time round and even the new consultant suggested it himself !

Fingers crossed it works for us this time as we do have other issues too. At the very least I don’t want early bLeeds before OTD.

I don’t understand why they gave you provera though? Was it to instigate a withdrawal bleed? To override your cycle.

As it’s a very strong drug used for contraception and not supppsed to be used if possibly pregnant. I just mention it in case someone scrolls through they won’t confuse it with cyclogest or other pessaries and will look into it if suggested.

Cyclogest has been far better than other supports I’ve had (I.e utrogestan) but I’m

Now also on lubion injections.

It makes me so angry that collectively on here us non specialists can see the same recurring themes, spot similar problems, solutions, interventions and yet the ‘specialists’ act surprised at every turn (!£

I don’t normally advocate taking matters into your own hands and ignoring doctors advice but I absolutely second your suggestion to keep pushing them! We know our bodies x

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Thank you Saya. You're totally right with the provera, it should not be confused for progesterone support, but unfortunately that's why I was prescribed it. When I did my own research I discovered it should really only be used in PCOS cases to induce a period and kick start a cycle. I used it because I trusted the professionals. I shouldn't have done, and I'm grateful that I only had a chemical rather than a later miscarriage or a baby born with problems as a result. But ultimately, the chemical pregnancy was the thing needed to convince the NHS specialist to put me on the "right" progesterone. Sometimes things really do happen for a reason xx

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So glad it worked for you.

They did a pregnancy test and an intravaginal scan before I was on provera to make absolutely sure I wasn’t pregnant as it can be that serious.

I’ve had it a few times now and you’re not even supposed to be on it multiple times.

It’s so frustrating they don’t even suggest upping progesterone when women are getting spotting and cramping on tww. It doesn’t do any harm from what we can see and could potentially save things - so many women- myself included- have managed to stop the bleeding instantly with extra progesterone.

But absolutely- I believe things happen for a reason and that it possibly wasn’t our time.

Hope everything goes smoothly for you and you get your bundle of joy happy and healthy ☺️🤞

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Just an update since I commented before our tww..... We got our first bfp !!!! And I'm still pregnant a week later woohoo!

I did get a light bleed straight after the bfp but not like previous cycles and it eased off quickly

I think that was irritation of cervix and to do with second embryo

Nothing since .... I took a pessary a little later than usual one day and could feel the cramps immediately and light pink discharge as soon as I took pessary it stopped.

I feel vindicated (!)

Definitely I believe the blood thinners have also helped for a healthy lining to stop spotting

And the steroids I was on helped my thyroid.

All of this could have easily been avoided in previous cycles if they had just listened and treated my case as an individual .... Not a sausage factory approach of 'lets do standard protocol and Wel see'.

But I'm so relieved !!!! I just hope there isn't more that were unaware of that may affect the pregnancy but for now I'm just so over the moon that after 9 years of barely ovulating and constant BFNs I actually have two positive lines for the first time ever !

And I hope lots of.women see your post- I have linked it a fair few times xx

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Congratulations Saya, that's fantastic news. I'm so glad the extra support worked for you this time. I wish you a happy and healthy pregnancy, and a little bundle of joy next August/September xx

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Thanks for sharing and congratulations too 😊💖 Spotting is something I have pre-period without fail! I have had lap/hyst- mild endo but think it was removed. 2 failed icsi, but poor embryos, 2nd go I had additional lubion. The pre period bleeding is something they aren’t interested in looking into! When did you take the progesterone? All through cycle? Sorry if that’s a stupid question! xxx

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Not a stupid question. I had to confirm ovulation through temp charting, then took it for 10 days. I had to do a pregnancy test each month. If BFN I would stop taking it. On BFP I continued to take it until after 12 weeks but did that on my own beliefs as shockingly my care stopped at BFP! Keep an eye on your endo, apparently it can grow back far too quickly so if you're ever worried get it checked again. Good luck and keep trying to get the right treatment for you xxx

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Wow. Amazing story. Congratulations.

