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.

 If you like this post, please feel free to share it and please return to myperfectbreakdown.com to follow my journey.

98 Comments on “Well That Was Unexpected

  1. oh i am so sorry girl! I don’t know much about this but my friend has low prog and rubs a cream for it on certain parts of her body before and after ovulation. Have you heard about this?

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  2. I think you need to see the doctor so you can get the answers to your questions. I also think you should complain about that dreadful woman. She should show more compassion in her role. Please don’t lose hope now. Xx

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    • I am pretty sure a complaint will be put forward!
      And, I think that’s my biggest issue right now, is I need to understand this from a medical perspective, and they are telling me I have to wait 2 months. That’s insane!
      Anyways, thanks for the encouragement. I definitely need it today!

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      • Do they do phone consultations with the doctor? That would be my suggestion. If the doctor can’t see you in the office, how about a phone consult?

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      • I asked for that, and nope.
        I even just asked her to find out more information from one of the other doctors who is not on vacation and the answer was not promising.

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  3. How frustrating! What is the point of giving results if you can’t explain them! On the positive side, I have a friend who had two losses before a day 21 test revealed her low progesterone level. Now she has to start prometrium as soon as she ovulates and has had two successful pregnancies this way.

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    • I think that might be part of the solution – starting to take prometrium once I ovulate, not once I test positive. I am really wondering if that two weeks will make a big difference to the overall success of a pregnancy. Which is why I’d like to talk to a doctor, because if ovulation and possible conception has occurred this month, I should be taking it now, not in another weeks time.
      Thanks so much for sharing. I really appreciate it!

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      • That is exactly what my RE uses for protocol. She does not mess around. Endoetrium (progesterone suppositories) start with ovulation or trigger. Period. With my entire process, whether it was timed intercourse, IUI, or IVF. I was started on suppositories with trigger or ovulation. I also have my progesterone levels checked weekly starting at that point. Good Luck!

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      • My clinic’s protocol is to start once I test positive for being pregnant, and I’m now thinking that’s just too late because without prometrium (the name of our progesterone suppositories) would screw up implantation. And, while I’m no doctor, I suspect the quality of implantation is critical to the success of a pregnancy.

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      • The way my RE has explained it to me, earlier losses are much more likely to be progesterone issues. Hope you get to talk to your doctor soon!

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  4. I had progesterone issues with my last one – I have never thought to get myself checked outside of when I’m actually pregnant! I always assumed it was fine because whenever I’m pregnant and tested my levels are fine, except for this last time. Ughhh you do not need one more thing to worry about. I’m so frustrated for you!

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    • My clinic automatically puts RPL patients on progesterone suppositories once they are pregnant, regardless of the number because there are some studies which indicate it will help in RPL patients. So, I’ve taken it with pregnancies 4 and 5, and we still lost each one. My thought right now, based on my logic (as opposed to scientific fact) is that with 4 my progesterone was probably still too low to sustain the pregnancy long term. And with 5, our chemical pregnancy, my number was probably to low to even allow for implantation to occur properly hence the chemical pregnancy. And from what I can tell progesterone is required for proper implantation, so starting to take it once you test positive could simply be too late.
      So yes, it is just one more thing to worry about and to be more aware of in the future.

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  5. *hugs* It is SO frustrating to not get the answers you need from nurses who think they are the authority on our bodies.

    Here’s what I can tell you – to me, it sounds like your progesterone DOES indicate ovulation- but either you just recently ovulated (within the last few days) and you have a short luteal phase (which can be corrected with progesterone- some women NEED PIO shots to lengthen their luteal phase because other forms just don’t cut it… this would also give you normal length cycles) OR, it was a weak ovulation, meaning your body kicked out the egg but something was out of whack and now its having a hard time catching up to sustain the process. Personally, if it were me, I would test like mad and the minute a bfp pops up, demand PIO. I know several women who have had P4s of 5-7 at BFP on 12 or 13dpo and got on PIO immediately and went to have successful pregnancies- the one I am thinking of in particular has also been through RPL.

    I hope this is helpful- I know you have been in this rodeo before and I’m keeping fingers crossed that this has a positive outcome for you! (Either no BFP, and clarity moving forward, or a BFP with a successful term pregnancy!)

