Off the Bench!

dpjennifer · November 2017

AF is here. Yeah CD 1!
So... called my RE and apparently my progesterone biopsy from Monday with AF starting today means that my body is naturally producing progesterone (Because I did NOT take clomid nor progesterone before the test). So, um... yay? I guess?
Also means, they have NO idea what's wrong with me, nor why I've had 4 MCs.
So... we're going to be trying on our own for a few cycles. If no dice, then they want to try me on small doses of Clomid to see if we can get PG faster. If I get PG but have another MC, they want to try again with small doses of Clomid to see if I can produce better embryos.
*sigh* I'm feeling really emotional right now. In a way it's good that there's nothing wrong... on the other hand, there's nothing to fix and no explanation.

*** Edited to add a real question to this Dear Diary Post:
Ladies, assuming they may have me take Clomid to see if it would help me produce better embryos, would you ladies try 3 cycles on your own first (when the ONLY thing they'd found wrong with me throughout all of these tests was ureaplasma. And I've had 4 losses). OR would you go straight to medicated cycles with small doses of Clomid? (pros/cons of Clomid appreciated).
Supernatural Crowley GIF

zamoraspin · November 2017

@dpjennifer I am excited for you to be off the bench! I know how terrifying it is to be unexplained RPL, a lot of excitement to try and also a certain layer of unavoidable dread. I am glad you at least (finally) have a plan to move forward. Is the thought with the clomid that maybe your eggs are immature? (Sorry, you know how I love the science).

vlagrl29 · November 2017

I'm so happy for you girl! Yea for off the bench. Although I have not had repeat losses I do understand not knowing why things haven't happened. I look at it like "yea nothing is wrong with me" but why haven't we gotten pregnant again and I know my body can do it because we already have a kid and I was preg with our loss. Probably why I haven't doing medical cycles yet because I really want to give my body the full time it needs to get preg. BUT alas I am becoming more open to medication so I may also be doing clomid along with you.

vlagrl29 · November 2017

@zamora_spin - I would assume that is the thinking behind clomid. My OB said it basically gives you a stronger ovulation if you do already ovulate on your own. My Prog is 14 which is great and I know my egg quality is good with the FSH number but he said I could still try it if I wanted to and if it didn't work I'd probably have to IUI.

shri929 · November 2017

@dpjennifer congrats for being off the bench, I know for me that was one of my first steps in healing and starting to move on

Kath525 · November 2017

Glad you're off the bench! You are one tough cookie! Hoping this is your month!

dpjennifer · November 2017

zamora_spin From what the nurse said, if I haven't gotten PG on my own within 3 cycles, it would help. And if we get PG and MC again, a small dose when we try again could be helpful in producing healthier embryos.

So on that note... actual question (and I'll edit my original): Would you try naturally for 3 cycles and see if we get PG and/or MC again. Or would you go straight to seeing about a small dose of Clomid? Pros and Cons and science and opinions and hate GIFs please!

honeybeebub · November 2017

YAY lady!!! Welcome back to the game! I am soooo happy to see you off the bench, I know just how painful and hopeless it is watching the time tick away. Personally, I would try the 3 cycles. See what happens and that way you at least know what's going on without the clomid.
I get wanting to know what is going on but being relieved that nothing is wrong. I thought that if I knew something was wrong with me it would make everything better, but unfortunately it has just brought out the complete BSC side of me even after fixing it... Now I am over analyzing everything and thinking that there is probably something they missed that is also contributing, being Dr. Google, but also trying to be positive accept that the septum was the reason for the MCs. RPL is truly brutal.

I asked on another post, but what was the progesterone biopsy for? Just to see if there was progesterone being produced? Cant they measure this through blood work? JW because I'm being prescribed progesterone at BFP but am testing levels through blood?

dpjennifer · November 2017

honeybeebub Thanks for the info! Yeah, it sucks not knowing what the 'problem' is, but it's also nice to know there's nothing wrong. Just a double-edged sword. And sorry, musta missed you asking about the progesterone biopsy before! It was basically same/similar to an endometrial biopsy. (so catheter up the cervix. NOT pleasant). It was to measure progesterone levels, and I think it's supposed to get a better overall picture/number than the normal blood test ones? But I honestly don't know enough about it to postulate!!!

honeybeebub · November 2017

@dpjennifer OK thanks for the information

tosh24 · November 2017

Yay for being off the bench!!! I think it's a very personal decision and I guess I would frame it against how you think you would cope with another natural cycle mc should one happen and, if it did, would it push you so far to your limit that the idea of starting treatment after that just seems overwhelming and/or useless?

