RE's office doesn't believe in this?

amd1982 · February 2012

The nurse from my RE's office called today and callously, rudely told me the test was negative and tried to say "ok, bye!" after she told me (which I already knew anyway). i caught her and asked about 7dpo bloodwork and my progesterone levels. again, very rudely she said "we don't do that here at all. studies have shown that there's nothing we can do about progesterone levels and so we don't test for it." uhhh, ok. this is mass general hospital people, not some guy doing business out of his garage. i can't believe one of the top hospitals is saying there's nothing they can do, yet so many other bumpies swear by the progesterone supplements. so whats the deal?? do i switch offices in the meantime during my break? even when i called brigham and womens the girl was really rude and told me they only do 7dpo b/w depending on the kind of cycle, etc. i feel so frustrated right now....everyone is treating me like an ATM rather than a patient. maybe i should call some places that aren't part of hospitals....i'm so lost right now.

brookelynpaisley · February 2012

Pardon my ignorance, but I don't know anything about REs within hospitals here - they generally all have clinics. If you don't like the way you're being handled, I'd consult with someone else, whether they run their business out of a clinic, hospital, or backyard.

mandyandmike2009 · February 2012

Sorry they were so rude to you. I just had a consult today to go over my IUI and my dr. said they dont know if progesterone helps or if it doesnt. There are so many conflicting reports that she just does it because it cant hurt. If you dont feel confortable I would get a 2nd opinion.

tst1998 · February 2012

My clinic doesn't do 7dpo blood work for IUIs or IVFs. They do routinely use progesterone supplements (Crinone) for treatment cycles but don't monitor your progesterone levels. I would ask your RE about their protocols. I have found that if I ask for something, even if there isn't any evidence to support it as long as it isn't harmful, my RE will usually do it for me.

I'm sorry the nurse is being so dismissive of your questions. I ended up at a smaller clinic (although affiliated with the university) because I wanted to avoid the fertility factory experience. Hopefully you can find someone to work with who you feel comfortable with and takes your concerns seriously!

SteFizzRich · February 2012

I'm sorry that they were so rude to you on the phone. It's definitely not necessary and doesn't help you trust that they have your best interest in mind. I can only imagine how frustrated you are. FWIW, my RE's office doesn't do 7 DPO bloodwork or progesterone levels for everyone either. They will only do it if there is something in your history that specifically suggests that there is an issue.

hmz819 · February 2012

If you don't feel comfortable I would try and find a new RE.

That being said the RE I am seeing said he doesn't put "a lof of weight" on a 7 DPO progesterone test. He says that this test doesn't tell you too much since progesterone can flucuate during the day. (I did ask about the test and he is willing to run it for me though, so I am going in on Friday for the test.)

jessican08 · February 2012

tst1998:
My clinic doesn't do 7dpo blood work for IUIs or IVFs. They do routinely use progesterone supplements (Crinone) for treatment cycles but don't monitor your progesterone levels. I would ask your RE about their protocols. I have found that if I ask for something, even if there isn't any evidence to support it as long as it isn't harmful, my RE will usually do it for me.
I'm sorry the nurse is being so dismissive of your questions. I ended up at a smaller clinic (although affiliated with the university) because I wanted to avoid the fertility factory experience. Hopefully you can find someone to work with who you feel comfortable with and takes your concerns seriously!

All of this! I will clarify though that my (and I'm sure tst1998's) RE's office obviously monitors your progesterone leading up to your IUI and/or ER, they just don't do it afterwards while you're in your 2ww.

Blsd4given · February 2012

brookelynpaisley:
Pardon my ignorance, but I don't know anything about REs within hospitals here - they generally all have clinics. If you don't like the way you're being handled, I'd consult with someone else, whether they run their business out of a clinic, hospital, or backyard.

This. The next RE may agree... but it never hurts to look around just in case. Not all REs and OBs are knowledge equal... Smile

pulga131 · February 2012

brookelynpaisley:
Pardon my ignorance, but I don't know anything about REs within hospitals here - they generally all have clinics. If you don't like the way you're being handled, I'd consult with someone else, whether they run their business out of a clinic, hospital, or backyard.

