@chichiphin - I'm glad that everything came back okay for you, but I'm so so sorry for the suspected MFI. How's YH handling the news? I know my DH has always been worried that he's the one that makes it hard for us to get pregnant. I don't know much about who to go to, but between the morphology and your short LP, I think I would go the RE route.
@chichiphin It's pretty common for a second SA to be done, just to make sure that this wasn't a fluke. At this point, I would say it's up to you if you would rather go to an RE now or wait to confirm if the results of a second SA show similar results as the first. Although if I were you, I would probably head to the RE now since you are dealing with an LP defect in addition to possible MFI
"It's time to try defying gravity."
Me: 38 DH: 38 Married 6/11/16 TTC Since 6/2016 12/2016 RE appt; 1/2017 SA & HSG results - all normal 3/2017 Dx Hyperprolactinemia; 5/2017 Prolactin levels normal; 8/2017 Low Ovarian Reserve 8/2017 TTA for personal reasons; 10/2017 NTNP; 12/2017 Re-start TTC 7/2018 Clomid+IUI 11/2018 Letrozole+TI 12/2018 Letrozole+IUI 2/2019 NTNP 5/2019 Stopping all TTC efforts; living Childfree
@marebear15 MH seems a little deflated, but this morning he was ready to make appointments etc. He is hopeful. @lulu1180 I just have to figure out how to navigate that request... Does my OB have to "refer" me, or can I just call and say what is happening and get an appointment? I guess that is actually an insurance issue really. Whats funny is my progesterone came back at 7.9 and my TSH at 1.46 for my 7DPO testing. Still waiting on my AMH though. So barring anything weird with my AMH, my OB thinks I am free and clear and do not have any explainable issues.
@chichiphin Yep, unfortunately it's up to your insurance. But obviously I would still recommend getting a referral from your OB, as long as you like your current OB and have a good relationship with them. Your progesterone is technically within normal levels but I think it's also on the low end of normal.
"It's time to try defying gravity."
Me: 38 DH: 38 Married 6/11/16 TTC Since 6/2016 12/2016 RE appt; 1/2017 SA & HSG results - all normal 3/2017 Dx Hyperprolactinemia; 5/2017 Prolactin levels normal; 8/2017 Low Ovarian Reserve 8/2017 TTA for personal reasons; 10/2017 NTNP; 12/2017 Re-start TTC 7/2018 Clomid+IUI 11/2018 Letrozole+TI 12/2018 Letrozole+IUI 2/2019 NTNP 5/2019 Stopping all TTC efforts; living Childfree
@lulu1180 just got off the phone with my insurance. Seems we only need 2 SA's that show the defect (done at least 2 weeks apart), and then we are free and clear to see an RE whenever we want, no referral needed. So, time to schedule that second SA!
@lulu1180 no I have not. I got the following tested: TSH, FSH, LH, Es, Progest, Prolactin, and AMH. Still waiting on AMH - apparently a lab in Cali does the test...
@chichiphin Once you meet with an RE, they'll have you do an HSG. It's obviously important to make sure that your tubes are clear before moving forward with treatment. Once you get the SA scheduled, you might want to schedule an appointment with an RE for some time after that just in case it takes a while to get in for a consult.
"It's time to try defying gravity."
Me: 38 DH: 38 Married 6/11/16 TTC Since 6/2016 12/2016 RE appt; 1/2017 SA & HSG results - all normal 3/2017 Dx Hyperprolactinemia; 5/2017 Prolactin levels normal; 8/2017 Low Ovarian Reserve 8/2017 TTA for personal reasons; 10/2017 NTNP; 12/2017 Re-start TTC 7/2018 Clomid+IUI 11/2018 Letrozole+TI 12/2018 Letrozole+IUI 2/2019 NTNP 5/2019 Stopping all TTC efforts; living Childfree
@chichiphin Sorry to hear that friend! We are in a similar boat with MFI. MH has had two SA's done. One when we first started (3% morphology) and then when we had moved on to our RE, he had the second. During our wait for the RE (Canada is a 6-8 month waiting list) we tried some supplements. I can not vouch for how diligent he was with them as he was deployed for a large portion. The second SA done by the RE was more in-depth and we discovered that his morphology had dropped to 2% and that there was an Acrosome defect (head shape) of 73%. So we are now doing IVF with ICSI. If you are reaching out to RE's now, maybe you can ask them if they require you to have a SA done with them specifically or if it is something you can do now ahead of time? Not sure how your insurance for that works or cost. But if it were me, I would definitely start looking at getting an appointment set up to move forward. If you have any questions, feel free to pm me at any time.
