Trouble TTC

Trying to understand everything still....

Hello all,

My husband and I have ben TTC since the day we got married (6/2013). I wasn't diagnosed with PCOS and Thyroid issues until I thought that I was pregnant last January (2014) (hadn't had a period since the November before that). I am on multiple medications including Metformin, and Synthroid.

On September 12th I went to an appointment with a new OBGYN in hopes of finally trying a fertility drug. My last cycle had just begun on September 1st and lasted about 5 days. The Dr. put me on Clomid 50mg and he said that the next time that I had ANY sort of bleeding (even spotting) to consider that CD1 of my new cycle. Anyone ever heard of this? The VERY next day (9/13/14) I was spotting so bad I needed a tampon. Called my OBGYN and they said to consider this day 1. I took the Clomid on CD5-9 and my husband and I BD CD 8,10,12,14,and 16. They did my 20 Day Progesterone test and my level was at 4.5 which I was told that I did not ovulate as it needed to be in the 10-15 range. But I have read some posts about women concieving with levels as low as 3 but had to take progesterone supplements thruout their pregnancies?

I am so confused. Does anyone know about this subject?

 

Thank you to anyone who offers help!

 

**************************SIGGY WARNING********************************

Dx: PCOS (January 2014)

Dx: Hashimoto's [Thyroid] Disease (January 2014)

Dx: GERD (August 2014)


Treatments/Medicines:

Metformin (since 1/2014) 1500Mg/day
Synthroid (since 1/2014) 50Mcg/day
Omeprazole (since 8/2014) 40Mg/day
Prenatal Vitamins (per OBGYN- 9/2014) 1/day

First Round of Clomid (begining 9/13/14)
Progesterone Level Day 20 Results: 4.5


Mom to 3 Furbabies and I have a 5 year old Step-Daughter

 

 

 

 

 

   

 

 

 

 

 

  

 

Re: Trying to understand everything still....

  • Ditch your OBGYN and get your care from a RE especially if you are going to be on medicated cycles. I made the mistake of taking clomid from my OBGYN, and after researching more about infertility I am so happy I stopped seeing my OBGYN for fertility issues. Fortunately I had no Bad effects from the 2 cycles of clomid I took from my OBGYN, but there are many women who do have horror stories.
    Me: 37 DH: 37, married since Sept. 2013. "actively" TTC for a total of 13 months (after 7 months of TTC, took a 1 1/2 year hiatus due to work scheduling and wedding planning. Started up again after our wedding in Sept.) First evaluation by an RE November 2013

    HSG-normal
    OH-tiny polyp found, but RE assured me she doesn't think it's contributing to infertility and doesn't recommend me to remove it because it's so small.
    DH's SA-normal
    Hormones all within normal levels
    Ovarian Reserve-RE says "is great" she's not concerned about my egg quantity (which I was until I saw her and results came back good!) 

    04/2012 50mg Clomid=BFN (prescribed by OBGYN, not monitored)
    06/2012 50mg Clomid=BFN (prescribed by OBGYN, not monitored)
    11/2013 100mg Clomid, with HCG trigger=BFN (prescribed by RE, monitored with US (2 dominant follicles) and baseline bloodwork done)
    01/2014 100mg Clomid, with HCG trigger-(prescribed by RE, monitored with US-1 dominant follicle)=BFN
    06/2014 7.5mg Letrozole, HCG trigger (prescribed by RE, monitored with US-2 dominant follicles), IUI #1 on 7/3/14=BFN
    07/2014 7.5mg Letrozole, benched for IUI#2 this cycle, because I ovulated on my own before my follicular US. Progesterone suppositories=BFN Diagnosed with PCOS this month too. Testosterone levels high at 76. =( 
    08/2014 7.5mg Letrozole, HCG trigger with 19mm follicle. IUI#2 on 8/31 cancelled last minute due to family emergency. 
    09/2014 Taking a 3 month break starting this month. If not pregnant in 3 months, will start up again with medicated cycles and IUIs. Had all my labs and AFC re-evaluated this month also. RE says nothing much has changed since my eval last November, okay for me to take a little break. =) 




    [Deleted User]Radiantlydogshowgirl
  • You need to have an HSG done prior to taking Clomid to make sure your tubes are clear. There's no sense in taking a medication to stimulate ovulation if your tubes are blocked. You also need to have monitoring ultrasounds done throughout your cycle to make sure your lining looks ok (Clomid can thin it) and that you don't have cysts since Clomid can cause that too.

