New and Nervous

Hi there. I'm new here, like today new. [And unfortunately this is my second time typing this post because I accidentally closed my web browser.]

So here we go: hormonal BC all my adult life switching brands of pills when side effects got unmanageable and eventually getting a Mirena. I had the IUD out in March '21, struggled with mental illness, and then got that settled. But I did gain a crap ton of weight. I'm 5'9 and currently 245. I was 210ish when I got the IUD out. When I tell you I gained the weight QUICK I mean stretch marks on the belly and love handles quick. Anyhow.

Me and DH have been TTC since then. We've had a couple of months when the timing didn't go just right, but every month is the same. I assume I'm ovulating (I have some symptoms and slow climb on my OPKs and then rapid descent and CM and CP are all consistent). I then have a 14 day luteal phase and the cycle starts all over again.

I told myself twice "this is the last month" but this last cycle (I'm currently day 14) really is. I called the doctor today and made my appoint for about two weeks from now.

So, I have some things I need help with and no one in my life who gets it or has relevant advice (if I hear one more time it'll happen when it's time...). So here goes:
1. What exactly do I say to my ob/gyn?
2. Am I just going to get the "lose weight" diagnosis?
3. Has anyone experienced super regular cycles when it comes to LH slow rising and then all the sudden it switched to sudden onset LH peak?

Re: New and Nervous

  • Your ob will ask the questions, just be ready with dates and other data. They will track your cycles with blood tests to check on ovulation.
    Then they would help you ovulate - meds or no meds.
    You have not told your age but if you want to speed up the process, ask ob for reference to RE and make an appointment while you work with ob. It takes time to get appointment with good RE.
  • Ah, sorry. I'm 33 turning 34. Thank you
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  • ttc3yttc3y member
    Hi @robotpopcan!

    I’m sorry your fertility journey has been so difficult. We can all relate to that here. Here are my 2 cents to answer your questions. 

    I would tell your ob/gyn that you and your partner have been trying to conceive for over a year and your are concerned that there could be deeper fertility issues and you would like to run some tests to look into them. If they still use the weight as an excuse to not do further testing, I would recommend looking for a another practitioner. There are practitioners who practice with a HAES (Heathcare At Every Size) philosophy to help you get the care you deserve. Also, when you do testing, make sure they test your husband too. A third of the fertility issues are caused by the male side, a third due to the female side, and a third is caused by both sides. The ob/gyn can help do preliminary tests (sex hormones, thyroid, blood sugar, vitamin D, etc…) but sometimes they won’t go as deep as a fertility specialist. For example, I wanted my ob/gyn to do an Anti-Mullerian test and she refused to do so. I had to wait until I saw a fertility specialist to draw that one. 

    The LH surge is suppose to be just that. A quick surge that initiates ovulation. It doesn’t sound like your LH is acting any differently from normal. The fact that you have a measurable LH is a good sign. It means you are ovulating.  

    I hope my 2 cents help. I wish you the very best on your fertility journey! ❤️
  • @ttc3y
    Thank you. I did do a Modern Fertility test, and they look into your reproductive hormones on a broad basis. My AMH came back high but so did my TSH (3.68) which is not high by normal standards but high for TTC apparently?

    As far as my LH goes, it has for over a year risen over the course of the week until it peaked and then would rapidly crash. Now, all the sudden, it doesn't rise over a week. It just peaks and is down to nothing the next day. I've seen some women's charting look that way, so I know it's normal. What's odd to me is that it suddenly switched from one type of onset to the next?

  • ttc3yttc3y member

    Sometimes an elevated AMH can indicate possible PCOS. I find the conventional methods of diagnosing PCOS not always the most skillful with the Rotterdam criteria and doesn’t capture everyone experiencing PCOS. Insulin resistance is usually the culprit behind it but it’s not part of the diagnosing criteria (get a morning fasting insulin test, optimal should be 8 or less when you look at it from a functional medicine lens). You could have a normal testosterone level but elevated DHEA which is a precursor sex hormone. In my situation, I think I have low grade PCOS but my current fertility doctor never outright diagnosed me with it but my Naturopath did. A fertility doctor who I got a second opinion also thought I had PCOS even though I didn’t technically meet the Rotterdam criteria. 

    As for the thyroid, I don’t think conventional medicine actually treats thyroid to optimal levels. Optimal TSH should be between 1-2.5. And if you are getting pregnant, a fertility specialist would like to see your TSH at least less that 2.4 (some experts will even say less than 1.4). You might have sub-clinical hypothyroidism and your thyroid may be contributing to your weight and fertility issues. Make sure they check your free T4, free T3, iodine levels, and TPO antibodies (to rule out Hashimoto’s). 

    I don’t think I have much more to add with the LH. Our hormones are not constant and they are always adjusting and changing in the environment we are in that is related to stress, the food we eat, toxic exposures, physical activity, emotions, etc… As long as the LH surge is reaching the threshold to help you ovulate, I think it’s fine but I’m not a fertility specialist or an Ob/Gyn. 
  • @ttc3y
    Holy moley you know a whole heck of a lot. I can't tell you how much I appreciate you taking your time to respond with this valuable information.

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