my Self

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Fort St John, BC, Canada
My husband, David, and I had been trying to have a baby since November of 2007. After 'letting things happen', we got the amazing news that we were pregnant in June of 2008. Sadly, that pregnancy ended at 9 weeks with a natural miscarriage. After two more chemical pregnancies, we turned to fertility treatments in 2009. That decision was a disaster, with lousy medical care and poor monitoring. In December of 2009, we made the huge decision to move onto IVF. Things fell into place like magic and we began treatment on January 15, 2010. After a blighted ovum in March, we did a successful FET in June, only to endure another blighted ovum in July. We kept up and underwent another IVF in September/October of 2010 with the arrival of our son, Brogan in July of 2011! After our lovely success (finally) we decided to undertake yet another IVF treatment and hope for a sibling for our little red headed boy. Well... so far it's worked. Our story continues below!

Tuesday, March 31, 2009

Signs Of The 2 Week Wait

They are HURTING. Hurting Hurting Hurting and it's annoying because it COULD be a side effect of the progesterone. I don't mind hurting boobs if they are possibly a sign of pregnancy. But if they're just confirmation that the pills I am faithfully inserting into my va-jay-jay every night.... well that just adds insult to injury.

I started myself on some excellent pre-pregnancy vitamin supplements...
3 mg Folic Acid
Omega 3 Prenatal
B6 300 mg
Vitamin E 800 mg
VitaminC 1000 mg
Aspirin 81 mg
Jameson Prenatal

1 DPO: No signs, didn't start the progesterone because I wanted to make sure I'd really ovulated and it wasn't just a flakey temp rise (that never happens but you never know).

2 DPO: Another temp rise and I cannot resist putting in one progesterone suppository (100mg) in the morning... if there's an egg in there I am going to do all I can to make sure he's got a place to grow! 200 mg Progesterone evening dose.

3 DPO: I had a HORRIBLE night's sleep! Went up several times to go pee and then was restless from 3:30 a.m. Don't trust my temp this morning but I have to take what I can get. I would like to see my temp higher above the cover line but the cover line is really high this month! Trying not to obsess about that and focus on the fact that my rise was very good compared to where ovulation temp.
*sore boobs tonight
*peeing all day long
*very tired
*evening - metallic taste in mouth

4 DPO: Better sleep last night, but was up three times by 4 a.m. to pee. Sheesh.
*extreme metallic taste in mouth
*tender breasts
*frequent urination
Author's note: I really have a hard time believing in symptoms prior to implantation; however, last cycle I was extremely bitchy, and I am starting to feel that way again. And no, this is NOT normal for me. I went to go to bed last night and made David get OUT of bed because I wanted to change the sheets. heh heh.

The thing that has me thrown off the most is this horrid taste in my mouth. It's like the air passing over my tongue is full of metal.

5 DPO: We spent the day travelling to Edmonton, AB. I can honestly say I was enduring some heavy mood swings - not like me at all! I mean, I was bitchy, and totally wrong about everything I was bitchy about. It was un-warrented bitchyness. That sucks. I only get so many bitchy outbursts a year and I am using them up during my actual, short lived pregnancies and (?) trying to get pregnant hormones! OH, and did a poll of 35 preggo women and 58% had metallic taste in mouth during early pregnancy! Good news *manic laugh*.... Anyhow, symptoms for today....
*extreme metallic taste in mouth
*tender breasts (and ITCHY!)
*frequent urination
*lower backache
*mood swings

6 DPO: Well to be honest I didn't have much for signs yesterday (I'm writing this 7DPO)... we did tons of running around Edmonton, getting stuff for the store renovations and eating at our favorite restaurants. I did have the metallic taste throughout the day but it seems to have subsided today for the most part. Did have a great night's sleep but a temp drop.... possible implant dip??
*somewhat mettalic taste in mouth
*lower backache
*very tired - lethargic, even
*frequent urination - could be due to extreme thirst?? lol
*extremly thirsty

7DPO: Had a great night, woke up quite a bit and couldn't resist taking my temp. A solid 37.1 every single time..... a def rise from the dip yesterday but not fully climbing up to previous temp of 37.2.... it's the first time I've ever had a drop like that (needs to be .3 of a degree drop to be considered a possible 'implant dip'). We drove home from Edmonton today - it's about an 8 hour drive with Dave's bronco on the car trailer...