    One last tidbit- if you are ovulating “weak” fertility meds like clomid or femara (I would go with femara- less side effects and no ‘may cause cancer, dont use for longer than 6 months’ disclaimer, plus- usually- more consistent results) could help you have a stronger Ovulation!

    That’s just my two cents.

    Lots of love and hugs girl!!

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    • Thanks so much for sharing!!
      Yup, I already starting testing today – I will have a peeing on sticks addiction this month (so happy I bought a bunch of tests in the US a few weeks ago – they are so much cheaper there – like half price). I’m about 6 days out, but I figured, I’d better start now just to be sure.
      I have gone on prometrium (progesterone suppositories) when I tested positive with both pregnancies 4 and 5, both which still ended in miscarriage. I’m wondering if the change that is needed is that I go on it right after ovulation to help with implantation?
      I do suspect my RE’s solution will be clomid or letrozole. But, and here’s the big but, if they aren’t going to treat me properly from the time of ovulation, then why would I bother?
      And, most importantly, thank you!! I love your support, and so appreciate your willingness to share! 🙂

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  6. I am so sorry. This is so frustrating!! I am pissed that she wouldn’t schedule an appointment for you to see your doctor!!!!!

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    • I know right? First, there is no way we will try next month without a better understanding of what this means. And second, if I have to wait 2 month for our appointment in November, then I might as well find another doctor (i.e. Dr. Braverman) and try to find some solutions rather then just twiddle my thumbs for 2 months being too afraid to try again. Heck, even if they refuse to let us see a doctor, she could have just agreed to speak to one of the other doctors in the clinic who is not on vacation to provide us with some understanding of the number!
      Thanks by the way.

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      • I think I would definitely be looking into a different doctor. With a different staff of nurses. 2 months is borderline unacceptable.

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      • If the clinic views it as urgent, you will get care immediately. Clearly, they don’t view this as an urgent matter, which just pisses me off.
        2 months is Canada.
        Quicker access means going out of country and spending a lot of money. But, if we can get answers in a timely manner, then it’s making more and more sense to go to Dr. Braverman (or someone like him).

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  7. Ugh. What a bitch of a nurse.

    As far as Clomid (and the other one) is concerned, because I was on it for my medicated cycles, I’m not 100% sure it helps as much with ovulation as it does stimulate your ovaries to produce eggs. Even though by the time I started treatment I had been trying for a year and a half, I really only TTC for a total of 5-6ish months and got pregnant twice (taking out time for each pregnancy, and time off after my first D&E), so my problem was less with conceiving and more with maintaining the pregnancy. Regardless, my RE put me on Clomid to increase my chances of conception during treatment.

    I was diagnosed with hyperprolactinemia before we started medicated cycles, which is known to prevent ovulation and cause infertility because it is a pregnancy/breastfeeding hormone. Because of this, my RE prescribed a medication to suppress my pituitary gland and then prescribed (for TTC) Ovidrel, which is an hCG-trigger. THAT, as far as I know, is what helps with ovulation. It acts as a catalyst and basically tricks your body into releasing eggs.

    My RE also put me on progesterone supplements, which were to be started after ovulation to ensure I had enough for the earliest stages of pregnancy (for the exact reasons you stated in this post). I did those until the end of my first trimester.

    Forgive me, I can’t remember if you’ve had testing done…thyroid, prolactin? I definitely think you should discuss progesterone supplements with your RE as they do not harm a pregnancy in any way (and if you’re concerned once you’ve lasted a few weeks in pregnancy with no problems, you can always have them test it and if they see it’s unnecessary, you can be taken off it).

    Whether or not to go on Clomid is up to you. I trusted my RE and just went with the flow. I know it poses a risk for OHSS, and multiples, and some people are concerned it is linked with cancer. But Clomid’s affect on ovulation…I just don’t know. I would ask about Ovidrel if you don’t want to bother with the stimulation (as you seem as “fertile” when it comes to producing eggs as I was). It’s just a one-time shot in your belly. 🙂 Sucks the first time but it gets easier every time. You may need to be monitored by ultrasound though around or after CD10 so they can see if you have mature eggs which would justify inducing ovulation. If your eggs aren’t maturing enough, or are taking too long, then maybe that would be reason for Clomid?

