Strange chart ever since MMC and CP

[Sheaby]

In May 2013, I had a MMC at 6w2d.  Following the D&C, my cycle took about 6 weeks to return - and my temperatures have been all over the place.  Last month, I was unable to identify a clear thermal shift, but I did in fact ovulate because we got pregnant again, however this was a chemical pregnancy, and my cycle started only 1 day late.  I had 3 days of + HPT's, so I don't believe this was a false result.  Since this cycle started, I switched to vaginal temping.  For 3 days, cycle days 15-17, I had a small but clear temperature shift that rose .1 degree each day, and then yesterday and today (cd 18-19), it is back down to pre-O temps and I clearly have EWCM.  My CP is high and mostly open, but not quite soft.  My typical ovulation day has been around cd17-19 with a 12 day LP, so seeing the shift at cd15 was odd for me - but I'm confused as to what could be causing the odd temperature changes.  In March, when we got pregnant, my temperature shifts were textbook, including the triphasic pattern.  I'm not on any medications, and only take 800mg of folic acid daily.  I temp at the same time every day, and my sleep does not normally get disrupted.  Any insight would be greatly appreciated.

[Sheaby]

I do know that I am ovulating, since my temperature shifts have always been quite clear.  Cycle day 17-19 has been the norm for me for several years with 33-35 day cycles being pretty clockwork.  Last month and this month are the only months in question - but with the chemical pregnancy, I obviously ovulated last month, I just didn't have that clear shift.  Is it possible that 2 miscarriages in 3 months have caused these changes?  And will it go back to normal?  I don't use OPKs, to me they are pretty much garbage.  I know some women swear by them, I personally prefer to chart with temperatures and just have intercourse at least every other day.

[Elaine Brown, MD]

Hi!
If you were my patient, I would wonder if you are truly ovulating.  Cycle day 17-19 is quite late.  I would do a cycle day 21 progesterone level in addition to ovluation predictors.  I would repeat on cycle day 28 if you have really long cycles.  If your progesterone level is not rising, you won't see a temperature elevation.  If you are not ovulating regularly, you won't have elevated progesterone levels.
Your positive hpt was probably a chemical pregnancy as you say, so you probably ARE ovulating with some of your cycles.
Good luck!
Dr B