*still slight mettalic taste in mouth

*combative - mood swings

*tired - fatigued

*slightly sore/heavy boobs

8DPO - Of course I broke down and tested today.

8DPO Edited

Now I'm not going to jump up and down and start making phone calls and planning out the nursery. I'm not even really excited about the fact that most people agree it's a line - it's an IC (Internet Cheapie) which are notorious for evaporation lines, and it's at 8DPO which is STUPIDLY early to test. But it's fun to ponder - like playing bingo... and addicitive.. like playing bingo and knowing you'll eventually win.

*mettalic taste in mouth
*gassy - little burps all day (I had this as a major sign for the past two pregnancies)
*restless legs (had this last time too)
*mood swings
*full and heavy feeling breasts
*daytime temp consistant at 100.4 ((???))

9DPO: Back to work Monday. Argh. Tired but got off my rear and made it there to put in a few hours. Still horrible little 'burpies' all day. Tested with IC's this morning and of course I held my pee ALL day and peed on a FRER this afternoon. I didn't see anything until it dried. Now, before you get all freaked out about me posting a dried test, I will tell you that all my early FRER's were dry before getting a good line.... and I can't find one TTC woman who has witnessed an evap on a FRER , even a dry one. So here's tonight's drama shot....


It looks "Promising". Not "Final" or "BFP!", but very promising!

*metallic taste in mouth
*lower backache
*heavy boobs

Friday, March 27, 2009

LPD Luteal Phase Defect

The luteal phase of the menstrual cycle spans the time between ovulation and the onset of the next menses. Luteal phase defect (LPD) is a common but misunderstood condition that frequently affects fertility.

Many people describe LPD in terms of its symptoms, e.g., a shortened luteal phase or disrupted basal body temperatures (BBTs). Quite simply, however, LPD is a failure of the uterine lining to be in the right phase at the right time. Since embryo implantation is highly dependent on the state of the lining, LPD can consistently interfere with a woman's ability to get pregnant and carry a pregnancy successfully.

A Normal Menstrual Cycle
In an ideal menstrual cycle, the body begins to produce follicle stimulating hormone (FSH) several days after the onset of menses. The increased levels of FSH result in the formation of a mature egg-containing follicle on one of the ovaries. When the follicle has adequately matured, a surge of luteinizing hormone (LH) is triggered. This surge performs two interrelated functions:
It prompts the follicle to burst and release the egg into the fallopian tube, where fertilization may take place.

As the follicle begins to refill after bursting, the increased levels of LH cause the fluid inside the follicles to change into a thicker yellowish substance.

The resulting structure is now called a corpus luteum rather than a follicle, and it is responsible for producing the hormone progesterone in the second half of the cycle. As a result of elevated progesterone levels, the uterine lining will thicken and develop additional blood vessels, which gives the embryo a place to attach. Progesterone will also prevent a premature onset of menses in which a pregnancy might be lost. In a normal menstrual cycle, the corpus luteum will produce progesterone for approximately twelve days.

A Cycle with LPD
A normal cycle can be disrupted in several places. Three causes of LPD include poor follicle production, premature demise of the corpus luteum, and failure of the uterine lining to respond to normal levels of progesterone. These problems can also be found in conjunction with each other.

Poor follicle production has its origins in the first half of the cycle. The body may not produce a normal level of FSH, or the ovaries do not respond strongly to the FSH, leading to inadequate follicle development. Because the follicle ultimately becomes the corpus luteum, poor follicle formation leads to poor corpus luteum quality. In turn, a poor corpus luteum will produce inadequate progesterone, causing the uterine lining to be adequately prepared for the implantation of a fertilized embryo. Ultimately progesterone levels may drop early and menses will arrive sooner than expected.

Premature failure of the corpus luteum can occur even when the initial quality of the follicle/corpus luteum is adequate. For reasons not wholly understood, the corpus luteum sometimes does not persist as long as it should. Initial progesterone levels at five to seven days past ovulation may be low; even if they are adequate, the levels drop precipitously soon thereafter, again leading to early onset of menses.