Thank you for sharing. I am familiar with how long a luteal phase should be, you research the hell outta everything when ttc. I know some women experience short luteal phases and that this can hinder conception. It should be taken more seriously xx

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Thank you Vicky. And congrats on your BFP. I hope this is your rainbow baby xx

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I have had spotting for years before my period and it was only my reflexologist who said I needed to look into this. It's incredible how basic checks are not done and you have to be and plead with doctors to help you when sometimes the answer is quite simple. I have had two ectopics so I can only conceive through IVF and you are given luteal support as standard but it should be considered more widely for those with unexplained fertility. Congratulations on your baby and well done for advocating xx

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Thank you Hollie. I'm so sorry to hear about your ectopic pregnancies. I hope IVF works for you xx

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Thank you for this post and congratulations on your baby!

We started trying in Aug 2017 and as I tracked my cycles, I started noticing 3-5 days of spotting. After 4 months, I began getting worried I may have a Progesterone deficiency, so I went to see a gynecologist. They said it wasn't anything to worry about, but ordered a scan to check things out.

The following May, after no success, we went to an IVF clinic for testing. They said all was normal. I asked about my spotting and they gave me Progesterone for 3 months, but didn't recommend any hormone testing. In July we went to see a new infertility consultant and were diagnosed with unexplained infertility. Again I asked about the spotting and what I thought was a 10-11 day luteal phase. She said no more testing was necessary as the IVF would be the first course of treatment regardless. We had a very successful treatment which resulted in 7 beautiful frozen embryos.

Meanwhile I'd been seeing an endocrinologist for a thyroid issue. I also asked her about my luteal phase and she agreed it wasn't worth investigating as the IVF process would cover any issues there may be. However, due to OHSS risk, I didn't do a fresh transfer and now they want to do a natural FET in January. I became anxious that if I have a luteal phase problem, after all this time, money and heartache, we'd be setting ourselves up for failure. I already love my embryos and decided I wasn't going to take that chance and took matters into my own hands.

I dove into a book I'd had called Taking Charge of Your Fertility and educated myself about my cycles and the luteal phase. I discovered what I'd thought was spotting was actually the begging of my period. This meant my luteal phase was actually on average 9 days with a couple as few as six. I found out that a series of Progesterone tests would be needed to get an accurate picture of my luteal phase.

I phoned my GP, which refused to do the series of tests because they wouldn't know how to analyze them. My IVF clinic would do the tests, but also said they couldn't analyze the results. On my next visit to my endocrinologist, I layed out all my evidence. She agreed I likely had a luteal phase problem and suggested we do the series test. Thank God someone was finally taking me seriously.

I'm currently in the middle of this test and will have the results by next Friday. It's been a year since I first started seeking answers from the professionals. It's unbelievable what it took to get here. I agree so much with your advice. You have to trust your gut and advocate for what you feel you need.

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I'm glad you're getting your answers very soon, and I hope that this leads to the right treatment plan for you. Good luck with your FET in January, your little embies are in such good hands xx

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Congratulations and thank you for sharing. We were diagnosed as unexplained but they couldn't find anything wrong even with progesterone testing. It just goes to show how you need to persevere to get what you want x

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Thank you and congratulations on your pregnancy xx

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I have this too. Such a positive story. Can I ask when in your cycle you start this? Xx

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Hi Steph, I was told to start once ovulation was confirmed which I did through ovulation sticks to pinpoint the window of ovulation and temperature charting to confirm it had occurred. I'd wait for 2 or 3 consistent temperature rises before taking my first Cyclogest as taking it too early could prevent ovulation if it hadn't occurred yet. I would then take for 10 days and then do a pregnancy test. Good luck with getting the right treatment xx

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What an inspirational and encouraging story! Well done and congratulations on the birth of your baby girl! 🎉♥️

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Thank you! I hope all goes well with your pregnancy xx

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Thank you 🙏🏽😘

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