    My goodness, this was a big ol’ blurb of information. Sorry. Just want to help. 😦 I hope you get some answers soon, and you can ask me any questions you have. Like I said, I can’t quite remember what testing you’ve had done or what type of treatment you’re open to. You can always email me at dreamsandrainbows820 AT gmail DOT com. Always willing to chat if you need it. 🙂 Hoping for ease of mind for you, hun. ❤

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    • We to are RPL -we’ve had 5 pregnancies in 2 years – ending at 5 weeks, 9 weeks, 13 weeks, 8 weeks and 1 chemical pregnancy.
      Thyroid has been tested – I’ve been on low dose synthroid since 2009 (years before trying actually). It was found through routine blood work. Now it is monitored through each pregnancy, and it has actually never even fluctuated – which is good.
      I’m not sure about prolactin – that has just been added to the list of questions for my next RE appointment – whenever that occurs.
      II have taken prometrium supplements (progesterone) during pregnancy 4 and 5, but only once we confirm pregnancy. With what I’ve read in the last 24 hours, I believe we need to start taking them right after ovulation. I believe that 2 weeks could make avvery big difference to the overall pregnancy.
      As for clomid, right now, I don’t see the point on taking it if we are not taking progesterone right after ovulation. I think clomid on its own isn’t going to change the outcome of a successful pregnancy. And, I still struggle with taking it, if I am already ovulating. As cool as twins sound, I don’t know that we need to be in an extra high pregnancy scenario.
      Thanks again, I really, really appreciate all of this information! Your support is just so awesome and truly appreciated!

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  8. Although nothing trumps the advice/opinion of your actual RE, I agree with some of the previous posters that a progesterone as high as 4.1 indicates *some* kind of ovulation. Most annovulation readings I have seen on the internet are 0.something. I’m sure you know this already, but your progesterone doesn’t automatically shoot up to 10 as soon as you ovulate, it takes a bit of time to build up in your system. So it’s possible you ovulated much more recently than CD14, whereas the inherent assumption with the CD21 test is that you ovulated on CD14 and are 7dpo. So best case scenario is that your progesterone is still climbing to a normal number. Is there a chance you can get back in for another blood test in a few days to see if it’s any higher? The other option that comes to mind is you kicked out an immature egg, which would obviously not be ideal, because it’s not likely to lead to a viable pregnancy. I agree with The Almost Mom that ovulation inducers like Femara and Clomid can help produce mature eggs. I have no way of knowing for sure, but I’ve always assumed that I finally got pregnant for good because Clomid helped me kick out a mature egg (two chemical pregnancies previously with natural cycles). Good luck, I hope you get an answer soon!

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    • First, thanks so much for taking the time to share your perspective – i appreciate it so incredibly much.
      Second, I’m with you on this. I suspect I ovulated a few days later in my cycle. I would love to get in for another blood test, but so long as I am unable to speak with another doctor, there is no-way I can. It makes sense in my mind to go back for another test and see what’s going on.
      As for clomid, I’m honestly scared of the drug, but only because there are no studies to say that it will help lower our chances of miscarriage. So, I don’t see the point on taking it, if we still have such a high risk of miscarriage. Oh, and really, there is no point if they wont start me on prometrium suppositories right after ovulation.
      Anyways, thanks again!!

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      • I 100% agree that at a minimum, you should start prometrium suppositories as soon as ovulation is confirmed. I’ve always heard that the biggest role of progesterone is to help with implantation, so taking it after a positive test wouldn’t be as effective as taking it ASAP. And I hear ya on not taking Clomid without evidence that it will help lower your chance of miscarriage. It’s frustrating to take drugs just because the doctor can’t think of anything better to do. For what it’s worth, my Clomid experience was fairly positive (night sweats were my main complaint), but I know that’s not the general consensus!

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      • Thanks so much both of you!
        Just an FYI – My GP sent me for another progesterone test today, so maybe we ca at least see if its rising, which would likely indicate late ovulation. It’s only been 2 days, but I didn’t want to get the blood test tomorrow because then I would have had to wait until Monday for the results as my GP’s clinic is closed on the weekend. And, I found some prometrium pills left over form our last failed pregnancy, so I am now taking them. I am not a fan of self-medicating, but I think the research is pretty solid on the necessity of adequate progesterone now, so I’ve decided that I’m better off taking them.

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  9. Wow, first of all, that nurse is a piece of work…I’m sorry that you had to deal with her! Secondly, although I totally see your concerns for this month…could this be a piece of the puzzle? Most of us that go through treatments start progesterone supplements within a day or 2 of our treatment…Could your Dr. do this with you after a positive opk instead of waiting for a confirmed pregnancy? I pray that you get some answers soon! And as always…sending Big Hugs!!!