Failure of the uterine lining to respond can occur even in the presence of adequate follicle development and a corpus luteum that persists for the appropriate length of time. In this condition, the uterine lining does not respond to normal levels of progesterone. Therefore, should an embryo arrive and try to implant, the lining will not be adequately prepared, and the implantation will likely fail.

Diagnosis and Treatment of Luteal Phase Deficiency
With the above information, it is easier to understand the many symptoms associated with LPD. Progesterone is responsible for the rise in basal body temperature during the luteal phase. Women who monitor their basal body temperature will thus often note that luteal phase temperatures do not stay reliably elevated for twelve days. Additionally, women who monitor the time of ovulation often notice that their next cycle begins sooner than the normal 12-14 days after ovulation.

Once a diagnosis of LPD is suspected, a serum progesterone test will often be performed at about seven days past ovulation. A level less than 14 ng/ml indicates that progesterone production in the luteal phase is inadequate.

Should progesterone levels prove to be low, the temptation is often to "treat the symptom" by giving the patient progesterone supplementation during the luteal phase. In the case of inadequate corpus luteum performance, progesterone support may indeed be the appropriate solution. However, inadequate follicle development may also be causing the low progesterone levels. Thus, it is important to measure midcycle follicle size (via ultrasound) and estradiol levels (via a blood test).

If follicle development is normal, then progesterone supplementation during the luteal phase is normally the correct treatment. If follicle development is inadequate, an ovulatory stimulant such as Clomid or an injectable drug may be in order; these drugs help the follicle to mature more appropriately, which has the double benefit of producing a higher quality egg and a better-functioning corpus luteum.

Women whose linings fail to respond to normal progesterone levels often have normal follicle development and adequate progesterone levels at 7 days past ovulation. An ultrasound image of the lining at seven dpo, however, will show a lining that has failed to convert from the triple layer lining typical of the time of ovulation. In this case, women are often given additional progesterone supplementation in the luteal phase in the hope that a higher level will be the push that the lining needs to convert appropriately. Some doctors use injections of human chorionic gonadotropin to further stimulate the corpus luteum. However, these injections can cause false positive pregnancy results.

Endometrial Biopsies
An endometrial biopsy is the gold standard in diagnosing LPD. Many doctors feel comfortable basing an LPD diagnosis on progesterone levels, luteal phase length, and ultrasound lining appearances. However, especially in persistent cases, many doctors will use an endometrial biopsy.

The endometrial biopsy is normally performed a few days before the next menstrual cycle is expected, ideally after a negative pregnancy result for the cycle has been obtained. The procedure consists of sampling a small amount of uterine lining and sending it to a pathologist for evaluation. Because the evaluation is done at a cellular level, the knowledge gained from it is at its most detailed and precise. The pathologist categorizes the lining as being typical of a particular cycle day. If this categorization is consistent with the actual cycle day that the sample was taken, the result is considered normal, and the uterine lining is in phase. If there is a discrepancy of more than two days, the lining will usually be considered out of phase.
LPD is a common disorder, but it is fairly easy to diagnose and, in most cases, it is extremely responsive to the correct treatment. The most important part of the process is determining the exact cause, because that will determine the most appropriate treatment.

Hmmm? What's That Taste?

Bitterness, is it? Well, miss perfect can't always be perfect, right? That was not a real question, it was a self-directed sarcastic remark that I am sure a lot of people, okay, maybe only a couple bitchy ones, would love to throw at me right now. No need. I'm perfectly capable of self-flagellation. Hand me the whip.

Better yet, let me observe the world with a teeny bit of anger and resentment, that way I don't leave any bloody marks across my back and I can just be quietly, invisibly oozing emotional blood, and don't have to cause anyone around me discomfort. (or satisfaction - reflecting on said bitchy people mentioned above)

Okay. So I know it's time to snap out of it. I know I was right, the doctor was wrong, I lost the babies (I can NOT get it out of my head that I was carrying twins). And that chapter is behind me and so forth. I know it's not like me to dwell on crap that I can't change. It's. Not. Like. Me.

But this snapping out is taking a few days longer than usual. It's happening, slowly, but surely... I think that with the oncoming ovulation, a full pharmacy of progesterone supplements and a more than willing husband trying to knock me up again, moving forward is getting a little easier every day. But this one is taking days, not hours, to move past.

