Progesterone levels......input appreciated

MNturnsVA · October 2015

Hi ladies,

I just got a phone call from the dr's office with my CD 21 blood work results.

However, I didn't actually go on CD 21 due to the insight of some of the wonderful ladies and that the OB wanted me to go on CD 21 under the thought process I O'd on CD 14.

Well we in this community know that not all women O on CD 14 and I'm one of them that doesn't.

So I O'd on CD 19 this month and went to the dr for CD 21 blood draw on CD 25, 6 DPO.

So they said that my progesterone level was 7.3......and that I should go see an RE. I'm glad that my appt is already with an RE is set up for next week......

So now I'm super confused.

Please help.....did I mess up by not actually going on CD 21?

WTH.......

bsckgb7 · October 2015

https://www.fertilityplus.com/faq/hormonelevels.html

I like this chart for levels. At 7dpo, doctors like to see Progeterone over 10 on a natural cycle

MNturnsVA · October 2015

So I'm really bad with the < > signs......

but I just looked at the chart and I'm guessing that my 7.3 is not good according to this from that chart :

Progesterone (P4)

7 dpo

> 15 ng/ml

A progesterone test is done to confirm ovulation. When a follicle releases its egg, it becomes what is called a corpus luteum and produces progesterone. A level over 5 probably indicates some form of ovulation, but most doctors want to see a level over 10 on a natural cycle, and a level over 15 on a medicated cycle. There is no mid-luteal level that predicts pregnancy. Some say the test may be more accurate if done first thing in the morning after fasting.

bsckgb7 · October 2015

I also remember it like this >10. The alligator is going to eat the bigger number. So they want over 10 on a natural cycle. So that would be shown as >10. You want progesterone to be the large than 10 (so that alligator would eat it). Another way I remember it <10 looks like a crooked L, so I remember that direction is less than 10. So your reading is <10. That looks a crooked L for "less". But yes, thats why they said you need to see an RE. How long long your typical LP?

MNturnsVA · October 2015

My LP is usually 12 days or so.....ugh.....freaking ridiculous.....I guess are there supplements they give you?? are they time sensitive? I'm supposed to be going out of town to help my older sister on Friday afternoon but I'm fully expecting my period on Wed or thurs of this week, especially after this news.....I want to go to see the dr though ASAP especially so that hopefully we can try to get this on track in the next few cycles.....

bsckgb7 · October 2015

If your only issue is progesterone, you get suppositories or PIO (injections) that you take during your LP.

MNturnsVA · October 2015

And how long does that take usually for it to build up in your system??? Thank you so much by the way for all of your input!!

bsckgb7 · October 2015

If you have suppositories, they say you can't check that in bloodwork, because it's just sitting in your hoo-ha where you want it and doing it's thing. You can have bloodwork to check if you have PIO. You typically start those progesterone 1-3DPO and keep on until a BFN, Should work right away though. An RE should draw blood on 7dpo to check progesterone and it should be much higher.

riveridgional · October 2015

@MNturnsVA you can also take oral progesterone pills, which my RE automatically gives me after O. It may be a little too late thus cycle to start the supplements since your already CD25, but I would request them from your Dr. To take right after O if they aren't automatically prescribed for you.

MNturnsVA · October 2015

And I'm guessing the injectibles cost more? I'd guess......i mean that just sounds like the logical way it would work.

I'm ok with where I'm at this month because I'm fully expecting AF this week and this cycle now that I know all this. And that's ok. I'm ok with all of it really, just so thankful for all of the info you ladies have provided me that has nudged me to get an appt scheduled sooner than later and I actually moved the appt up.

So if I get AF on Wed or Thurs, I'm going to see the Dr on Friday and plenty of time to talk options, do an HSG maybe if they are willing to do so at this point this month maybe and get on track to get either the pills or suppositories or injectibles going this month.