@nitnat007 I almost paged you because I recalled morphology in your dx. Our insurance allows us to immediately book the RE, but we need the second SA showing the dx before a treatment plan is approved by insurance. It is kind of wild, but I called the clinic I wanted and they had an appt available on Nov 16. They are scheduling the second SA for that same day so they can run it (they did his first one too). Thank you for the PM offer. I might take you up on that once we have confirmed results on the second SA...
So I had some bloodwork done this morning. Has anyone had a 1 hour glucose to go along with it? My ob didn’t mention it to me and the lab didn’t understand why I would need one not pregnant. Is it insulin resistance related? I didn’t have one the last time I got bloodwork done, so slightly confused.
So... I thought of something silly. I sleep on a heated mattress pad, with an electric blanket every night (joint pain) - Am I totally throwing off my temping??? Is it okay because it's consistent? Opinions?
In record turnaround of my 7dpo labs, I got them back already and my progesterone is 6.22. Anyone have any good literature they can link me to? I definitely expected that and am now waiting to hear back from my fertility naturopath on how she would like me to proceed.
@mamanbebe I’m sure others have better resources, but I’ve been reading a few scholarly articles (thanks @lulu1180 lol) discussing what is “technically” ovulatory but still low. Link in spoiler to what I was reading this morning. I’m also mad that my OB was just going to let my 7.9 slide as perfectly normal with a LP of only 9-10 days
@chichiphin Thank you for linking that. Have you seen anything out there that discusses what happens with levels less than 10, beyond shortened LP? I'm having a hard time wading past all the forum posts in search results.
@chichiphin interesting. My first progesterone test that they did resulted in an 8.5 or so. Now, I typically ovulate somewhere around CD17-20 depending on my cycle and sometimes as late as CD24 or 25 (my luteal phase is fairly consistent though and cycle lengths are usually 30-33, sometimes 37 or 39 days). I had that blood drawn on CD21 the first time so I wonder if they said I O'ed because that may have been my levels at only 2-3DPO when the average 28 day cycle has O around CD14 or what would be 7DPO for the blood draw.
The 2nd month they tested my progesterone on CD22 and it was up to 14 something.
Makes me anxious for my blood work with the RE. I wanna know what's going on!
*TW* History:
Me: 34 DH: 36 | Together since 2007 | Married July 2016
TTC #1 since 7.2017 Dx: low morph (1%), ANA positive, low decidualization score, high TSH and testosterone, histone antibodies
IUI #1-3| all BFN IVF #1 | 6.11.19 | 24R, 17M, 15F, 6B, PGT-A tested - 5 normal, 3 girls & 2 boys FET #1 | 9.10.19 | BFN "I know you, but we've never met. I'm with you, but I don't know your name" RPL, Receptiva, & ERA testing | all normal/negative, recommended going on gluten and dairy free diet for next FET FET #2 | 3.31.20 | Opted to cancelled due to pandemic, continued diet and tried naturally over the summer 2nd Opinion with another RE | 8.20.20 | Not immune to measles (received 1 dose); SA results similar to 2 years ago; decided to move forward with FET #2 redo at start of next cycle Surprise natural BFP! | 9.22.20 | MC 10.23.20 at 8 weeks TTCAL naturally | starting 11.22.20 Initial consultation with Reproductive Immunologist | 9.14.21 Decidualization score biopsy | 10.1.21 | abnormal - low score of 1; endometrial scratch recommended and progesterone supplementation Saline sono | 10.15.21 | normal Bloodwork | 10.21.21 | high TSH, high testosterone, positive for anti-nuclear antibodies and histone antibodies, high protein S, multiple genetic mutations BFP! | 11.3.21 | EDD 7.14.22 | biopsy provided same effect as endometrial scratch; added supplemental progesterone and estrogen, prednisone, levothyroxine, and MTX Support to maintain pregnancy DS born 7.19.22 after induction
TTC #2 begins 6.2023 Consultation with RI | 6.6.23 Saline sono, endometritis biopsy, skin & eye check | all normal Labs | high TSH, Factor XIII mutation, high %CD56 Follow up | 8.8.23 | prescribed metformin, prednisone, plaquenil, and levothyroxine Repeat labs after 3 weeks on meds Follow up | 11.9.23 | Green light!, increase in prednisone, added lovenox Repeat labs in 8 weeks Follow up | 1.16.24 | Green light continues TTC put on pause
@inthewoods23 I consulted with the IF board here and they all suggested to get the testing at 7DPO, so I went in on that day based on OPKs and BBT. Your scenario could certainly cause the levels not be accurate.