Several of my WTE buddies are newly pregnant. It is the first time I have felt both total joy and amazement that someone I have been 'in the trenches' with is pregnant.... and a real anger at being shoved back to the other side of the fence again. Left behind!

Sigh. Not that I didn't feel a true heartache when I last announced my happy pregnancy news on the Grief & Loss board.... so many women trying for so much longer, enduring much more emotionally fatal blows with late-term losses, infertility. I actually had survivor's guilt over being pregnant and not taking every single wanting female with me. Is it selfish to want survivor's guilt over the realization that I am still on the non-survivor side?

Thursday, March 26, 2009

No Shit, Sherlock.


Luteal phase defect (LPD) occurs when the luteal phase is shorter than normal, progesterone levels during the luteal phase are below normal, or both. LPD is believed to interfere with the implantation of embryos.

Sorry for the swearing. I am in a swearing kind of mood these past few days, and it's NOT related to being pregnant. It is, however, related to NOT being pregnant. Gawd. Did you get that? I had to read it twice to make sure I did.

Well maybe I'm not so sorry after all. I mean, I did just lose another pregnancy to what I am pretty sure was medical idiocy. The last words I said to my doctor two weeks ago, as he told me the beta results at 17DPO were a shitty '6', were, "What if my progesterone was still low?"

"It won't be."

"But what if it is?" I pressed, searching his face.

"But it won't be," stupid, 'you are an idiot' grin.

"What are the chances of it being low?"

"1 per cent; that's not the problem, we have you on clomid. That's taking care of your low progesterone."

"So if it's low this time, then we have something else totally on our hands?"

"Yes, but it won't be low."

"But, what if it is?" I asked again, about as amused as he was by our conversation.

"I'll be shocked."


The JERK didn't even act like he remembered our converastion. Didn't he read his notes on my file before David and I went into the office today to see him?

"Have you started to bleed yet?" He asks me this because if I haven't, there is a chance I am still pregnant and progesterone could save the day. I know this, and it is like salt in my womb. Ya, stupid pun, I know, I know...

"Yes, I miscarried the day after I was here last time."

"Oh, yes, I see... well, I'm gladyou came in. Your results were very low, I am going to give you a little pill... you take it right after you ovulate..."

I sat down, concentrated on holding my temper and keeping my jaw off my chest. Watched him fumble through his computer until he got to my file. "How low?" I asked, dumbfounded at his ignorance. I know how low my levels are because I went to see my GP two days ago and got the number from her. I want to hear it from his flabby lips.

"Oh, here it is.... Oh! I already gave you the prescription! Um... it was 4.7, that's very low." He's realized something is up... and I can see the SHOCK settle into his features, and he's trying to cover it.

"I know it's very low. 1% chance of it being that low. But I knew what was happening.... I asked for the progesterone before you got the test results, but by the time you gave it to me, I was miscarrying."

Abrupt change of attitude, body language... he knows.... he remembers... and he knows I remember.

"There was no reason at the time to believe you needed this prescription. You must have two low readings during your lutueal phase in order to be diagnosed with luteal phase defect."

I remind him that I was diagnosed in December with my first reading, and that it takes up to three weeks to get results back. I remind him that this was my third miscarriage in a row.

He sputters, "Three?"

"Yeah," I slump back in the chair, wondering if he ever does a history on his patients and actually writes it down somewhere, "9 weeks in July, chemical pregnancy in October, and 5 weeks this time. That's three."

"Well, that puts you in a very different category..."

I interrupt, "In a 1% category."


And so forth it goes. He knew AFTER my tests that progesterone would save my pregnancy. I knew BEFORE my tests.

Monday, March 23, 2009

Q&A About Progesterone and Clomid - Ask Away!

I am getting a bit of a reputation for my 'progesterone' rants, and trying to do at least something in my power to make sure that nobody who knows me loses another baby because of some dumb ass doctor, or because we are not educated properly when TTC.

So... I am trying to create a space here where I can answer some of your common, unusual, or downright interesting questions. Please keep in mind that I am NOT a medical expert and am NOT 100% sure of anything I am copying, or websites I am linking to. I am just a mom with two miscarriages and an idiot for a doctor. Ex-doctor. Ahem. I digress.