This! The only reason NOT to do 7dpo is if your progesterone has always been good. But you should at the very least have it done as initial testing and every time you start a new medication to see how you are responding. I will tell you that mine was low and the nurse told me that they don't start supplements unless its low after an HPT. She stated that at 7dpo it more reflects ovulation. But, I still plan on speaking to my RE personally about this instead of the nurse. I suppose if they are confirming ovulation with u/s and checking progesterone with a beta then thats probably okay but they need to check your progesterone at some point. And regardless you shouldn't be treated that way. If you want a test scheduled why won't they just do it? GL hun and sorry about the BFN

CousinVicki · February 2012

My dr does not do 7dpo testing either. If you are confused, call back and have the actual RE call you, or go in to talk to him/ her. Why do so many on here let these people who are NOT dr's push them around??

hootie123 · February 2012

FWIW - I never had 7dpo b/w done with my RE - 3 IUIs and 2 IVFs. I personally do not think that progesterone supplements are the golden ticket - you need to get a fertilized egg that implants!!! Your RE will test your progesterone once you get a positive beta - and if it is low at that point - then supplements will be used then.

GL!

limpetfan · February 2012

Honestly, you might be placing too much value on 7DPO testing during a treatment cycle.

My RE tests 7DPO blood work during your testing cycle. If it comes back OK, they don't test it again as long as you are doing TI or IUI. The assumption is that if it comes back OK on a non-medicated cycle, it should also come back OK for a medicated cycle. Also, if you do get pregnant as a result of TI or IUI, they check progesterone as part of the pregnancy test, and give supplements at that point if necessary. The only additional time I've ever had post-O blood work was for IVF, and that's to make sure the ER didn't disrupt the body's ability to make progesterone (which would then require additional supplementation).

However, if you're not satisfied with the way you're being treated, that's a huge issue, and it would be perfectly acceptable to go out and find a practice you are comfortable with. Good luck!

steff13914 · February 2012

hootie123:

FWIW - I never had 7dpo b/w done with my RE - 3 IUIs and 2 IVFs. I personally do not think that progesterone supplements are the golden ticket - you need to get a fertilized egg that implants!!! Your RE will test your progesterone once you get a positive beta - and if it is low at that point - then supplements will be used then.

GL!

All of this, especially the bolded part! I never had it checked until I got a BFP, and then I was put on a supplement because my levels were all over the place. However, my progesterone was not the reason I didn't stay pregnant, it was an egg quality issue.

Sorry about the BFN. Best of luck to you!

nycitygirl1 · February 2012

steff13914:
hootie123:

FWIW - I never had 7dpo b/w done with my RE - 3 IUIs and 2 IVFs. I personally do not think that progesterone supplements are the golden ticket - you need to get a fertilized egg that implants!!! Your RE will test your progesterone once you get a positive beta - and if it is low at that point - then supplements will be used then.

GL!

All of this, especially the bolded part! I never had it checked until I got a BFP, and then I was put on a supplement because my levels were all over the place. However, my progesterone was not the reason I didn't stay pregnant, it was an egg quality issue.

Sorry about the BFN. Best of luck to you!

I agree with this and the clinic I go to (which is also part of a teaching hospital) never does the 7DPO testing either - or at least not for IUIs. Just wanted to let you know that you weren't the only Bumpie on here not doing that.

It sounds like the bigger issue though is patient communication and your RE doesn't seem to be doing a very good job (or the nurses). In this anxiety-ridden process, you need all of the bedside manner and answers to questions you may have and NOT to be made to feel like you shouldn't ask questions.

Everyone has different levels of what they can tolerate, but if this clinic is not working out for you in terms of their patient care and communication you should look elsewhere. Big ((hugs)) to you girl!

adoruhbul · February 2012

My RE also doesn't believe in it. He will however order it if I ask him personally. After I get a positive beta he doesn't either. During my last pregnancy before the m/c I had him check P4 and E2 and both were very low and he did put me on an estrogen supplement, however he believes if the numbers are low it's indicative of an impending m/c and supplementing just drags it on. I am on PIO every cycle because I have pituitary failure, which means I have 0 progesterone on my own, ever.

