Well That Was Unexpected
We got the results of my CD 21 progesterone blood test.
Considering we have had 5 miscarriages in the last 2 years, we all (our RE, my husband and I) assumed I am ovulating correctly. One must ovulate in order to get pregnant, and 5 past pregnancies is by far the best indicator of ovulation. We expected the results to be normal.
Alas, the results are not normal.
My doctor is away. At about 3pm yesterday, I had the pleasure of speaking to the first horrible nurse I’ve encountered at my clinic. When I saw horrible, I would prefer to actually use a lot of other words, none of which are very nice. But, my parents taught me that if I don’t have anything nice to say, then I just shouldn’t say anything at all – I’m trying really hard right now.
My progesterone level on day 21 of my cycle was 4.1. All the horrible nurse said was that ovulation occurs with a number of 10, but 4.1 is too high for someone who has not ovulated. The horrible nurse would not clarify anything else. She dodged every single question I asked. She refused to book me an appointment next week with my doctor – she did offer to book one for 2 months from now. Why give me results, if you cannot explain them?! Why send a crazy RPL patient to Dr. Google for advice?! And why be an evil witch about it?! This is just stupid.
So, here I go doing something I despise – turning to the ever so untrustworthy advice of Dr. Google.
From what Dr. Google tells me, anovulation (not ovulating) for one cycle can be very normal for people with a regular cycle and who regularly ovulate. But let’s be honest, we don’t fall into the normal people category, so clearly I cannot accept this as an answer.
Second, a progesterone number of 10.0 is required to confirm that ovulation has occurred. If this is true, then this cycle is dead in the water as there is no way I could be pregnant if I didn’t ovulate (I don’t know much about biology, but I do know that without ovulation one cannot conceive).
Yet, my husband’s version of Dr. Google and scanning scientific journals says a number of 4.0 is considered the minimum requirement for ovulation in the US and could indicate either an early or late ovulation. And what’s even worse is that even if I did ovulate this month and conception occurred, a female body cannot not sustain the pregnancy with this low of a number. In the past, including 2 of our miscarriages, we have started the prometrium supplements when we find out we are pregnant, as per our clinic’s standard protocol. So, this means we would start the prometrium supplements in about a week’s time assuming my pregnancy test is positive. And, our logic says that it would probably be too late to save the pregnancy.
In fact, one article states that 96% of those with progesterone levels below 10 had a non-viable pregnancy.
So right now, my way of viewing this is that no matter how we read the results, it’s not good.
Like really not good.
The two week wait is normally frustrating enough, but I didn’t expect that half way through the wait it would be shot dead in its tracks and make me absolute petrified of becoming pregnant this month. Needless to say, this was unexpected.
Simply, I would rather not get pregnant if I have a 96% chance of miscarriage! If this is my stat, then I’m done. I’m out. Game over.
Part of me suspects that if we do choose to continuing trying, Clomid or Letrozole will be strongly recommended. (I have no scientific reasoning for this suspicion, other than the idea that it is used to help with ovulation). But honestly, unless someone can give me a statistic on how putting my body through these drugs will help me sustain a pregnancy, I just don’t know if I’m willing…I just don’t know…
Regardless, for now, I’m mad at myself. I should have asked the question about our CD21 progesterone level earlier. I should have done more research – I knew low progesterone is linked to miscarriage, but I had made the assumption that you just start it when pregnancy is confirmed. I should have looked harder and educated myself on the importance of CD21. I am smart enough to know better and I know that my husband and I have to be our own best advocates in this. I simply should have pushed harder. I have let myself down which means I am disappointment in myself and am mad at myself all at once. (This is not a feeling I like, and I’m sure I will pull myself out of it pretty quickly, but I also acknowledge the important of allowing these emotions to exist).
And, because I’m mad, I contacted Dr. Braverman’s clinic. Today will involve more reading about Dr. Kwak-Kim. We will see what transpires with this as a realize my decision to contact them now is largely based out of an emotional response and I doubt we will rush into anything.
So with no information on what this result really means, I have no choice but to wait until next week when my doctor gets back. (I’m too angry to call my clinic right back today, so my husband has called and left a message asking for/demanding more information, but I doubt we will hear anything back today). And now, for the first time in our 2 years RPL journey, I hope to hell I am not pregnant this month. I would give anything to have known this earlier as to have avoid trying, but we’ve done the deed at all the right times to ovulation at virtually any point this cycle – early, on time or late. So now it is just a matter of waiting and dreading the possibility of a positive result.
Because I have no better choice, I will remind myself that I can and will survive another miscarriage if we are in fact pregnant this month. And, I will continue to focus on what I said yesterday (and I do see the almost serendipitous fact that I shared this on the same day I got this news – reading this over and over again and your positive comments yesterday was exactly what I needed to get through my evening).
No matter where my life leads. No matter the outcome.
I will live.
I will thrive.
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