New to infertility loss mentioned

rmroethler · August 2014

Hi everyone, my name is Rebecca and I'm new to being an infertility patient as my OB/GYN just switched me to an infertility patient after we discovered I haven't been able to get pregnant since my loss in February of this year and found out I have a hormone imbalance. My husband and I took a month off after we had tried for almost 4 months and decided we wanted to start trying again. Any advice on how we can keep our spirits up and not get discouraged again? And not feel like its a job to bd?
Any help would be great!!

BethKate2 · August 2014

I'm sorry for your loss.

How long have you been TTC total? What kind of "hormone imbalance" do you have?

rmroethler · August 2014

Hey everyone we found out back in March that i don't produce progesterone so it was surprising that I even got pregnant the first time. We also found out that it was the reason as to why the baby was only measuring 8weeks when I was 11 weeks. My dr listed me as infertile because it would be amazing if I sustained a pregnancy with out the medicine.

rmroethler · August 2014

@BethKate2‌ we have been trying ever since March.

catlover790 · August 2014

I'm sorry for your loss.

It can be discouraging when there are certain days when it's important to have sex, it can feel like "we have to" and not always "we want to" so I understand your frustration with that. I try to keep things fun and not think about the "it's O day!" mentality. Anyway, enough about that!

I'm sorry you have low progesterone, what does your OB have planned for your treatment? How long have you been TTC total? That would influence what I'd recommend to do next. Good luck with everything.

BethKate2 · August 2014

rmroethler said:

@BethKate2‌ we have been trying ever since March.

So, you've been TTC for 4 months total?

How do you know that you don't produce progesterone ever? What have your cycles been like since your loss?

Having one cycle after a loss where you don't ovulate or your progesterone is really low isn't abnormal. Hormones tend to be out of whack after a miscarriage, and low progesterone is a common indicator of a miscarriage.

I'm concerned that your ob is jumping the gun by labeling you infertile after only 4 months of TTC, especially since those 4 months have been post-loss when your body is trying to regulate itself again. Typically, people seek treatment after 12 months of TTC or 6 months if they're over 35 (or earlier if they've had multiple losses).

rmroethler · August 2014

Okay I'm going to clear things up so everyone knows why my OB diagnosed me. I have gone in every month 5 days after I ovulate( I know I ovulate because I use ovulation tests and my OB does an ultrasound of my ovaries) and have my levels drawn in the morning before I start my medicine. Each month my levels have come up at a 0. My doctor had me on 300mg of Prometrium (progesterone) orally but just switched me this month to 200mg via suppository. My OB/GYN is one of the best in my state even people from out of state come see him and he is the only infertility specialist at my hospital. I'm not trying to be rude but quite a few people keep telling me I'm not an infertility patient because I haven't been trying for over a year. Honestly you don't have to b trying for over a year to b classified as infertile or have a fertility issue. They did testing on the fetus after my D&C and determined nothing was wrong with the baby except its size. That's when they started narrowing down tests they could run on me.

Pintobean39 · August 2014

I'm sorry for your loss.

I see your Dr is doing a progesterone test on day 5 but this really needs to be done on day 7, it can makes difference on the levels. All 5 of my miscarriages I had to take progesterone because mine was low. My RE told me it doesn't necessarily mean there is a progesterone issue, in my cases I did have 2 confirmed trisomy pregnancies so that's why my progesterone was low. I don't have a diagnosed progesterone problem but my RE automatically puts me on progesterone the day of ovulation, because he says it doesn't really do much good after the fact if there is a progesterone issue. Also I'm 40 and it's common with people my age to have low progesterone.

rmroethler · August 2014

One did my testing on day 5 after ovulation because he said if I waited any longer to start the medicine there is a chance we could miss implantation. This month he wants me to start the medicine 2 days after ovulation to get my lining built up some more before implantation.

Hollowvic · August 2014

Sorry for your loss. Are you seeing an RE? If not, I would ask your OB to refer.you to one.

Pintobean39 · August 2014

rmroethler said:
One did my testing on day 5 after ovulation because he said if I waited any longer to start the medicine there is a chance we could miss implantation. This month he wants me to start the medicine 2 days after ovulation to get my lining built up some more before implantation.