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    • First, thank you!
      And, I completely agree with you about going on progesteron suppositories right after ovulation (this just makes sense in my mind) but it’s impossible to discuss this with an RE since apparently I’m not allowed to speak to one for 2 months. Here’s to hoping my husband does a better job then I did getting this point through to them.

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      • Yeah…that is just ridiculous!!! I’m hoping once your RE is back in the office he has the good sense to call you about your results and do some explaining!

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  10. My two cents: when you do a progesterone test on CD21, you’re assuming that you ovulated on CD14, because progesterone test is supposed to be done 7 days after ovulation. Many ladies don’t ovulate on CD14. When I did my progesterone test way back when (way before all the IVF cycles hoping that that was the answer), I was told to do it on CD21 and I was like no, nurse lady, I would do it 7 days past ovulation because that’s when the level is the most accurate. I ovulated back then on CD9 or 10. CD 21 would be like already 11 days past ovulation. If you ovulated earlier or later than CD14, CD21 is definitely NOT 7 days past ovulation. You could’ve ovulated on CD 18 or something like that and CD21 would’ve been only 3 dpo. Do you do OPKs or basal body temperature to make sure that you’re ovulating and when you’re ovulating? Nevertheless, I think progesterone supplement should started a few days after O instead of confirmed pregnancy. I hope that you get an answer from your doctor and hopefully you will get an phone consult with Dr. B soon. My appointment took a whole month to schedule. ❤

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    • Thanks so much for sharing! I am with you on this, part of me thinks I just ovulated late, so I would love to get another blood test done in a few days – but without being able to talk to someone at my REs clinic, that will be virtually impossible. And, I think in the future I want to start the progesterone right after ovulation not once we have a confirmed pregnancy.
      Because we have always been able to get pregnant, I have never done temping. I have done OPK’s, and I always have an LH surge. Of course, this month I decided not to do anything, and now I really wish I had to know when my surge occurred.
      I cannot remember, did you end up seeing Dr. B?

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  11. I’ve had a lot of progesterone issues. 3 things come to mind.
    1. My RE says to start progesterone at 3dpo, not later. If you suspect you do have a progesterone issue and you confirm ovulation with a temp rise, start then.
    2. If you ate before your blood test, it can affect the levels in your blood. This is pretty controversial but I have personal experience that it’s true. Fasting, my levels were double what they were after eating breakfast.
    3. CD21 is not necessarily the best day to test. I’m a late ovulater on my own (CD17-21). If I were tested at CD21, my levels would be crazy low or non-existent. Are you temping or using OPKs?

    Hope this helps! I’m sorry for the horrible nurse.

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    • Thanks so much for all your thoughts!!
      1. That’s what I figure – I need to start on them right after ovulation.
      2. I did eat before my blood test. And, I read a bunch of stuff saying a progesterone level can fluctuate within a single day, so this could make sense.
      3. Because we have always been able to get pregnant I have never bothered temping. I have use OPK’s some months – this month of course I did not. That said, every single time I use them I have an LH surge, so presumably I ovulate.

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      • Before I had issues with IF, I would just use OPKs and assumed I O’ed the next day. When I started temping, I realized that I actually O’ed two days after my positive OPK, which in the grand scheme of things is no big deal, but when you had P4 testing, it can make a big difference.

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      • I’ve always just assumed after my LH surge, I probably ovulate within the next 48 hours sometime – I’ve never felt the need to be more precise. I may have to start temping next month – I don’t really want to do it, I think it will remove any last remaining element of fun from trying. But, it sounds like I should.

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  12. I’m convinced my problem is low progesterone, as it’s been tested as lower on CD21 and now that I’m on it with IVF I’ve gotten positive pregnancy tests with both transfers. Looking back, I have a stange feeling my husband an I could have been getting pregnant on our own, but that my level was too lower after ovulation to ever make a pregnancy viable. Maybe I’m looking at this too simply, but couldn’t you just start progesterone supplements after ovulation?