And the suppositories just go up there? WTH.....I mean, i've been checking my CM and use tampons and used the Nuva Ring so you'd think sticking something up there should not be a foreign idea to me....but......

bsckgb7 · October 2015

I think each RE has their own set of standards. Mine defaults to suppositories. Never mentioned PIO. You can google and see, some stuff says PIO is better others say suppositories are better. Mine are compounded and insurance doesn't cover, so it was about 100 bucks for 30 (so they last 2 cycles). Not sure about the cost for the others.

I know there is also an oral progesterone and you can also you that same oral as a suppository. I used the applicator, so its like a tampon.

misspuppychow · October 2015

How long is your LP? One progesterone level is relatively meaningless. I had mine checked 7 DPO one cycle and it was 1.5. The next cycle, on 7 DPO, it was 12.9. Progesterone is released in pulses, so depending upon when you catch it, it could be high, low, or in the middle.

MNturnsVA · October 2015

My LP is about 11-12 days so not terribly short but not terribly long either. So I have a few more questions, especially now as @foreverlaur just brought up something nobody else has: 1) should I be fully expecting my period this week? We had pretty good timing this month. -3,-2, 0, +1. 2) did I mess the test up by doing it as late as I did (CD 25) or was that the right way to do it still you think? Even though the OB wanted me to do it on CD 21? Thank you again for all of your input!! I really appreciate it.

misspuppychow · October 2015

The 21-Day progesterone test should realistically be called 7 DPO progesterone test. Even that is questionable. It is done 7 DPO because that is halfway through a typical LP when progesterone should be peak. However, 7 DPO is not peak for all women. I don't think you have a single thing to worry about with your 7.3 lab result. Simply put... if you ovulate monthly and your LP is a normal length, you are fine. Regardless of your progesterone level, if your LP is short, you should supplement with progesterone. Most REs (including mine) will completely disregard any progesterone levels as it has no diagnostic significance. OBs have no training on getting you pregnant. They deal with you after you are pregnant. If you are having difficulty conceiving (> 1 year assuming you're under 35), see a RE and leave your OB behind until you are pregnant.

How long have you been trying to conceive? Have you had any other testing done?

MNturnsVA · October 2015

I am 35 and we are on 6 months right now of TTC. We had pretty good timing this month, but with yesterday's news I'm not expecting a BFP this month.

I've asked about an HSG 2 x from OB but they are saying its too invasive at this point. My deductible will have been met though as of Nov 1, so I'm trying to do it this year vs Jan 1. I'm definetely going to bring it up when I see the RE on Friday.

riveridgional · October 2015

@MNturnsVA I like that you are on top of everything! Your RE will probably order the HSG as one of the first steps. You need to get it done before CD12 (some places require it before CD10). I'll still hold put hope for you, but if not I'm glad you are getting to meet with an RE!

mazza13 · October 2015

Hi, I made this mistake too for a few months and got so confused. I'm now seeing a different RE. This month I ovulated on day 16 and he told me to do the day 21 blood test on day 23. So don't worry your results were low of you ovulated a bit later. Sounds like you need to adjust the timing of the test. Good luck.

misspuppychow · October 2015

I agree with everyone else... HSG is the next logical step. You're at 6 months and 35+. I would also check FSH, E2, and AMH if you have not already and have your DH get a semen analysis.

Yes, the HSG has to be done early to ensure you are not pregnant, hence why it is done prior to ovulation. The procedure is not a pleasant experience, but it does not last long. It's entirely diagnostic and outpatient and routine so i'm not sure why your doctor would not order it. ACOG recommends it has part of an infertility workup. My RE is very old school so he's not a big fan of the MRI... he prefers the HSG and u/s. He's really awesome though.

MNturnsVA · October 2015

I am a little bit of wreck this AM, I'm just wondering, hoping that I get AF, which is crazy because I'd much rather get a BFP, but is that really even possible with a 7.3 progesterone level?? My LP is usually only 11-12 days, so tomorrow would be 12 DPO. Do you think I should get a pregnancy test to take Friday AM if my temps have stayed up and AF hasn't shown by then because my appt with the RE is Friday afternoon.