Q. Will breastfeeding affect my progesterone levels?

A. When you are breastfeeding, the milk producing hormone, prolactin, is high while the menstruating hormones estrogen and progesterone are low. The more exclusively you breastfeed (no other fluids, foods or bottles), the higher your prolactin level will be, which will delay menstruation.

If you are no longer breastfeeding exclusively, your hormone prolactin will begin to drop. Eventually your menstrual period will return under the influence of rising estrogen and progesterone levels.

Q. Can I Take Progesterone During or Before Ovulation?

A. I searched for a couple of hours, trying to find a credible website that had information on this question, but came up with nothing except a few forum references that I didn't think were really worth posting a link to. Everything I've read tells the reader to start progesterone on the third day after ovulation (I assume to confirm ovulation has occured). The few things that I did happen to read suggested heavily that progesterone before ovulation can actually prevent ovulation from happening, or at least seriously mess it up.

So the real question is, why would you want to start progesterone before you are ovulating? Since the main purpose is to aid the body in building a healthy uterine lining, something that occurs (or should) naturally after ovulation, then it only makes sense to introduce the hormone in tandem with the body's natural timing.

Q. Will taking the progesterone vaginally seep into the uterus and harm a developing embryo?

A. Well I spent some time on this question and although there was no SPECIFIC reference to the hormone 'seeping into' the uterus (through a not quite closed cervix), there have been thousands of records of post-progesterone-supplement births, with no harm to babies. Those who use synthetic progesterone have a teeny, slightly higher rate of cleft pallet, but this risk is miniscule compared to the baby not making it past 6 weeks in the womb.

Back to the question. Progesterone inserted vaginally (or any progesterone, for that matter) SHOULD be absorbed into the body (specifically the uterus) in order to help build a strong lining. This hormone *should* be raging through the female body after ovulation, and especially after fertilization... so I don't think that something our body produces naturally will likely be of any harm to a developing embryo.

Saturday, March 21, 2009

Progesterone Supplements (oral & vaginal)

Most of this was taken from an excellent blog that I stumbled across. Many thanks to the Stirrup Queen for compiling this information... as a writer I am flattered by imitation, so in my utmost belief that most of the world thinks exactly as I do (or should, anyhow), I am sure she is happy that I have endured to copy her work.... right?

Why would you be taking progesterone supplements?

There are a few reasons you might be taking progesterone supplements, which can be delivered orally, through vaginal suppositories, or via intramuscular injection (commonly referred to as PIO).

Some examples:

(1) You have low progesterone levels. This is usually diagnosed by having a blood test done 7 days post-ovulation.

(2) You have a short luteal phase regardless of the results of the 7 dpo progesterone results. I believe that any luteal phase less than 12 days is considered short.

(3) Even if your progesterone level and luteal phase are fine, if you are doing IVF (and depending on the RE, IUI) you will probably be prescribed progesterone supplements. Taking the supplement just covers your bases.

Why would you take them orally or vaginally?

The oral supplement is definitely the least invasive way to do the job if it works for you. However, when you take progesterone (or apparently any hormone) orally, it must be metabolized by the liver, which makes the delivery system inefficient and less effective.

As for vaginal supplements versus injections, for most women, there seems to be no difference in the results. Many clinics use the suppositories because they feel after all the pre-procedure injections they just don’t want to prescribe more injections. Some clinics state that when they switched to suppositories their pregnancy rates increased. However, there does seem to be evidence that some women have a better response with the injections.

What to expect:

You can expect to take the supplements until you take your beta. If it is negative, you will stop and your period will arrive. If it is positive, you will continue taking the supplements for at least a few more weeks and possibly through the entire first trimester. If you are having blood tests done after insemination or transfer and are using vaginal supplements, your blood tests may not reflect high progesterone levels. Do not freak out if your level seems low compared to your friend doing injections. The vaginal suppositories are not systemic- all the progesterone stays right around your uterus and does not show up in blood tests. That doesn’t mean it isn’t there.

The common oral supplement is prometrium. If you are taking this, expect to feel tired… fast. Twenty minutes after taking this you may feel dead to the world.

There are two vaginal forms:

suppository (yellow pill--see picture)
suspended in gel (white bullet-like pill--see picture)

The suppositories can be either prometrium (yes, the exact same pill you can take orally) or they can be pharmacy compounded. Not all pharmacies have the capabilities to compound these suppositories. I have read that it doesn’t matter if you use prometrium or pharmacy compounded. Whether you use prometrium or the compound suppositories, your dose will typically be 2 to 3 times per day.