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      • I wish I had more time right now to tell you about a doctor that works with my mom. I haven’t been going to this doctor, as she is a family practice doctor, but my mom has been begging me to see her. Basically she is getting hundreds of women pregnant who had IVF or other methods fail. It’s almost like a miracle really. Anyway, my real point here is that she makes an effort to figure out the issue before jumping to lots of drugs that make us crazy. I know she draws blood every single day of a cycle to see what is happening with all your hormone levels. Once she makes sure they are in line, with supplements, people are really truly getting pregnant on their own… Just wanted you to know there is hope out there!

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      • Thanks for sharing! I am starting to think that there is still hope, but the hope lies with a specialist in RPL. My RE is great, but I firmly believe this should have been tested a year ago, and doing it now is not acceptable. I’m mad, at the moment I don’t have alternative options re another RE locally and I don’t see the point of finding a new RE when RPL is not there specialty.

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  13. I am so sorry. No one ever wants to hear that something is wrong or even really wrong. I hope your doctor can give you clarity and help you. Maybe he/she can even help you keep your levels up some how and this bad news might possibly turn into good news. Sending you positive thoughts.

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    • Thanks so much! I actually don’t mind hearing that something is wrong – after two years of “unexplained” RPL, part of me would love to have an explanation. That said, the problem I have is telling me a number without explanation or follow up. While i can read Dr. Google and scientific journals, I would really like the interpretation from my RE.
      Anyways, thanks for the encouragement! 🙂

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      • My family doc sent me for a blood test today, so at least we can try to figure out if I just ovulated a few days late. As for my RE clinic, I have a sneaking suspicion they are not going to be following up with me anytime soon!

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  14. I have no experience w/ progesterone or knowing much about that…but it sounds like the earlier, the better. I m truly sorry you hve to go through all of this, and I sincerely hope you get conclusive answers so you can start a protocol ASAP. So sorry about your dr’s office. How frustrating!! Praying you turn a corner really soon!!!!

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    • Thanks so much Kate! I think my frustration would be a lot lower right now if they had just taken the time to explain what this number means and what the next steps are. Instead I’m left in limbo land trying to decipher things that are better left to the medical professionals.

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  15. I am going to email you about sending you drugs; I hope you don’t have to wait forever for the RI appointment. It’s not too late to take P4 supplements if you’re 8DPO (I’m guessing that’s where you are roughly) though that may be stupid. I hate that you may better understand why the LP and I chose to stay away from that clinic; I’m really sorry you’ve had the roadblock attitude. Your recent experience was like my introduction (except for the part where they kept my money despite me being unable to attend an appointment for medical reasons and giving them a month’s notice I wouldn’t be able to attend).

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    • Thanks so much – I almost emailed you last night, but then I got a migraine and gave up for the day and went to bed! I sent in all the info last night to Dr. B, so hopefully I hear back sooner rather then later.
      The reality is, no matter how you look at it, a specialist in RPL is not an RE. We are not a typical patient for our clinic, which means they are not super knowledgeable about our circumstances, and it makes no sense to not seek out the best medical advice possible.

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      • Call the office, tell them you’ve sent in your 14 page online form, and book the consult. He won’t really read your form in detail before the consult if it’s the free one you’re booking first, in my experience. I called and booked and he said they never got my form even though they had so clearly it wasn’t a big deal!

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  16. Oh dear…you know disappointing news is one thing but when it’s delivered in such a rotten package, it makes the entire situation worse. I’m sorry – what a crappy way to find out.
    There’s a ton of support for the PIO injections now and many women have had far greater success with it then with prometrium (vaginally or orally). How open minded is your GP? Would he/she prescribe it to you?
    As per clomid – go with your gut on that. I say get your progesterone tested again next month to have a more conclusive result. Clomid is hard on the body, you know that. Unless you aren’t ovulating at all, ask more questions.
    And the luteal phase debate – I think there’s a lot of merit in this discussion with your docs. Sometimes the embryo will develop at a slower rate than what the lining of your uterus is at or vice versa and it’s just not compatible. Finding the sweet spot, quite literally can be hard. For me, it was this last IVF cycle where they let me stim a little longer and held out on freezing until day 5/6 and then doing a frozen transfer as my lining was already getting thicker then where the embryos development was at – it likely wouldn’t have implanted correctly. (I did eat pineapple core this time too….can’t hurt right?!). This I didn’t entirely understand until my FS showed me the numbers and broke it down.
    Lastly…have you ventured down the path of PGD testing? Sorry, I can’t remember if you’ve done IVF or not.
    Wishing you better numbers next month and a less cranky nurse to deal with 🙂

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    • Thanks so much for your awesome input! I am so grateful for you and everyone else today!
      My GP sent me for another progesterone test today, so maybe we ca at least see if its rising, which would likely indicate late ovulation. And, I found some prometrium pills left over form our last failed pregnancy, so I am now taking them. I am not a fan of self-medicating, but I think the research is pretty solid on the necessity of adequate progesterone, so I’ve decided that I’m better of taking it then not.
      To date we have not done IVF, however, if we do end up going that way we will absolutely do PGD.
      Thank you again!