Also, I'm kind of in an interesting spot at work. My boss knows that at SOME point, kids are in my future, but its not like I've gone into major detail with him about anything really. To be honest he probably would hasn't thought 2 about it since we had the conversation 6 months ago. I have a direct co worker who is my "team lead" but she causes a lot of drama is interested in seeking other positions with the company and I don't want her to be any possible competition for me in regards to other job openings that are coming up. I know that depending on what happens at the appt on Friday because of where I'd be at in my cycle, they could want to do the HSG ASAP and on somewhat short notice to my employer.

So my issue is, I don't want my boss to not consider me for any future positions due to possible pregnancy in the future, which I know is not ethical or really something he can do, but I can't prevent him from doing it either.

I also don't want said co worker to be throwing that card out there anytime my name comes up as a way for her to get an advantage over me.

Any suggestions on how to go about letting them know I'll possibly be needing time off on short notice in the next few weeks??

KidShrink · October 2015

I think you can be broader, and just say you're waiting for some last minute medical appointment, and hope there's a way you can make up hours or what not. Legally, employers are not allowed to ask you what the medical issue is, so it could be a very benign thing or more serious, and no one needs to know if you don't feel comfortable.

NordyMN89 · October 2015

@MNTurnsVA - Be happy you aren't in MN today. It's cold and starting to flurry. Sure could use some sun to cheer me up. Anyway, on to the work thing. I could tell my boss was getting worried when I would tell him that I had another appointment to go to. He was genuinely concerned for my health and is super supportive. It was kind of funny really. He knows he can't ask what's going on, but I could tell he was worried, so I ensured him I wasn't dying or severely ill, but that my husband and I were going through fertility issues. That's all he knows. I know I didn't have to tell him, but it makes leaving work for the appointments a lot easier. And as for the concern with coworkers noticing, or calling you out, it's okay to tell them it's none of their business. If I had this problem I would probably guilt them, say something like you don't know what I'm going through, mind your own business.

Ok, that's probably not the most professional route, but it will certainly get them off your back. If you let your boss in, even just a little bit so he knows you're not leaving to interview at a new place, or just taking off because you feel like it, I think he would understand and never hold it against you. It all depends on your boss though. Does he have kids? Can he, even in a small way, understand what you're going through, or sympathize? Just keep working your butt off and proving to your boss that your the best candidate for the next promotion. He won't even remember those dr. appointments. Good luck!

MNturnsVA · October 2015

@cwirth89 Awwww!!! I have some friends on facebook who have hinted at possible snow back home!!! Nope! That's one of the reasons I moved!!

Well, fortunately my boss sits all the way on the other side of the room I work in so I barely see the man on a daily basis except for in passing in the morning to get coffee, etc. In fact, he probably wouldn't even know whether I was here or not unless somebody else told him otherwise some days.

He's great actually, he oversees a group of at least 20 women at various ages and he's the only male in our office. He's a saint to deal with all that!!

He probably wouldn't give me a hard time about the appointments/missing time at all. The company I work for is actually pretty awesome about that too, they don't usually ask too many questions when we need time off.

I guess more than anything its my direct co worker that is supposed to be the "team lead". She knew a few months ago that TTC was on our radar but she's a drama queen so I don't talk much to her about personal stuff anymore. And I just worry she'd use my goals to her advantage to make her self look better.

I agree though, its really none of her business. I'll just have to figure it out.

Just stinks because there are a few other things going on right now and I've been going to physical therapy for some other stuff.....good times!!

Thanks for your input though, I appreciate it!! Makes me feel better about moving forward!