@mamanbebe this particular article suggests that it could indicate being anovulatory, specifically with values less than 8. They mention the gold standard for detecting O is with ultrasound, not just serum levels of progesterone - I’ve screenshotted the section below:
@inthewoods23 They should have drawn at 7dpo and not at 2-3dpo. That early post O your progesterone levels are much lower than they would be mid-luteal. From what I've read, they typically start to increase around 4-5dpo. I asked before I scheduled my labs and they said only CD21 if you O on CD14, otherwise, 7 days out from your O date.
@chichiphin@mamanbebe the test was done for my regular OB, not an RE. Looking back in my app, it looks like I was about 4DPO when my blood was drawn for those tests. I'll have to ask my RE the next time I have an appointment with them!
At the same time I'm not sure if it's worth bringing up of my numbers are up that much at only 4DPO. I imagine I would be well in the normal range if they had done it at 7DPO.
*TW* History:
Me: 34 DH: 36 | Together since 2007 | Married July 2016
TTC #1 since 7.2017 Dx: low morph (1%), ANA positive, low decidualization score, high TSH and testosterone, histone antibodies
IUI #1-3| all BFN IVF #1 | 6.11.19 | 24R, 17M, 15F, 6B, PGT-A tested - 5 normal, 3 girls & 2 boys FET #1 | 9.10.19 | BFN "I know you, but we've never met. I'm with you, but I don't know your name" RPL, Receptiva, & ERA testing | all normal/negative, recommended going on gluten and dairy free diet for next FET FET #2 | 3.31.20 | Opted to cancelled due to pandemic, continued diet and tried naturally over the summer 2nd Opinion with another RE | 8.20.20 | Not immune to measles (received 1 dose); SA results similar to 2 years ago; decided to move forward with FET #2 redo at start of next cycle Surprise natural BFP! | 9.22.20 | MC 10.23.20 at 8 weeks TTCAL naturally | starting 11.22.20 Initial consultation with Reproductive Immunologist | 9.14.21 Decidualization score biopsy | 10.1.21 | abnormal - low score of 1; endometrial scratch recommended and progesterone supplementation Saline sono | 10.15.21 | normal Bloodwork | 10.21.21 | high TSH, high testosterone, positive for anti-nuclear antibodies and histone antibodies, high protein S, multiple genetic mutations BFP! | 11.3.21 | EDD 7.14.22 | biopsy provided same effect as endometrial scratch; added supplemental progesterone and estrogen, prednisone, levothyroxine, and MTX Support to maintain pregnancy DS born 7.19.22 after induction
TTC #2 begins 6.2023 Consultation with RI | 6.6.23 Saline sono, endometritis biopsy, skin & eye check | all normal Labs | high TSH, Factor XIII mutation, high %CD56 Follow up | 8.8.23 | prescribed metformin, prednisone, plaquenil, and levothyroxine Repeat labs after 3 weeks on meds Follow up | 11.9.23 | Green light!, increase in prednisone, added lovenox Repeat labs in 8 weeks Follow up | 1.16.24 | Green light continues TTC put on pause
In my labs that were uploaded to the patient portal, this is the data that was supplied for ranges:
Female:
Follicular 0.14 - 2.03 ng/mL
Peri Ovulatory 0.4 - 4.47 ng/mL
Mid-Luteal 5.22 - 22.7 ng/mL
Luteal 1.42 - 16.6 ng/mL
1st Trimester 6.57 - 40.3 ng/mL
2nd Trimester 9.66 - 62.3 ng/mL
3rd Trimester 24.5 - 334 ng/mL
Post Menopausal 0.15 - 1.04 ng/mL
Since my temp has been mostly stable and on the rise vs previous cycles, I had a +OPK, fertile CM and O pains, I'm feeling good that I probably O'd this cycle but I'm definitely so low it looks to puts me at risk of not being able to sustain a pregnancy. Wondering about that and if low progesterone affects the fertilization of an egg, survival of an egg as it travels, implantation of an egg, etc.