Expect to feel like you have constantly wet your pants. The prometrium is like a vitamin E--a softish gel capsule. Prometrium is much less oozy--one or two pantyliners a day should cover you just fine. You may notice some of the yellowish coating on your pantyliner. Gross, but normal. Prometrium can be kept at room temperature. The pharmacy compounded suppositories are very oozy. These need to be kept cold or they will melt. When you take it out of the wrapper, it feels kind of waxy. But if you let it rest in your hand, the surface feels slick and oily. This is only the outer coating--if you look at the non-pointy end, you can see there is white goo inside the waxy shell. You may notice some of the disintegrated shell on your panty liner amongst the ooze. Also gross, but also normal. The suspended in gel supplement (Crinone and similar products) comes in a pre-filled applicator (the pharmacy will give you an applicator for taking the prometrium vaginally but using your finger may be more comfy and is easier to wash.). You might see some of the suspension gel ooze out.

With all of these supplements, you may feel some bloating. They also cause me to have to pee a lot--especially in the middle of the night.

Friday, March 20, 2009

David Comes Home. Tomorrow

At last. It seems like a lifetime since he left for work last September. I've seen him every month, but not for long... except Christmas, when I think we had 12 days together...... I was working huge long heavy hours..... But... the winter is behind us now, and we have spring and summer and fall and the wedding and the house and making babies ahead of us. So much to look forward to! I am beyond blessed with the men in my life. Mason, Jerry, and David... my boys.

How delicious it is as a mother and wife to have all of her family near her at once. I know it won't be forever, I know the boys will eventually find a path they'll want to follow and I know that David and I will as well. I hope the paths are close, and I hope they cross over many times each year, but whatever happens, I know eventually they'll go in different directions.

Thursday, March 19, 2009

To Recap It All....

Okay... realized I don't have a timeline that I can go back to... one that is written out for all of us who like to see the days and times and numbers written out in simple form. So.. here it is:

MC last July at 8.5 weeks, the day after we saw HB....

I was tested in December and have low progesterone, 9.6.

My doc put me on 50mg clomid in January and progesterone at 8DPO was 40.

I had already asked the doctor twice about progesterone supplements. He said:

Progesterone is 'ancient' and a 'waste of money'. He said doctors prescribed it to make their patients feel a false sense of security.

We got pregnant 2nd round clomid (February)....

I went to my regular doc for the supplement and she refused to go around my obgyn (he's the resident RE - we are in a small town)... That was about 14DPO.... She wouldn't even give me a beta because I had 12 positive tests and they were getting darker.

At 17DPO I started spotting a teeny bit and temp dropped... lines on tests became lighter.
So I went to the obgyn and he did give me a beta and I INSISTED on a progesterone count.

At 18DPO I went back to his office, and begged for a script, but found out my beta was 6. Horrid considering I was getting tests for ten days with lines. The baby was dying... and the timing was PERFECT for a dying corpus luteum and me failing to produce the progesterone needed between 2 and 14 weeks!

I insisted on pushing my point the obgyn, an older, 'been there done that' doc. He said 'show me something on the internet that proves progesterone works!' and I replied 'show me something in your medical journals that proves it doesn't.'

I walked out with a script for progesterone - with no instructions on how or when to use it, or how much to take, and my baby dying, or already have died. Too Late!

I did my research.... and in REOCCURING miscarriages, progesterone can improve the chances of a live birth from 30% to 80%

Monday, March 16, 2009

Patient, Heal Thyself!!!

Progesterone, Why is it so Important?
the keep-it-simple version

I shamelessly stole this amazing blog from another woman who obviously needed some answers as much as I did. I followed her trail of bread crumbs to the website:

Saving Babies Online - Please visit it if you want some really amazing info...

I'd like to thank her for her research, and say a little 'sorry' for stealing her well written info. Not that I feel bad about it. This information NEEDS to be passed around as much as possible.

The Importance of Progesterone:

Progesterone is important not only to keeping a pregnancy but also may determine whether or not you conceive. During your cycle, the uterine lining grows thicker in anticipation of a fertilized egg and progesterone helps ensure the endometrium (lining) is ready. Progesterone is responsible for preparing the uterus for implantation. If you have low progesterone, chances are the baby will not be able to implant which may result in a chemical pregnancy. And, low progesterone may keep you from ovulating.