If I were in your shoes, I'd just start with the Clomid. Take it from someone who totally dragged a** getting back to the RE this time around and now I'm already 5.5 years TTC. I wish I would have just bit the bullet sooner. You already know that you can get pregnant fairly easily on your own, so chances that you will get pregnant again while trying naturally are probably pretty good. What you don't know is if you will miscarry again and I guess this is the variable they're trying to manipulate with the addition of Clomid. Clomid is an easy, cheap drug to take, so why not? If it could give you a better chance of a stronger ovulation and/or a better quality egg, why not see if it works? I hesitate to say this because I don't at all want to come across as insensitive because it's absolutely not my intention, but when I'm trying to make fertility-related decisions, I always think of the saying "the best way to predict the future is to study the past". In my case, if I were to not do treatments, the best way for me to predict if I'm going to get pregnant on my own is to look at my past history - and the answer is probably a big fat NO. Sure, there are always miracles/exceptions, but if I really want to make logical decisions to get me to my goal based upon the information I have, I'm obviously going to choose to undergo treatments instead of repeating history. I suppose you can look at your situation the same way. Going through treatments is no guarantee either, but it is a bit of control that you can try to take back and at least feel like you've given it all you can if it comes time to move on. And egg quality is a very tricky thing - there is absolutely NO way to assess egg quality without doing IVF and taking them out and looking at them and trying to fertilize them and grow embryos. I am also unexplained and both of the REs I've seen recently have said it's likely egg quality issues, but there's not way to know until doing IVF. If you could potentially get a better quality egg and resulting embryo with trying a $30 drug, I'd totally go for it and try something different than you've been doing. Good luck with your decision - I know it's not an easy one to make.

vlagrl29 · November 2017

I think it's a very personal decision and there is no wrong way to go about it. I don't see the problem with doing natural cycles but I can see if you'd want to go straight to clomid - maybe it would give you an answer quicker. Small doses - does that mean the smallest dose they offer for those 5 days you take it? Did you find out what your prog # is?

dpjennifer · November 2017

tosh24 Excellent things to mull over! Before we found out the results of this test I told myself that I would do 2 more MCs before I ‘quit.’ So if I had a MC after trying naturally with no meds, I would definitely be willing to try Clomid for a cycle. If it seemed promising (i.e. got further along in a PG before MC again), I would maybe even consider trying it again as well. I guess my only thing is that the ONLY thing they found was ureaplasma, which I was treated for. So, if that change would pan out for me being able to carry a child to full term (or if the issue is as zamora_spin put info up about recently: That recurrent early MC by people who seemingly get PG fairly easily, could be that your body implants ANY embryo, even bad ones) then I never know if the ‘next’ PG is the one that could be “it” for me. Also, the article Zamora_spin put up about almost 70% of women with RPL go on to have a healthy baby with no medical intervention. It’s just a hard decision to make. Part of me is like, just try regular first… and part of me is like, stop d*cking around and just do Clomid.

vlagrl29 They said “very small dose” but they did not specify as to what that was over the phone.

vlagrl29 · November 2017

@dpjennifer - it's going to be very expensive for us if we decide to do clomid with an RE next year. I may have to call my OB and beg them to monitor me. IUI is $1200 total for 1 month omg - for something that may or may not work.

zamoraspin · November 2017

@dpjennifer As to the question of trying three cycles naturally or jumping to the low clomid, here is one link I found that very briefly discusses it:

https://bocafertility.com/Recurrent_Miscarriages If the miscarriage is caused by faulty ovulation, treatment with fertility medications such as Clomiphene citrate (Clomid, Serophene) can restore normal ovulation and may improve your chance of a successful pregnancy. In some patients with ovulatory dysfunction caused by Polycystic Ovary Syndrome (PCOS), treatment with Insulin blocker (Metformin) has been shown to improve ovulation and may also decrease the risk of miscarriages.