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  17. Oh hon, I’m so sorry! I simply cannot believe that nurse! If she can’t answer your questions, she should not have been the one delivering you the information! And waiting 2 months to get any answers is unacceptable! I know you’re too angry and upset to call back right now and don’t blame you at a! But I would cause some serious sh*t with that clinic if I were you! Another doctor should be available to go over your results now. You’ve had too many losses already to possibly endure another one because that nurse refused to help you!

    Sending you a huge hug and praying you get in to see your dr or another dr ASAP to get some answers.

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    • Our fear with causing too much shit, is ultimately, we need them. They may suck, but if we ever do get pregnant, I need someone in my city who is willing to deliver the baby! That’s not to say we need them to treat us, that’s debatable now!
      So, my husband left a rather upset message last night. We didn’t hear anything back – surprise surprise. But, on other news, my family doc stepped up sent me for another progesterone test today when I explained the situation to a nurse there, so maybe we can at least see if its rising, which would likely indicate late ovulation. It’s only been 2 days, but I didn’t want to get the blood test tomorrow because then I would have had to wait until Monday for the results as my family doc’s clinic is closed on the weekend. And, I found some prometrium pills left over form our last failed pregnancy, so I am now taking them. I am not a fan of self-medicating, but I think the research is pretty solid on the necessity of adequate progesterone now, so I’ve decided that I’m better off taking them.
      Anyways, thanks so much for your support!

      Like

      • So glad again that your family doctor sent you for another test and that you are taking matters into your own hands! I really hope you just ovulated late this cycle and that your second progesterone will be perfect. The prometrium can’t hurt either way though. Glad you still had some left over!

        Like

      • My test result yesterday had gone up to 6.5 (before I started taking progesterone). So, I suspect I just ovulated late. But, honestly, from what I’ve read (and others on here have said) a 4.0 is considered ovulation, so I think I did.
        And my clinic called, I spoke to a nicer nurse (that I still don’t agree with), but she did get me an appointment with our RE in two weeks (Oct. 3), which also happens to be exactly 2 days after we do the free skype initial consult with Dr. Braverman and we meet with my local immunologist. So, I suspect we will have some big decisions to make that weekend!
        Anyways, thanks again! I hope you are doing well!!

        Like

      • Glad your progesterone went up. Hopefully it will continue to go up and with the added progesterone, you’ll be okay! I’m also so glad you’ll be seeing your RE again soon and having a phone appt with Dr. B. Hopefully, you’ll get some answers soon so you can make some decisions. Hugs hon.

        Liked by 1 person

  18. I know the progesterone was your point, but I’m stuck on the evil nurse who won’t allow you to see your doctor to discuss these results for TWO MONTHS? What the heck is that all about? Lovely woman.

    I wish I had answers for you, but all I can do is offer some hopeful thoughts. I hope the communication improves between you and this doctor’s office. I hope the conversations with the other doctors are worthwhile. I hope that this test result is the key to providing some answers and that the answers come quickly.

    Like

    • Part of me thinks the evil nurse didn’t even look at our chart to see that we are RPL patients, so our issue is not getting pregnant, which of course means there is a real possibility we will get pregnant each month. Not that it would be acceptable for an IVF patient, but I suspect that’s what she thought.
      Anyways, thanks so much for your support and hopeful thoughts! I’d be lost without them! I managed to get a requisition for a follow up blood test from my family doc. So, we should at least be able to know if the levels are rising or not.

      Like

  19. My quick, non-professional thought is that you did ovulate this cycle but super late…hence, 4.0 @ testing. You may have been about to ovulate the day of the test? You are right, a person can have a wacky cycle from time to time. What’s important is that they re-do your progesterone again next cycle to see if its the same or has changed. Unlike that rude nurses advice, this is a reason to see your doctor sooner rather than later so that you can get a requisition to test progesterone again next cycle! Hang in there. Hugs!

