7dpo bloodwork - where to go from here?

KittyKatMom

So I finally broke down and went to a different OB after my doctor refused to test my progesterone. My main concern is the 6-8 days of spotting I have before AF every cycle. The new doc was wonderful - compassionate, listened to everything I had to say, looked at my charts, and immediately ordered bloodwork. She also checked my cervix and did an ultrasound on the spot - both were normal.

Tuesday was 7dpo for me, so I had my blood drawn and they tested my thyroid, estrogen, progesterone, and HCG levels. The other doc at the practice (actually a midwife) called me today with the results and she said everything was normal. However . . . when I asked her what the actual number was for progesterone, she said it was 8.5.

Is that low?? I told her I thought the level needed to be above 10, and she said the labs for this particular test have a normal range of 2.8 - 21.6. She has no explanation for my spotting, but said that it could be caused by a polyp that didn't show up on the ultrasound, and that I could have a sonohysterogram to find out for sure. She said if it is a polyp, it shouldn't cause any problems TTC, and that I should continue trying and think positive. She was very kind and was very patient answering all of my questions.

I was hoping to feel better after all of this, but I don't really. I'm glad that everything looks normal, but I want to know where all this damn spotting is coming from! What do you think I should do? Should I talk to the actual doc that I saw at the office? Should I go ahead with the sonohysterogram to make sure there are no polyps? Should I just keep trying and hope for the best?

s.alarie

This must be so frustrating for you. 

A few questions before suggestions: are you paying OOP for testing, or does your insurance cover it? If they do find a polyp, what is the plan? (or is there one? Do they just leave it there because it's just causing annoying spotting and probably isn't causing trouble TTC?)

If insurance covers testing, I say go for it. Even if they find nothing (which in itself is entirely frustrating), you have no less information than you went in with, other than that you have a healthy, normal ute. If they did find a polyp, no big deal, right?

If they find nothing, will that make you want to have more testing to find out the source of the spotting?

I'm just full of questions. I guess just trying to help you troubleshoot this  

KittyKatMom

s.alarie:

This must be so frustrating for you. 

A few questions before suggestions: are you paying OOP for testing, or does your insurance cover it? If they do find a polyp, what is the plan? (or is there one? Do they just leave it there because it's just causing annoying spotting and probably isn't causing trouble TTC?)

If insurance covers testing, I say go for it. Even if they find nothing (which in itself is entirely frustrating), you have no less information than you went in with, other than that you have a healthy, normal ute. If they did find a polyp, no big deal, right?

If they find nothing, will that make you want to have more testing to find out the source of the spotting?

I'm just full of questions. I guess just trying to help you troubleshoot this  

All I want is for a doctor to tell me that the spotting has no impact on my ability to conceive. I guess the midwife more or less did tell me that, but for some reason, I'm hesitant to believe it. I'm just afraid of TTC for months, only to find out that there is a problem we could have corrected a long time ago. As long as the spotting isn't keeping us from conceiving, I can deal with it. It's more of a nuisance than anything else.

I'm not sure if insurance would cover the sonohysterogram. I should probably call and find out. Thanks for trying to help. :-)

Laurakat81

My RE would consider that low. He says above 10 is normal for an unmedicated cycle and above 15 for a medicated one. Even when I had a 10.8 (on an unmedicated cycle) he said while it was "normal" he still didn't like it so he treated it. I would request progesterone supplements each cycle you are TTC no matter what your levels are. I'd take them starting 3dpo until 14dpo or continue through a pregnancy. It sounds like your doctor doesn't really understand progesterone. The lab might have a "normal range" but I worry she might have said your levels were fine even if they'd been 3! Good luck! Edited: dpo not CD...sorry!

twotexans

My RE would consider that low also.  Mine was 8.8 the first time she checked it.   For me, I would ovulate around cd22 and then would spot from 5dpo to when AF would show, usually around 9pdo. Here is what my RE did:

My RE explained that my low progesterone was likely caused by a weak ovulation.  My egg was sitting around a little too long and was deteriorating in quality.  The corpus luteum was not producing enough progesterone, due to poor quality.  She prescribed clomid to strengthen my O.  My progesterone level went up to 10.4, but she still felt it was a little low.  She then added an Ovidrel injection, usually used to trigger ovulation, to further increase my progesterone.  It went up to 15 with the Ovidrel added.  Since I was low at the beginning of my last pregnancy, she has decided to add in progesterone and estrogen supplements in my 2ww, starting 4 days after +opk.  That way we are assured the reason I did not get pregnant was due to inadequate levels.