    Additionally, that CD 20 blood work you had done is supposed to be done at 7dpo, but since you weren't being monitored, they didn't know when/if you ovulated.

    As pp said, ditch the OB and get an appointment with a RE.


     

    TTC since July 2012 
    BFP 5/22/13. Lap. to remove ectopic and dx with endo. 6/16/13

    RE consult: June 2014

    DX: FVL, endo, hypothyroidism, blocked left tube

    Oct. 2014: First treatment cycle: Clomid+trigger+IUI=BFN

    November 2014: Clomid+trigger+IUI again=BFP!

    BFP 11/28/14 MC discovered 1/14/15

    Blogging to stay sane

    dogshowgirl
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  • Hi there, so sorry you are struggling with this! I'm glad your thyroid/PCOS issues were found so you can get treatment.

    Your doctor has made some very poor decisions, including having you start Clomid without seeing what was going on with your body on that odd cycle, and without monitoring to see if you were developing a follie, and with assuming CD20 progresterone proves anything (what medical professional would ever assume that ovulation occurs on CD14? That's just foolishness). As previous posters pointed out, you took Clomid on the later days that are recommended so why didn't the doctor think that an iffy number like 4.5 couldn't mean you have ovulated later than CD14?

    A reproductive endocrinologist would be a perfect next step. I would not continue Clomid with the OBGYN because they are not taking care of your health (Clomid can thin the uterine lining, which can be a long-term problem; cause dangerous/painful cysts, especially if new cycles of Clomid are started without checking for cysts on ultrasound; and as there is a recommended limit of 6 Clomid cycles for health, it seems foolish for the doctor to waste them without knowing your real situation). 

    There are a whole set of tests that can make sure exactly what your diagnosis may be (HSG to show your uterus and tubes are clear, sperm analysis to see if your partner's sperm has a chance of getting you pregnant with timed intercourse, and other hormones that an RE can analyze to predict your response to meds and the health of your eggs). My husband had a pretty bad SA years ago and we assumed that was the problem, but when we finally did testing with an RE we found that each of us had multiple issues going on, and I needed surgery, he needed meds, and IUI at least was needed.

    Good luck, I hope you do find a doctor that takes good care of you and that you can trust! :)
    January 3T Siggy Challenge - New Year's Resolutions
    image
    imageimage

    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
    dancersposedogshowgirl
  • I also second everything Bunny said.  For the sake of your reproductive health, please see an RE.

    Good luck!
    Me: 31 (PCOS) possible right tube issues DH: 36 (SA normal) 
    Started dating in 2006, Married 2012 
    TTC since November 2013 
    First RE visit due to irregular periods: June 2014
    Lap/Hysto to remove polyps, cyst and tube blockage 11/6
    Cycle 1 (Dec. 2014) TI with Clomid, Trigger, & Progesterone CX due to no response
    Impatiently Waiting CD1 to try again with Fermara Back on the bench due to giant cyst,
    who know I'd ovulate on my own after a cancelled cycle and end up with a mega cyst :(
    All Welcome
     
    image
    dogshowgirlBunnyBerry
  • Good luck! I agree with the ladies who have spoken up, it's the best advice possible. I personally have a blocked tube (the re sent me to HSG first thing) and he said he would not do clomid because of that. My next step is surgery and IVF but I'm hoping I get pregnant naturally first. Have been trying since wedding 7/2013. Oh AND I think I'm finally ovulating this month and it's day 20!
    TTC#1 since Aug 2013, I'm 37, DH 41.  
    Maya Arvigo Abdominal massage (daily self care), plus TTC meditations.
    I'm very sensitive to diet (gluten, avoid processed foods) and environment. Have a history of inflammation and tendinitis before going off gluten in 2009.  
    July 2014 - RE Visit #1: Eggs look good, Endometrioma on R ovary, HSG showed blocked R tube close to ovary. DH SA normal 
    DX: Endometriosis probably the IF cause and gunking up tubes.  Since egg reserve is high, RE says I can wait a couple months and then get laproscopic surgery to remove endo & clear tube.  If that doesn't help then move to IVF. 
    Dec 2014 - Saw new RE - does not recommend surgery on tube as it isn't likely to help.  Doubts I have endometriosis.  My endometrioma shrunk to neglible size (yay!) 
    Seriously considering IVF in March/April
    12/17/14 - Natural BFP! 
    dogshowgirl
  • Oh my Gosh everyone! I have never had so many responses to a question! I do truly feel so loved here. Thank you SO MUCH. I didn't even know that such a thing as an RE existed and it wasn't until the later comments that I actually had it spelled out for me lol. WOW, just WOW. I go to am endocrinologist for my Thyroid and PCOS. Do you think SHE can do it or are there different levels of endocrinologists? Also, what is a HSG? Do any of you think I STILL could have ovulated then!? If so, when do I take a Pregnancy Test? I don't know which day exactly I ovulated.....