    Like

    • PS 🙂
      Do you temp? Have you tried it before? I really wonder if you’d like it. It is incredible what it reveals (whether or not ovulation happens, on which day in a certain cycle it does happen, etc). It can be hard for some people to get into but for many it is so helpful in getting a better picture of what’s going on.

      Like

    • in my original comment I said that you likely did ovulate this cycle but super late. I should have worded that better. by super late I mean super late for what you were thinking (cd14 ovulation). not super late in general! I ovulate later than cd21 sometimes!

      Like

      • Thanks so much for all your thoughts!
        First, I agree, I think I did ovulate, just a few days late. My RE clinic never got back to us, but my family doc sent me for another blood test today, so we can at least see what the level is doing. I suspect it will be higher today then it was on Tuesday. We will find out tomorrow.
        Second, nope, I have never done temping. I figured since we are getting pregnant, then there wasn’t much point. That said, I might try it next month to see what happens.
        Thanks again!

        Like

  20. Oh shit. I’m so sorry this is bad (and confusing) news. My brain is too fuzzy to give an intelligent and rational response but my emotional reaction is to say you are being way too hard on yourself…. We live and learn and my (brief) experience of you is that you do your best. You have a new development and I’m sure you will do what you can with it, but I really don’t think you should beat yourself up about the past. Hugs.

    Like

    • Thanks. I know I am being hard on myself, and I know I’ll pull myself out of it. More then anything I feel like my RE should have done this test a year ago and at least had a knowledgeable nurse call us with real information.
      Thanks again! 🙂

      Like

      • I understand the frustration… My DOR diagnosis was only picked up when I moved clinics and the new doctor reviewed blood tests that had been done initially by my first doctor… Extremely frustrating. But yes, rather be irritated with the docs who are specialists and should know better, than with yourself.

        Liked by 1 person

  21. First, i agree with everyone that you should seriously give your clinic a piece of your mind. Two months is unacceptable. I also wanted to share something’s with you from my experience so you don’t feel totally hopeless. Every doctor is different but a four on progesterone is ovulation, according to mine. Ive even been told one cycle when i had a two that it was a ‘wishy-washy’ ovulation, but it indicated ovulation nonetheless. Because of this i did take Clomid and got pregnant the first cycle trying it. Here’s what i want you to know – i stayed pregnant, even though my progesterone that cycle was only a nine. So, idk if im the four percent that doesn’t miscarry if it’s under a 10, but i dont have any sort of luck usually, so im inclined to think it’s more possible that that article you read said. I took progesterone (crinone) but didnt start until A WEEK after i got my positive – so i was five weeks pregnant. Basically, cd21 was a 9, cd28 was a 17, and cd35 was a 12. That’s right, it dropped. But i went on the crinone and im due in five weeks.

    Dont get discouraged and dont let Google get the best of you. Stay in the game. Id recommend taking them up on the clomid if they offer – i believe i had seriously low progesterone before and it did play a part in bumping the number up a bit. Plus the generic version was like $20, so i didnt see a reason not to.

    Good luck hun. And seriously, tear your doctor’s office a new one. You are a priority.

    Like

    • Thanks so much for sharing such a wonderfully hopeful experience! I think I ovulated, but probably a few days later then expected. And my family doc sent me for blood work today so that we can see if the number is rising. And, I decided to start taking progesterone supplements today. We have some from our last miscarriage, so I decided to take them after the blood test was done.
      As for the RE, we will be careful with how we respond to it – ultimately I need him to deliver a baby should we ever get pregnant and stay pregnant. That said, i don’t necessarily need him to get me pregnant. 🙂

      Like

  22. I’m so sorry you were treated so horribly by the nurse. I agree completely with you and everyone else – if she can’t answer questions or speak intelligently on the topic then she shouldn’t have made that phone call. And, if your doctor is not available, they must have SOMEONE covering for your doctor that is available! Totally ridiculous.
    Unfortunately I don’t know much about this topic and have no experience with it so I can’t offer any advice or experience. Just know that I am wishing you all the best and hoping you get some answers on this soon.