Some REs believe in it, some don't have a real opinion and some will think you're playing with G-d. Once you decide which feels like the best approach to you, I'd call around other REs in the area and find one who believes in what you believe. Understand however low progesterone will not prevent you from getting pregnant, it'll just not be able to support the pregnancy a week or so after a positive. I'd just ask for the draw when you get a beta, however if the staff is disrespecting you, I'd find a new practice.

If you've never had an issue with the staff before, it's likely because of your request. People in the medical community frown upon those who try to go online and be doctors. I personally think its very important to be your own advocate and do research, but it does come at a price. Multiple times over years they've asked me to show my medical license when I've said things they disagree with, so not surprised, just sorry.

DMCKnox · February 2012

I noticed part of your issue is anovulation which is part of mine too. FWIW the reason my RE does the 7dpo bloodwork is to monitor my response to the clomid, otherwise they wouldn't know if I had a quality ovulation. Now, my RE doesn't normally do p4 supplements because he says it's after the fact unless you're right at the recommended level. Just as PPs have said, if you're not comfortable, it can't hurt to shop around!! Good luck and sorry for your frustrations.

lovekatespade · February 2012

I go to RSC in Lexington, and they have not done 7dpo testing since my initial tests came back fine.

However, they are the BEST set of nurses and doctors I have ever dealth with. The nurses are very friendly and went out of their way to welcome me and make me feel like they care about me personally. I get a call from my actual doctor with the results of all of my tests, including my BFN on Friday. The nurses who call about routine stuff (number of follies, etc) explain everything clearly and are never in a hurry.

If you are ready to move on, I would highly highly recommend calling them. You should never feel like a number.

BAKERMOMHDS · February 2012

tst1998:

I'm sorry the nurse is being so dismissive of your questions. I ended up at a smaller clinic (although affiliated with the university) because I wanted to avoid the fertility factory experience. Hopefully you can find someone to work with who you feel comfortable with and takes your concerns seriously!

Do you mind if I ask Which one? I goto SRM Kirkland office, and I'm kinda feeling the *fertility factory* a bit, and I've thought heavily about changing....

kellyrn9956 · February 2012

There's different schools of thought on progesterone. Mine is always done at 7dpo, and I take supplements. But my RE is also convinced that my progesterone deficiency is the majority of the reason we are not conceiving.

If you have blood drawn, and the level is not high enough to even confirm ovulation, there's nothing that a progesterone supplement will do at that point. However, progseterone helps to lengthen my short LP in hopes that we can get implantation to occur. If you don't have a confirmed LP, there might not be a need for progesterone, particuarly if you are taking Clomid.

My office does to 7dpo bloodwork on ALL inject and IVF cycles. Injectible drugs can shorten your LP, and having the supplements can help to lengthen that.

Blueyed228 · February 2012

I am also in Mass ( I go to a different clinic) and I might know why they dont do it there. My clinic tested me once and determined that I would need progesterone help, but they dont test me every cycle. I asked why and they said since Ma is a mandated insurance coverage state, that if you progesterone test results change, or show something strange, they can use that as an excuse not to cover the procedure. Since I need the help, they dont feel the need to keep testing and risk my coverage.

That being said, I have heard wonderful things about the fertility program at mass general, and my sister had both her babies there, however, I do know of a few people who were patients there and felt pressured into IVF, so they switched clinics.

I go to RSC in Lexington and have had a wonderful experience there. But I would want to talk to my RE before I made any decisions. Best of luck to you.

amd1982 · February 2012

thanks for all the feedback ladies, i appreciate it. Blue, unfortunately my insurance company is out of minnesota so of course i don't get to take advantage of the MA insurance mandate

so everything i do is not covered anyway. but thank you for the information. i know it's not always standard protocol, i just figured since they know i'm anov and it was my first medicated cycle that they would do some kind of a follow up. and when i asked about a f/u with the RE, they said they can't fit me in for several weeks (the end of the month) and even the nurse made it sound like i had no reason to meet with her and we were just going to start a new cycle. maybe my expectations are too high but i figured we have a little sit down before jumping in to something new. who knows. but thanks again everyone for the feedback, i'm feeling a little better today....

racheyt0227 · February 2012

Mine don't do them for iui cycles either, but I insisted & they did it for me. I don't see why they would refuse if its something you want.

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