Wednesday, September 11, 2013

A Day In The Life of a Wannabee SMC: I am the Official Owner of a Luteal Phase Defect (?).

Yesterday, I dropped by Diamond to get my fasting progesterone drawn before I went to work.  Forgot my progesterone, had to go home and get it.  Ended up being late, but Heidi fit me in anyways.  Went to work hoping for the best. 

I found out this morning that the level is only 6.8.  They would like to see it above 15, as this is a medicated cycle.  This is after being on 50mg of progesterone for 5 days (I started the evening after my IUI; the level was checked 6dpiui).  Either the blood level isn't high enough because the progesterone is being absorbed "locally,"  or I'm just not responding to it.  My dose has been doubled, but they won't even check the level with my beta this month.  They'll only check it if I get pregnant, and then if it isn't high enough, they will stick me on progesterone in oil (PIO) shots.  Otherwise, they want me to continue on the 100mg twice a day for my next cycle, then only switch to PIO if the 7dop level is still too low.

Honestly, I am very irritated right now.  I'm feeling like a science experiment test subject, except this "study" is severely playing with my finances and more importantly, my heart.  This could have been checked out last cycle, but they "didn't think it was necessary."  And now, they want to play it conservatively, because the injections "are a pain."

I'm going back and forth with the "plan."  I understand that I may indeed be getting enough progesterone, and it just isn't showing up.  But either way, at least with PIO shots, the level can be checked more accurately.  I probably wouldn't be thinking this way if the level had been borderline, but this is WAY under what should be seen with even an un-medicated cycle.  My insurance will cover the injections.  Yes, they are painful, and yes, I may be kicking myself in the arse after a few weeks of daily IM shots, but in the end, I want to be successful.  I will do anything I have to to help ensure I get pregnant, stay pregnant, and have a healthy baby.  If that means a lumpy sore rear end, so be it.  I've got ice packs.

I'm even more determined to do it this way, since I am looking at an injectable cycle if this one is not successful.  If I am going to spend the money on the extra U/S and E2 levels, then I should be able to have the post-IUI support that makes me the most comfortable right?  There have been so many things about this process that I have no power over, but THIS is one thing I can control, and with relative simplicity to boot.   

Speaking of which, I am almost as intrigued to hear this as I am irritated by it.  Could this be the answer I have been looking for all these years?  Was this the reason I miscarried before?  Did I just not make enough natural progesterone to support the pregnancy?  If so, this could be corrected.  It also upsets me in other ways.  Why wasn't my progesterone level checked at my first prenatal appointment?   I remember the nurse stopping when I told her about my mother's history of miscarriages.  They drew just about every other lab they could; so what's one more vial of blood?  Maybe if they had, I would have brought my child to her first day of second grade last week.  Also, when I looked for answers, I was just told to "come back when you are ready to have more kids" and slapped on birth control.  I was told this for years.  I know that there are so many other factors that may have caused this, and that this may not even be an issue.  It's just hard to stop my mind from going there.  I hope it's understandable.

 I would love to hear all of your thoughts.  What were your levels at 6-8 dpo?  What was your course of treatment?  Do you think I am correct in my thinking, or am I reaching?  M also brought up an interesting thought:  is it possible that I am getting enough progesterone, but my corpus luteum isn't producing enough to make up the difference due to poor egg quality?  My numbers were great, and I am young(er), but is that something I should be asking about as well?

I'm sorry for all the rambling and questions, but's so frustrating to be told you can get pregnant with "a little help," but then have all these other things come to the surface that may or may not even be happening.  I know I over-think a lot of this.  But when you want something so badly, that's something that tends to happen; or at least it does in my case.  It's just that throughout this entire process I have had doctors and other medical professionals telling me I am incorrect and that the things I want to explore "really aren't necessary."  According to them, I didn't need Provera to induce my period, I didn't need male hormone and insulin levels checked, I wasn't losing weight because I didn't eat right and didn't exercise like I said I did, and I certainly didn't have PCOS.  But when I insist on these things being explored, it turns out that I was correct to do so.  I did have insulin resistance, I do have PCOS "or something like it," and once I started on the metformin in addition to doing everything I was already doing, almost 50 pounds fell off in a matter of months.  It's frustrating, and I keep reading about this kind of thing on other people's blogs and the boards too!

And...what can I expect to go through if I end up needing to be more aggressive with treatment than I am already?  Yikes! least I have a day off tomorrow and a night at the movies with the girls to look forward to.  And hey, maybe I am pregnant after all.  It could happen....  


  1. That is so frustrating. Where are all the doctors that are supposed to be patient advocates and work for their patients?
    I know doctors don't want to "over-test" but when it is something as simple as a blood draw and the patient (or their insurance) is willing to pay for it then I don't see why they continue to believe the patient is "crazy" or "overreacting". And it's especially frustrating when you have test results that prove something might indeed be wrong and they still don't take you seriously.
    Sorry about the rant. Can you tell I've run into similar situations with doctors? Sigh. I hope you are able to convince your doctors to stop treating your cycles like science experiments.

    1. Hmm...let's see if I can actually reply this time! Yes, it is very frustrating indeed! I think a lot of us learn early on to bring a lot of our own intuition to the table when dealing with doctors. It's not like I WANT to be right, I HATE being right. Because when that happens, it's not like it's good news; you know?

  2. Frustrating is the word! I know you know it, but I just wish I had been so much more aggressive with my protocol from the beginning. They never checked my progesterone level during a TTC cycle -- maybe because I requested to go on supplements after the first time? But I still had LPs in the 9-10-day range, which they just didn't seem concerned about.

    Even the best providers and clinics seem to require a lot of 'management' if you want to stay on top of things -- I'm sure the Diamond IF nurses will support you if you say you want to be as aggressive as possible for the next cycle. (But I'm hoping you won't even need it!)

    1. Hey, I can reply to things now!!! I agree I need to be aggressive for sure! Like you said, Gonal-F and PIO all the way! That's so weird that they never checked your levels, as a short LP is a major sign that it's too low...well, I'm sure your little girls makes all of this very trivial in the long run. At least you're prepped for the next go-round if there is one!