I don't think the progesterone will thicken your lining. That is what the estrogen does before you ovulate. The progesterone is to help maintain a pregnancy if one happens to occur.

Pintobean39 · August 2014

I'm curious how your progesterone can be 0. I have progesterone in my system all throughout my cycle. If you are ovulating the corpus luteum will produce progesterone and since you did get pregnant it seems to be working even though it was probably low. I can't imagine it was 0 during your pregnancy because you would have never become pregnant without having some in your system.

I know you say you are going to one of the best Dr's in your state but before I'd take the diagnosis of "infertile" I'd go get a second opinion if I was you.

catlover790 · August 2014

rmroethler said:

Okay I'm going to clear things up so everyone knows why my OB diagnosed me. I have gone in every month 5 days after I ovulate( I know I ovulate because I use ovulation tests and my OB does an ultrasound of my ovaries) and have my levels drawn in the morning before I start my medicine. Each month my levels have come up at a 0. My doctor had me on 300mg of Prometrium (progesterone) orally but just switched me this month to 200mg via suppository. My OB/GYN is one of the best in my state even people from out of state come see him and he is the only infertility specialist at my hospital. I'm not trying to be rude but quite a few people keep telling me I'm not an infertility patient because I haven't been trying for over a year. Honestly you don't have to b trying for over a year to b classified as infertile or have a fertility issue. They did testing on the fetus after my D&C and determined nothing was wrong with the baby except its size. That's when they started narrowing down tests they could run on me.

I did not mean to sound snarky at all about trying for a year. I apologize if that's how you took my reply. I was just trying to get a better understanding of your situation. It is hard to give advice if we don't have all the information.

I also sought the help of a RE before a year because I was anovulatory.

It sounds like you are working with the best infertility specialist in your area so I would figure they know what they're doing. I'm not sure about the rest; my RE also puts (i think) all patients on progesterone during the lP. good luck with everything.

Eta: I didn't realize you're seeing an OB. I would definitely recommend a RE. I think they would be much more able to help you. I think I'm getting confused because what you've explained just doesn't match up with my experience with the results of ovulation and your progesterone levels. Sorry I'm not much help and for the edit, it's late!

BunnyBerry · August 2014

Hi there, I am so sorry for your loss. This is a very confusing situation for sure, but whether or not your OB and you are perfectly clear on what is going on, it makes sense that since your doctor has given you an IF diagnosis, you are searching for support and answers.

I second PPs and recommend seeing an RE to get a full testing work-up and a clearer explanation of what is going on with your body. It's just that the way your OB explained it to you makes little sense to us based on our own experience, especially about the progesterone and ovulating and lining, so perhaps seeing an RE can clarify things and help get you an effective treatment plan, if one is needed.

As far as BDing - what worked for us was realizing that BDing had nothing to do with pregnancy for us (as we have MFI)! Just kidding, kind of. We still see BDing regularly as a way to keep his sperm in tip-top shape, so it can feel like a frustrating pressure on both of us. And it doesn't help that treatments take their toll on my body image.

Sometimes going for "good" timing instead of "perfect" timing can reduce the pressure and the bad feelings?

rmroethler · August 2014

I can go online and look at my lab results. The highest it has been is 0.2. Otherwise it's been a 0 a few months and then between those numbers other months. Either way you look at I don't have enough to sustain a pregnancy without help. But you know what I'm not using these support groups anymore because all you guys do is second guess what people say and what a specialist has said. Good luck to you all but I don't constantly second guess people and what their doctors have told them. I may ask for clarification but I never tell someone "I think your doctor is wrong or you need to get a second opinion" I wish the best to you all but this isn't support this is just more stress having to explain myself a million times over. Good- bye

catlover790 · August 2014

rmroethler said:

I can go online and look at my lab results. The highest it has been is 0.2. Otherwise it's been a 0 a few months and then between those numbers other months. Either way you look at I don't have enough to sustain a pregnancy without help. But you know what I'm not using these support groups anymore because all you guys do is second guess what people say and what a specialist has said. Good luck to you all but I don't constantly second guess people and what their doctors have told them. I may ask for clarification but I never tell someone "I think your doctor is wrong or you need to get a second opinion" I wish the best to you all but this isn't support this is just more stress having to explain myself a million times over. Good- bye

I am not trying to second guess you or your doctor. I am trying to understand your situation so I can share what knowledge I have that might relate to your situation.