Keep in mind that once both estrogen and progesterone levels drop, your body prepares to break down the lining and thus your period begins. If your progesterone is dropping during pregnancy, you are in danger of losing the baby.

Some symptoms of low progesterone:

If you have short cycles (25 days or under), you may have low progesterone. As women age, progesterone may decrease as well. Other symptoms may be severe PMS and weight gain. Stress, which stimulates cortisol production, will also decrease progesterone production making conception more difficult and could jeopardize a pregnancy. Progesterone actually produces a more calming effect than cortisol which increases stress.

Natural or Synthetic (man-made) Progesterone:

Although I'm reading a lot on the benefits of both synthetic and natural progesterone in maintaining a pregnancy, there does seem to be some consensus that synthetic progesterone may cause some birth defects. I haven't really seen that those studies are reproducible and am unsure how valid they are, but the risk of birth defects should be taken into consideration.

Natural progesterone, however, looks to be much safer with no side effects as long as you don't overload yourself with it. Also topical progesterone and injected progesterone seems to be more effective than progesterone taken orally.

What it boils down to is this:

If you have short cycles, have suffered from infertility or are a bit older than the average mother, you may want to have your progesterone checked. The best time to get checked is around the time of ovulation so you can begin taking supplements if needed. Natural progesterone seems to be a safer than synthetic progesterone and can aid in both achieving and maintaining a pregnancy. Take what you've learned about progesterone to your doctor. If you have a doctor who is not open to testing for progesterone, it may be time to find a new doctor.

What are Typical Progesterone Levels?
(taken from 's website)

Mid-Luteal Phase
5+ ng/ml -- A level of 5 indicates some kind of ovulatory activity, though most doctors want to see a level over 10 on unmedicated cycles, and over 15 with medications. There is no mid-luteal level that predicts pregnancy.

First Trimester
10-90 ng/ml -- Average is about 20 at 4 weeks LMP, and 40 at 14 weeks LMP. It is important to note that while a higher progesterone level corresponds with higher pregnancy success rates, one cannot fully predict outcome based on progesterone levels.

Second Trimester
25-90 ng/ml
-- Average is 40 at beginning, 90 at end.Third Trimester 49-423 ng/ml Usually peaks at about 175.

One note, FertilityPlus has some wonderful information, however, they do take the stance that beginning progesterone supplements after a positive test is unlikely to do much.

I've been able to find studies online to contradict that opinion. I'll be sharing some of those studies below!

Studies involving Progesterone
why progesterone may be more important than you or your doctor realize

Feel free to take a look at the links and then take this information and discuss it with your health care provider.more to follow...

A combination treatment of prednisone, aspirin, folate, and progesterone in women with idiopathic recurrent miscarriage: a matched-pair study.
In a nutshell, this study found that taking this combination resulted in a much higher rate of live births (77% vs. 35% in the group who were not treated) in women who have had recurrent miscarriages.

Use of synthetic progesterone in the treatment of threatened habitual miscarriage
Synthetic progesterone was begun no earlier than 7 weeks in women who were 7 to 16 weeks pregnant and experiencing a threatened miscarriage. Of those studied, approximately 8% miscarried, 9% experienced preterm birth and 82% gave birth 'normally'.

Effects of vaginal progesterone on pain and uterine contractility in patients with threatened abortion before twelve weeks of pregnancy.
This study found that the use of vaginal progesterone diminished pain and contractions in women with threatened abortion. They also found that the placebo group had twice the miscarriage rate of the supplemented group.

Sunday, March 15, 2009

Okay, then..

Pregnant. Not Pregnant. For a woman who writes - A LOT - this blog has been pretty difficult to get my mind around. I avoided coming to my site because I would have to see my 'happy pregnant blog' and photos of my new baby.

However, it has to be faced. Like telling the few friends and family that I trusted with the early news. Like the photos of my beautiful positive pregnancy tests. Like the tests themselves. Like the stupid emails coming, with information about being 'five weeks pregnant... six weeks pregnant'. It has to be faced.