Given that your losses have primarily been very early, maybe there is some truth in it? I haven't been able to find a study yet but just based on the sheer volume of message board posts about treating RPL with clomid it seems like something RE's must try to do. I would maybe also ask your dr what success they have seen with this approach.

I kind of am inclined to agree with @tosh24 that if your dr really does think there is a chance clomid will help maybe just do that sooner. I am assuming you would be monitored? Aside from multiples the only downsides I know about clomid (other than possibly being miserably bitchy) are that it can thin your lining (but I imagine in a small dose and without lining issues that is unlikely).

amberruka · November 2017

@dpjennifer I’m so happy you’re off the bench! Let the Sexy Time commence!

I don’t have an answer for your other question, you can have all the facts and knowledge but what does your gut tell you?

vlagrl29 · November 2017

@amberruka she makes a good point. I'm where we are at regarding ttc because of my gut feeling.

fishee333 · November 2017

tosh24 said:

Yay for being off the bench!!! I think it's a very personal decision and I guess I would frame it against how you think you would cope with another natural cycle mc should one happen and, if it did, would it push you so far to your limit that the idea of starting treatment after that just seems overwhelming and/or useless?

My thoughts exactly. Personally, I have pretty much put my own limit to one more MC trying naturally, and then I think I'm going to go right to IVF if possible. Lot's of reasons behind that, but the main one is that I don't think I can handle many more MCs. I haven't done much research about Clomid so I can't give you much advice there, but if I were to do the research, the main thing I would try to figure out is the risk vs benefit of trying it.

vlagrl29 · November 2017

@fishee333 - i've done lots of research on it and I think they say the benefit outweighs the risk which I could agree with if that includes monitoring. Otherwise I'd be an anxiety driven basket case!

cassafrass15 · November 2017

I'm so happy for you that you're off the bench! That's great news. Happy trying!

And as for my two cents regarding the natural route vs straight-to-clomid issue: I agree with everyone that it's a very personal decision and I don't think there's any wrong answer based on your specific situation and what works best for you. I am also an RPL sufferer and have had 4 early losses with zero explanation. I have tried both naturally and with letrozole and Clomid. I ovulate on my own, but we started medication hoping that I would ovulate more than one egg at a time, increasing the chance of fertilization. I respond really well with Clomid and I've gotten pregnant twice this year using it. However, I don't take Clomid lightly. It has caused considerable side-effects for me, the least pleasant of which is heightening my emotions to near nuclear levels. And I don't know about your RE, but mine instructs that Clomid isn't a long-term plan and at some point in the very near future he won't prescribe it to me any longer. Again, this is just my personal experience and I'm sure it's a little different for every woman. But for me, if your only pressing issue is egg quality I might consider another unmedicated cycle or two before moving on to Clomid.

vlagrl29 · December 2017

@dpjennifer - do you take any supplements? Maybe add a few if you do natural cycles. @cassafrass15 - eek on the nuclear level - wow! I'm assuming you weren't as bad on letrozole.

honeybeebub · December 2017

@fishee333 Sounds like we have the same plan. I know another mc will really emotionally drain me, so if we have another one naturally, onto IVF with PGS.

dpjennifer · December 2017

@cassafrass15 Yeah, that's what I was leaning towards. I know Clomid isn't a long-term thing (isn't it the one with like a 6 cycle lifetime limit? Although I'm not sure if it's more than that with very small doses prescribed). I'd also definitely be monitored by my RE! The big risk they said is multiples, so if too many (eggs? follicles? crap what did she say...) during a cycle while monitoring they'd abort trying that cycle. But I also don't want to try something that just helps me get PG more easily, just to have more MC. It'd really be about egg quality if I went there. Which is why I was considering a few natural cycles first... ugh. Problem is my gut is torn on this decision!

vlagrl29 I've tried a variety of things. I was on baby aspirin at one point. I've tried many months of raspberry leaf tea (not the kind sold in stores, but actual herbs made by a crunchy friend of mine). Etc. Ugh.

Thanks all for the insight! Still debating what to do...

vlagrl29 · December 2017

@dpjennifer - I understand the gut issue. For me we put a limit on how much more I'd try naturally before turning to medication. 2 more months and then I'm at peace and will be willing to try something different to see if it produces a different result. I told DH about all the prices for different medicated cycles with an RE and he says we'd make it work. me on the other had gets anxious by debt.

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