There are times on these boards where people have had doctors who don't do the proper testing and aren't qualified to treat infertility. I was seeing one of those doctors. The ladies here helped me see that maybe I should seek help from a specialist.

I'm sorry that you don't feel these replies are helpful, the intention was to help understand your situation so that I could give you good advice. I wish you the best of luck and I hope you are able to find some answers.

rmroethler · August 2014

You asked me if I have seen an RE. Easy way for you to find out. My OBs name is Dr. Stephen Thorn at Mercy Medical Center north iowa and he is a RE. You can see all his qualifications if you type it into google and go to the mercy web page. I would say yes he is a specialist and he knows what he is doing.

Hollowvic · August 2014

Usually people don't refer to RE's as an OB. You asked for advice and we're just trying to help. Sorry you are offended. Good luck.

catlover790 · August 2014

rmroethler said:

You asked me if I have seen an RE. Easy way for you to find out. My OBs name is Dr. Stephen Thorn at Mercy Medical Center north iowa and he is a RE. You can see all his qualifications if you type it into google and go to the mercy web page. I would say yes he is a specialist and he knows what he is doing.

I am trying to be helpful. I looked up your OB. On the hospital website it says OB who specializes in infertility. My RE is board certified in reproductive endocrinology. It is additional training beyond OB and just an interest in infertility. Now, it could be that the website is not up to date, or it could be incorrect but from what I'm seeing it doesn't look like a RE. I could be wrong though.

I am honestly trying to help and I hope you can tell that since it's midnight and I'm searching hospitals on google to try to help you!

rmroethler · August 2014

https://www.mercynorthiowa.com/body_mason.cfm?id=273&action=detail&ref=1105
Here is the web page and right under his name it says Reproductive Endocrinologist. I also took a screen shot of it. I thank u for trying to b helpful. But as the web page explains he sees patients who aren't infertility and who are. He has seperate answering machines and nurses for these patients.

catlover790 · August 2014

Thank you for the pic; I guess it's hard to tell since it says "specializes". To be a certified RE there is additional 2-3 year training and my RE has a designation of "board certified in reproductive endocrinology". I just don't see that where it says certification. That's not to say it isn't true, I could be mistaken! There are some ladies here who know a lot more about different medical things and can probably help tomorrow when they're here!

Anyway, I hope that if you want to stay on you can find the support that you need here. We really all want the best for each other because infertility is so hard. I only advocate for proper testing because I know how stressful and difficult TTTC is and I hate for people to spend more money and time when they aren't getting the care they deserve.

There are so many aspects of IF and causes that it can be very overwhelming! I've learned a lot from reading other posts and the announcements at the top of the board have links to lots of info too. Good luck with everything!

Pintobean39 · August 2014

Everyone here is just trying to help. You have to be an advocate for your own healthcare sometimes. I agree with a PP some things you said your OB told you didn't make sense. If you hang around you will notice lots of people have been given bad advice from their OB's and some have even ended up in the hospital. So when someone comes on here saying "their OB told them ...." We automatically recommend going straight to an RE, because that's what their speciality is .... Getting you pregnant. While OB/gyn's just help maintain a pregnancy and any gynecological disorder.

An RE will start you off with cd3 testing and 7dpo testing. Not all OB's get this right, I've seen so many come in and post about testing done on wrong days and it can make a huge difference. My OB happens to be one that gets the testing days right but I'm still seeing an RE of which my OB recommended that I do.

The difference in an OB/GYN that specializes in infertility and a Reproductive Endocrinologist is the 3 extra years of fellowship in reproductive medicine that is needed to be called a Reproductive
Endocrinologist. As far as your Dr, if you like him by all means stick with him, it's your prerogative. We are just giving you advice on the information you have given us.

Just remember in life regardless of if it's infertility or anything that happens you need to educate yourself and ask questions. Not all Dr's are created equal. You know what they call the person that graduated last in medical school .... A Doctor!

Good luck!

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