    **************************SIGGY WARNING********************************

    Dx: PCOS (January 2014)

    Dx: Hashimoto's [Thyroid] Disease (January 2014)

    Dx: GERD (August 2014)


    Treatments/Medicines:

    Metformin (since 1/2014) 1500Mg/day
    Synthroid (since 1/2014) 50Mcg/day
    Omeprazole (since 8/2014) 40Mg/day
    Prenatal Vitamins (per OBGYN- 9/2014) 1/day

    First Round of Clomid (begining 9/13/14)
    Progesterone Level Day 20 Results: 4.5


    Mom to 3 Furbabies and I have a 5 year old Step-Daughter

     

     

     

     

     

       

     

     

     

     

     

      

     

  • Oh girl. I just got the "you need an RE and not an OB" talk only a few days ago from these ladies, and let me tell you they had some scary stories out there.I was taking clomid with OB, but after reading some stories decided it was best to see an RE instead (not only do they treat you more vigorously, they will also monitor you). 
    Also: I just got my bill from OB. It was a LOT; like we might as well have gone to RE to begin with. Hard lesson learned right there, but we're still learning this process. You are too.
    4.5 is considered as weak ovulation I think; like maybe you released an egg, or your body tried to, but the liklihood of concieving is pretty low. It sounds though too like you don't really know when you O'd and since you're not being properly monitored, you might have O'd late than you thought. :)
    Me: 24 
    DH:25
    TTC for over a year with PCOS. We'll see what happens. 
    November 3 2014-finally going to see an RE!

    image
    Favorite villain: Alex from A Clockwork Orange
    dogshowgirl
  • Thank you for your insight! I'm hoping I just Ovulated later. When does one usually run a Pregnancy Test after ovulation? How many days? I had A LOT of cramping on CD16 on my left side so I thought maybe that was the day I ovulated? My husband and I also used preseed as I had read online that it can help the sperm's vitality and mobility.

    **************************SIGGY WARNING********************************

    Dx: PCOS (January 2014)

    Dx: Hashimoto's [Thyroid] Disease (January 2014)

    Dx: GERD (August 2014)


    Treatments/Medicines:

    Metformin (since 1/2014) 1500Mg/day
    Synthroid (since 1/2014) 50Mcg/day
    Omeprazole (since 8/2014) 40Mg/day
    Prenatal Vitamins (per OBGYN- 9/2014) 1/day

    First Round of Clomid (begining 9/13/14)
    Progesterone Level Day 20 Results: 4.5


    Mom to 3 Furbabies and I have a 5 year old Step-Daughter

     

     

     

     

     

       

     

     

     

     

     

      

     

  • Thank you for ALL the information. I will call the place where I go for my endocrinologist and ask for an RE. I guess I will just wait and see if I get a period and if not, test on the 13th as then it will have been a month. Thank you so much ladies!

    **************************SIGGY WARNING********************************

    Dx: PCOS (January 2014)

    Dx: Hashimoto's [Thyroid] Disease (January 2014)

    Dx: GERD (August 2014)


    Treatments/Medicines:

    Metformin (since 1/2014) 1500Mg/day
    Synthroid (since 1/2014) 50Mcg/day
    Omeprazole (since 8/2014) 40Mg/day
    Prenatal Vitamins (per OBGYN- 9/2014) 1/day

    First Round of Clomid (begining 9/13/14)
    Progesterone Level Day 20 Results: 4.5


    Mom to 3 Furbabies and I have a 5 year old Step-Daughter

     

     

     

     

     

       

     

     

     

     

     

      

     