So here we go. For one thing I have to say that I handled it great. Like a champion! Threw out all the positive pregnancy tests. Facebooked a couple close friends, phoned the in-laws, ordered Boston Pizza (with cheesecake for desert), pulled my huge comforter off my bed and onto the couch, and ate cheesy, saucy, hot pasta with ice cold pepsi followed by caramel drenched cheesecake while watching a chick flick and cuddling with the cat. Could be worse I guess. There were a couple tears of frustration, but they were pretty much in private and I managed to spare my loved ones any more trauma than they had to endure.

So I am pretty pissed off at my doctor. He doesn't 'believe' in prescribing progesterone. Progesterone is what my body isn't doing properly. It's the hormone that is needed to build up the uterine lining (placenta). I am on Clomid, which does trigger the corpus luteum to blast out a healthy does of progesterone.... but that little bugger dies (the corpus luteum) about 14 days after ovulation and surprise, surprise, that's just about when I started to lose the baby.

I went in to see him and told him that I had done a ton of research. I told him that every fertility clinic I'd researched used Progesterone. I told him that I knew alot of women who were on the drug to help them get through the first 14 weeks. (The placenta takes over producing the hormone at that time). I told him I needed to know I was doing all I could do to save my babies' lives, regardless of how HE felt about it.

He told me to "show me something off the internet that proves progesterone prevents miscarriages", and I replied, "show me something in your medical journals that proves it doesn't". I did a lot of research tonight on this hormone and here is some information that came up on some very reputable websites:

Trials that show benefit to progesterone supplementation are few and far between. A Cochrane Review on the matter reviewed 14 trials and found no statistical evidence that using progesterone supplements reduced the miscarriage rates for women who had one miscarriage prior to the trial. Cochrane Reviews are generally felt by the medical community to be a fairly definitive word since they usually compile results from multiple prescreened trials in order to generate results of statistical significance.

But the same Cochrane Review also found evidence that progesterone supplements might help women with recurrent miscarriages, stating, "In a subgroup analysis of three trials involving women who had recurrent miscarriages (three or more consecutive miscarriages), progestogen treatment showed a statistically significant decrease in miscarriage rate compared to placebo or no treatment (OR 0.39, 95% CI 0.17 to 0.91)."

Anyhow. I got my progesterone supplements. Too late, of course. The baby had already died and my body was preparing to flush everything out as I was sitting there having the conversation with the doc. The same one I'd had THREE times before about this hormone.

I'll never know if this baby died because of natural chromosomal issues, or because I didn't get the progesterone in my system fast enough. I will NEVER know, but I will ALWAYS suspect.

Now back to the clomid and trying again....

Friday, March 6, 2009

4 Week Old Fetus


Wow. Freaky. I'm Pregnant.

So I took 12 pregnancy tests. T-W-E-L-V-E. Okay. 13. The "most advanced piece of technology you can pee on" was negative, which sucked and sent me into a downward emotional spiral until I retested that evening with two more brand name tests and they were both positive.

The photo to the right is the last test... I had to prove to the digital world that I was pregnant. Besides, there's something wickedly delicious about having that word magically appear as a result of peeing on something.

I'm due on November 13th. That's Friday the 13th if you want to look it up on a calendar, which you most likely don't... but it's an interesting enough trivia that I thought I'd mention it!

We got pregnant on the weekend of the Vagina Monologues. How appropriate!
So far, it's going okay, I guess. Lots of pregnancy signs are a good thing. I am currently sitting in what seems like an unnatural position on the couch with a couch cushion behind my back because it hurts! My back, not the couch cushion. My breasts feel like they are being squeezed in a vice and my gassy tummy would make a truck driver blush. Shall we discuss the hormones?

I went to the doctor's office this morning and cried for most of the appointment. I was embarassed so I cried some more. She wouldn't give me a beta test because she said I was *obviously * pregnant, and I didn't need more numbers to agonize over. Instead she ordered an early ultrasound to check for 'multiples'.
Huh? Pardon me? She wants to check for TWINS????? It seems that I have a lot of factors that put me into that category. Fertility drugs. Age. Lots of eggs. Sounds like we are making an omelette. And the onslaught of major, major preggo signs. So..... although I am not convinced I am having twins, I am kind of in shock that the doctor even suggested it. She even wrote on the ultrasound request "check for possible multiples".

Okay. Later.