Hormonal testing revealed that Chioma had a progesterone deficiency and luteal phase defect that were keeping her from getting pregnant. There are millions of women with a similar problem but don’t know it.
Chioma and her husband Chukwuma had been trying to get pregnant for about three years with no luck and she had begun to worry.
She was 35, the dreaded threshold when getting pregnant can become more difficult and pregnancies can be riskier. So she had started using ovulation predictors and charting her basal body temperature to pinpoint the best times to try. But it was tough failing month after month.
As she rose early one morning to try the home pregnancy test yet again, her mind was full of trepidation. Would it be another failure or would it work this time?
She picked up the plastic wand and stared at the tiny window that would show two pink lines if she was pregnant. No matter how hard Chioma squinted, all she saw was a single line in the middle of stark whiteness.
The test was negative. A few days later, her period came, and the cycle of disappointment began anew.
Chioma continued that rollercoaster ride for several more months, growing more desperate and crestfallen with every failed cycle. And as she continued to chart her temperature fluctuations during her cycle, she noticed something amiss.
She had often heard about the 28-day cycle, which has three parts: the follicular phase, which is when ovarian follicles mature in preparation to release an egg; ovulation, when a mature egg is released and fertilization can occur; and the luteal phase, the time between ovulation and menstruation when the production of progesterone is up, helping thicken the uterine lining for a fertilized egg to implant, causing pregnancy.
A normal luteal phase usually lasts between 12-14 days. For Chioma, it was generally between 7-9 days. Even though her cycles hovered around the usual 28 days, she could tell by her temperature fluctuations that she almost always ovulated later than the typical mid-cycle point of day 14. And thus, there were only a few days after ovulation before her period would begin.
Chioma passed on this observation to her OB-GYN who agreed that she needed testing to determine if she had a progesterone deficiency, but insisted the test be done on the 21st day of her cycle. In doing extensive research about what might be happening, Chioma knew that day 21 testing was based on a 28-day cycle in which a woman ovulates on or around the 14th day.
If a woman has longer cycles or ovulates later, the testing time should be adjusted—it should be done 7 days after ovulation.
Chioma realised that if she was tested on the 21st day, the results would likely be misleading because she would either just have or not yet ovulated.
Chioma tried explaining this, but her doctor wouldn’t budge. She felt like she was wasting time that she didn’t have at her age, so she made the difficult decision to find a new doctor who would administer her testing correctly.
She approached a practice that had a reproductive endocrinologist and felt more confident that she would get her testing done at the correct time in an office that specializes in fertility issues.
The results of her test confirmed what she already suspected—her progesterone levels were very low, and the new doctor diagnosed her with a luteal phase defect.
This solved the mystery of why she hadn’t gotten pregnant, and the doctor also explained that if she had somehow gotten pregnant, the defect would have put her at very high risk for a miscarriage.
As a remedy, the doctor prescribed a progesterone supplement pill that Chioma was to take as soon as she detected ovulation. The day after she obtained a basal body temperature spike that indicates ovulation, she began taking the drugs, hoping that this might make a difference.
After two weeks she was beginning to feel a bit more optimistic—her period still hadn’t arrived, and her luteal phase was finally a normal length.
Chioma continued monitoring her temperature, and when she noticed another spike, decided to try taking another test. This time, she saw two distinct pink lines—after more than two years of trying, She was finally pregnant.
But it wasn’t the end of her hormone treatment. Once Chioma became pregnant, her doctor urged her to continue on the progesterone supplement—this time in suppository form—throughout the first trimester to ensure she didn’t miscarry.
While it certainly wasn’t the most pleasant experience, it was totally worth it to make it through the first stage of pregnancy with no issues. She and Chukwuma were rewarded with the birth of their child—a healthy baby boy—a few months later.
While Chioma’s story ended happily, she can’t help wondering how many women experience the same hormonal deficiencies and don’t have the knowledge to advocate for themselves to get the proper testing and medication. Had she not done significant research, monitored her basal body temperature, and pushed to get the proper testing done at the correct time, she might not have ended up pregnant.
The bottom line is this: If you think something isn’t right, ask questions and don’t be afraid to stand up for yourself, even with your doctor—any discomfort you may feel advocating for yourself will be totally worth it when you hold your baby in your arms.