MNturnsVA · October 2015

Update from my RE apt- would love some input from you ladies because I'm thoroughly confused now......@riverridgional @foreverlaur @bsckgb7

So I had my apt with the RE yesterday, it was the physicians assistant actually but I'm pretty sure the actual RE would have said everything she did. We went over my health history and she said that she did not think my progesterone level was low at all. She said that actually none of my blood work levels was anything that was out of line or anything to be overly concerned about and that my ovarian supply? I cant remember the wording she used, looked good and in normal range. She asked about SA and DH is getting that done this Thurs. She said to call their office when I started AF so we can get the HSG scheduled, which I'm 100% behind doing that and doing it now.

Then she said we can start talking about Clomid and IUI's and things of that nature depending on what test results are from the HSG.

I said no progesterone? She said no, I don't see why you would need it. She said that they want their patients to have at least a 3 for IUI and being my was a 7.3 there was no need for progesterone at this point.

The nurse said the same thing when it was just she and I in the office before I left.

So I'm thoroughly confused and that was not what I was expecting at all.

I'm also not feeling anywhere near as confident as I was, silly me for thinking I know more than or better than a medical doctor and that I knew the answers to the problem and we'd be on our merry way to a BFP sooner than later with an easy fix like progesterone.

I don't want to jump into anything too soon medication wise, especially since I've heard that Clomid has a 6 cycle span and that's it. Also the dr said yesterday the 1st 3 cycles are the ones that really have the most 'impact' or increased chances of pregnancy and after that your chances level off. She did not say anything about only being able to use Clomid for 6 cycles though. When I told one of my friends this about the Clomid that is seeing the same dr, she said she had not heard of that before either.

I think we are probably going to wait realistically until January at least before we do anything because I've only been temping for 4 months, so we've really only had 'good timing' for the last 2 months while I was figuring all this out. Also, one of the 4 months I didn't ovulate.

I just don't want to jump into medicated cycles and all that just yet because once you jump down that hole there's no where else to go but back out of it really and there is a cost associated with all that as well. Plus you always here about those people that do all of the infertility stuff for years and then when they stop, they get a BFP on their own......

Just frustrated because I don't feel any more confident necessarily than I did a few days ago.

I don't think I need to change docs just yet or get a 2nd opinion necessarily just confused.

Would love to hear your thoughts!! Hope you all have a great weekend!

bsckgb7 · October 2015

Glad you got in. I'm not sure what to say about about the Progesterone, because that does seem to conflict everything I have heard. Maybe there is something more that we are missing. I will say you are perfectly ok with starting down the rabbit hole and backing off. I think it's quite common to back off during the process. I have done 3 IUI and just had Lap surgery. We decided to go back 1-2 med free (but monitored cycles), then jump back into IUi at the first of the year. Maybe your hubs SA will reveal something. My RE even said its possible we are "on the wrong side of the statistics", meaning everything looks great, it's just not lining up. So please don't feel like it's all or nothing. Most REs want to do whatever you are comfortable with. You can do monitored cycles with no meds as an option.

MNturnsVA · November 2015

@bsckgb7 What would they monitor my cycles for if I wasn't on meds? I may want to try Clovis come January or so but at the same time if it's only got a 6 time usage per lifetime, I'm kind of hesitant to start that to early, especially if IUI is a path we take anytime soon.....I really was not thinking any of this was in our future. And maybe it's not. Just a little overwhelming though.....don't want to put a bunch of time & $$ into it only for it to not work either.....

bsckgb7 · November 2015

I am doing 1-2 monitored/unmedicated cycles before jumping back into IUI. They check your hormones and follicles at CD3. They check follicles and hormones again around O time. Then give you a trigger shot, so you can pinpoint O and time sex accordingly. Then back at 7dpo for a other hormone check. It's a way to monitor and time things, but less intrusive (and possibly less overwhelming) than Clomid/Femara

bsckgb7 · November 2015

Also, sent you a PM

Want a personalized experience?

Progesterone levels......input appreciated

Re: Progesterone levels......input appreciated

Choose Another Board

Search Boards