  • Oh my Gosh everyone! I have never had so many responses to a question! I do truly feel so loved here. Thank you SO MUCH. I didn't even know that such a thing as an RE existed and it wasn't until the later comments that I actually had it spelled out for me lol. WOW, just WOW. I go to am endocrinologist for my Thyroid and PCOS. Do you think SHE can do it or are there different levels of endocrinologists? Also, what is a HSG? Do any of you think I STILL could have ovulated then!? If so, when do I take a Pregnancy Test? I don't know which day exactly I ovulated.....
    Endocrinologists can work hand-in-hand with an RE if needed. For example, my RE said that if an MRI showed a pituitary tumor was causing my elevated prolactin hormone, then he would send me to an endocrinologist to treat it. And the thyroid/PCOS is something they can both work on, although if your purpose is to be more fertile instead of just controlling symptoms, you'd want an RE making the decisions for meds.

    HSG = hysterosalpingogram, they inject dye through the cervix into the uterus and watch on Xray as it fills your uterus and hopefully spills easily from both your tubes (the colored dye can show if your uterus has fibroids, and if your tubes may not be completely clear, or even if they are totally blocked). Since women with PCOS often do eventually get pregnant on their own, it's important to make sure there aren't other issues that have been keeping you from getting pregnant.

    The guidelines for progesterone levels that indicate ovulation are based on being 7 days after ovulation occurred. Since you (and your doctor) have no idea when that was, the progesterone number they tested is meaningless, unfortunately. You could have O'ed before or after, or never. It does seem to match up that you may have O'ed on CD16 when you felt something, and then 4 days later a progesterone level of 4.5 might make more sense, but you really can't know for sure.

    Taking a pregnancy test at the one-month mark isn't any kind of guarantee either. If you did O on CD16, a test might show positive as early as CD26-27, or not until CD 32 sometimes. But if you O'ed later, you might not see a positive test until well after. And of course, if you didn't O, you might see your period come really really late but still not be pregnant.

    I hope this ends up being our month after all and you never have to worry about all this stuff!! But it sounds like a great plan to ask your endo for a referral to an RE. If your period comes, you will likely schedule a CD3 ultrasound and bloodwork (to see how your ovarian reserve is among other things), then around a CD7-10 HSG. And of course you'll have to get your partner to go in for his sperm analysis!! That's always a fun battle. :)
    January 3T Siggy Challenge - New Year's Resolutions
    image
    imageimage

    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
    dogshowgirl


  • Oh my Gosh everyone! I have never had so many responses to a question! I do truly feel so loved here. Thank you SO MUCH. I didn't even know that such a thing as an RE existed and it wasn't until the later comments that I actually had it spelled out for me lol. WOW, just WOW. I go to am endocrinologist for my Thyroid and PCOS. Do you think SHE can do it or are there different levels of endocrinologists? Also, what is a HSG? Do any of you think I STILL could have ovulated then!? If so, when do I take a Pregnancy Test? I don't know which day exactly I ovulated.....

    Endocrinologists can work hand-in-hand with an RE if needed. For example, my RE said that if an MRI showed a pituitary tumor was causing my elevated prolactin hormone, then he would send me to an endocrinologist to treat it. And the thyroid/PCOS is something they can both work on, although if your purpose is to be more fertile instead of just controlling symptoms, you'd want an RE making the decisions for meds.

    HSG = hysterosalpingogram, they inject dye through the cervix into the uterus and watch on Xray as it fills your uterus and hopefully spills easily from both your tubes (the colored dye can show if your uterus has fibroids, and if your tubes may not be completely clear, or even if they are totally blocked). Since women with PCOS often do eventually get pregnant on their own, it's important to make sure there aren't other issues that have been keeping you from getting pregnant.

    The guidelines for progesterone levels that indicate ovulation are based on being 7 days after ovulation occurred. Since you (and your doctor) have no idea when that was, the progesterone number they tested is meaningless, unfortunately. You could have O'ed before or after, or never. It does seem to match up that you may have O'ed on CD16 when you felt something, and then 4 days later a progesterone level of 4.5 might make more sense, but you really can't know for sure.

    Taking a pregnancy test at the one-month mark isn't any kind of guarantee either. If you did O on CD16, a test might show positive as early as CD26-27, or not until CD 32 sometimes. But if you O'ed later, you might not see a positive test until well after. And of course, if you didn't O, you might see your period come really really late but still not be pregnant.