    Like

  23. It sounds like everyone here has already supplied you with so much great information. I just wanted to say I’m sorry for the horrible way the nurse delivered the news to you. You really don’t need that. I’ve never had my progesterone checked, but now I’m thinking I should! I also think you should try temping, although it can drive more obsession, it is really nice to have so much information. All the cycles where I’ve tried skipping temping or OPKs I’ve always gotten frustrated with the lack of info and transparency I had into what was going on! And definitely start progesterone after ovulation, which is sounds like you’re going to do. Fingers crossed for you that you get to the bottom of all this! ❤

    Like

    • Everyone has been so amazing!!
      I did start progesterone today, right after I got a second blood test done. I figure this way we can see if the number is rising without the introduction of the suppositories.
      What I’ve learned in the last 24 hours really does indicate that getting your progesterone tested a few times after ovulation makes sense to do. But, if you are taking the supplements after ovulation then it may not be necessary.
      Also, I think I may try temping next cycle, just to see. I really have nothing to lose by trying.
      As for my clinic, I’m still mad, but I also know I need them. I need them to see me through a high risk pregnancy, but I also know I don’t need them to get me pregnant and it might be better if I go elsewhere (i.e. Dr. Braverman). I’m not sure about this yet, but we’ll make a decision soon enough.
      Anyways, thanks again! I so appreciate your love and support!

      Liked by 1 person

  24. First of all, I am so sorry that the nurse treated you so poorly! I do hope you’ll complain!

    Second, this post freaks me out. I am scared for you . . . and me. On Tuesday, I got a 7.6 test result. I was told it was “a little low” but that the doctor said it was “okay.” I told them my concerns and was told they thought it was lower because I had a LH surge early and we would retest next week. They said I could take 3 Progesterone instead of 2 if I wanted to but that the doctor didn’t recommend it. They said it wouldn’t hurt anything though.

    I have no idea what to think or do about any of this. I hope that you get some answers and that I do too. Sending hugs your way! ❤

    Like

    • Thank you so much for your comment and your experience! I got a second test yesterday an my number went up to 6.5. So, I do think I ovulated, but probably late. And, last night I started taking progesterone that I had left over from our last pregnancy (that ended in miscarriage). So, I have a bit more peace of mind in case conception did occur.
      Thank you again!

      Like

  25. Wow! What a lot of comments. This post obviously touched many. First off I want to say I’m sorry to hear this but having seen above that the second test was more positive I’m keeping things crossed for you. Secondly you haven’t done anything wrong re: researching and educating yourself. I’ve re-read your post and I think the awful nurse has made you feel this way through her non-explanation. The reality is you are not Drs or medical professionals and you deserve answers from your carers. Simples. When we use the word “should” in this manner it’s normally because someone has made us feel that way, not the reality of the situation. You expect a certain level of professionalism (and compassion) from people who are giving you the results and if she is unable to answer your questions then it is the Dr who needs to talk to you about it – not you who needs to scour the internet in the hope of gaining more information about your results (no matter how intelligent you are). Annoyed for you! x

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  26. With my first three miscarriage my CD21 progesterone was lower than 5 and I still got pregnant those cycles naturally. We later found out that I don’t make any Prog. once preg so that is why I had my losses. My last pregnancy I started Prog three days after my positive opk and made it to 12 weeks only to loose it to a completely random angular pregnancy/cornual implantation. I now start supplements every cycle after ovulation and then stop them after 2 weeks if/when I get a neg hpt. My doctor thinks that if I wait until I get a positive test it is too late to save things in my case. Hoping you get some answers!

    Like

    • Thank you so much for sharing! This is exactly what we are thinking could be happening with us. We used progesterone for our 4th and 5th losses, but we didn’t start until we tested positive, and we’ve now learned the importance of taking it right after ovulation (no thanks to our RE of course). This is our plan moving forward because it just makes so much sense and is clearly the most common time to start progesterone.
      Anyways, thank you again for sharing! It really helps me think we are making the right choice now that we are aware of it.

      Like

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  36. I feel so frustrated on your behalf! Unfortunately some people in the medical field have such a clinical view of things that they fail to see that we are people who have feelings (who would have thought!?) I hope you are not too hard on yourself – how are you supposed to know what you don’t know? It sucks that you have gone through this so many times – I have had 2 miscarriages in the last few months and have that same “I hope I’m not pregnant again” feeling at the moment – thinking of you and hoping for a good outcome.

    Liked by 1 person

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