    I hope this ends up being our month after all and you never have to worry about all this stuff!! But it sounds like a great plan to ask your endo for a referral to an RE. If your period comes, you will likely schedule a CD3 ultrasound and bloodwork (to see how your ovarian reserve is among other things), then around a CD7-10 HSG. And of course you'll have to get your partner to go in for his sperm analysis!! That's always a fun battle. :)


    Thank you so much for your advice! Luckily, husband already said he would go in for a SA. He does have a 5 year old daughter that we see every other weekend, but anything could have happened to his sperm in the past 5 years, right? He is on board for anything that could result in a baby.

    **************************SIGGY WARNING********************************

    Dx: PCOS (January 2014)

    Dx: Hashimoto's [Thyroid] Disease (January 2014)

    Dx: GERD (August 2014)


    Treatments/Medicines:

    Metformin (since 1/2014) 1500Mg/day
    Synthroid (since 1/2014) 50Mcg/day
    Omeprazole (since 8/2014) 40Mg/day
    Prenatal Vitamins (per OBGYN- 9/2014) 1/day

    First Round of Clomid (begining 9/13/14)
    Progesterone Level Day 20 Results: 4.5


    Mom to 3 Furbabies and I have a 5 year old Step-Daughter

     

     

     

     

     

       

     

     

     

     

     

      

     

    BunnyBerry
  • I agree with PP about running to an RE. I was stupid and wasted 3 &1/2 years with horrible OB/GYN's who had no idea what to do with me. I would hate for you to waste precious time too. Also, there are different SA's my husband got one in 2012 that reveled his levels were awesome. This July he redid an SA, but they also did a Kruger test which reviled he has too many gentlemen and not enough soldiers. We would have never known that if we didn't redo his SA.
    Me-33 DH-36.
    Married 11/10 TTC 11/10
    06/11- diagnosed with PCOS 
    7/11- D&C and benched for a year 
    9/12-4/13-6 rounds of 50 mg Clomid- no sucess 
    6/13- new doc
    7/13-4/14- 6 more rounds of Clomid. 50 mg and then stepped up to 100mg- no success 
    5/14-7/14- took break waiting for new insurance 
    7/14-new insurance= new doc- actually a RE!!!! 
    7/14-HSG and blood test good-PCOS confirmed by new doc 
    10/14 looking forward to 1st IUI w/ Menopur. Blood Test= Negative
    11/14- IUI #2
    w/ Menopur- Blood Test= Negative
    1/15- IUI # 3 w/
    Menopur- Blood Test= Negative
    2/15- Self Benched this cycle
    3/15/15-Suprise BFP on natural cycle!!!! EDD-11/16/15

    dogshowgirl
  • Shauntee said:
    This July he redid an SA, but they also did a Kruger test which reviled he has too many gentlemen and not enough soldiers. We would have never known that if we didn't redo his SA.
    @Shauntee That is soooo funny! Never thought of them as "gentlemen." This week DH was making all sorts of jokes about his "soldiers" (like, hey give me my helmet back! - No, I need it, I have two heads!, and Come on guys, follow your captain to the egg! -Don't listen to the captain, he swims in circles! - That's not an egg, it's a bomb, run!). :D
    January 3T Siggy Challenge - New Year's Resolutions
    image
    imageimage

    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
    dogshowgirlsouthernyankeegirl
  • Lmao Now I am going to HAVE to make a military reference fto my husband. That just made my night!
    TMI- I am starting to have (dare I say it) purpleish/browning discharge. But in what looks like EWCM. This is only when I wipe though..... WTH? :-S

    **************************SIGGY WARNING********************************

    Dx: PCOS (January 2014)

    Dx: Hashimoto's [Thyroid] Disease (January 2014)

    Dx: GERD (August 2014)


    Treatments/Medicines:

    Metformin (since 1/2014) 1500Mg/day
    Synthroid (since 1/2014) 50Mcg/day
    Omeprazole (since 8/2014) 40Mg/day
    Prenatal Vitamins (per OBGYN- 9/2014) 1/day

    First Round of Clomid (begining 9/13/14)
    Progesterone Level Day 20 Results: 4.5


    Mom to 3 Furbabies and I have a 5 year old Step-Daughter

     

     

     

     

     

       

     

     

     

     

     

      

     

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