It seems like we are both in healthy range for luteal. I wonder how estrogen dominance plays into fertility with estrogen is normal but progesterone is low.
Re: Chart stalk/ questions October
I don't know much about who to go to, but between the morphology and your short LP, I think I would go the RE route.
"It's time to try defying gravity."
Married 6/11/16
TTC Since 6/2016
12/2016 RE appt; 1/2017 SA & HSG results - all normal
3/2017 Dx Hyperprolactinemia; 5/2017 Prolactin levels normal; 8/2017 Low Ovarian Reserve
8/2017 TTA for personal reasons; 10/2017 NTNP; 12/2017 Re-start TTC
7/2018 Clomid+IUI
11/2018 Letrozole+TI
12/2018 Letrozole+IUI
2/2019 NTNP
5/2019 Stopping all TTC efforts; living Childfree
@lulu1180 I just have to figure out how to navigate that request... Does my OB have to "refer" me, or can I just call and say what is happening and get an appointment? I guess that is actually an insurance issue really. Whats funny is my progesterone came back at 7.9 and my TSH at 1.46 for my 7DPO testing. Still waiting on my AMH though. So barring anything weird with my AMH, my OB thinks I am free and clear and do not have any explainable issues.
married 11.1.14
ttc #1 since 5.18
bfp 12.22.18 letrozole + progesterone
d&e due to trisomy 13/hydrops at 15wks
bfp 7.21.19 letrozole + IUI
little girl A born 3.26.20
"It's time to try defying gravity."
Married 6/11/16
TTC Since 6/2016
12/2016 RE appt; 1/2017 SA & HSG results - all normal
3/2017 Dx Hyperprolactinemia; 5/2017 Prolactin levels normal; 8/2017 Low Ovarian Reserve
8/2017 TTA for personal reasons; 10/2017 NTNP; 12/2017 Re-start TTC
7/2018 Clomid+IUI
11/2018 Letrozole+TI
12/2018 Letrozole+IUI
2/2019 NTNP
5/2019 Stopping all TTC efforts; living Childfree
married 11.1.14
ttc #1 since 5.18
bfp 12.22.18 letrozole + progesterone
d&e due to trisomy 13/hydrops at 15wks
bfp 7.21.19 letrozole + IUI
little girl A born 3.26.20
"It's time to try defying gravity."
Married 6/11/16
TTC Since 6/2016
12/2016 RE appt; 1/2017 SA & HSG results - all normal
3/2017 Dx Hyperprolactinemia; 5/2017 Prolactin levels normal; 8/2017 Low Ovarian Reserve
8/2017 TTA for personal reasons; 10/2017 NTNP; 12/2017 Re-start TTC
7/2018 Clomid+IUI
11/2018 Letrozole+TI
12/2018 Letrozole+IUI
2/2019 NTNP
5/2019 Stopping all TTC efforts; living Childfree
married 11.1.14
ttc #1 since 5.18
bfp 12.22.18 letrozole + progesterone
d&e due to trisomy 13/hydrops at 15wks
bfp 7.21.19 letrozole + IUI
little girl A born 3.26.20
"It's time to try defying gravity."
Married 6/11/16
TTC Since 6/2016
12/2016 RE appt; 1/2017 SA & HSG results - all normal
3/2017 Dx Hyperprolactinemia; 5/2017 Prolactin levels normal; 8/2017 Low Ovarian Reserve
8/2017 TTA for personal reasons; 10/2017 NTNP; 12/2017 Re-start TTC
7/2018 Clomid+IUI
11/2018 Letrozole+TI
12/2018 Letrozole+IUI
2/2019 NTNP
5/2019 Stopping all TTC efforts; living Childfree
Edited because I realized I came off super self centered.
If you are reaching out to RE's now, maybe you can ask them if they require you to have a SA done with them specifically or if it is something you can do now ahead of time? Not sure how your insurance for that works or cost. But if it were me, I would definitely start looking at getting an appointment set up to move forward.
If you have any questions, feel free to pm me at any time.
married 11.1.14
ttc #1 since 5.18
bfp 12.22.18 letrozole + progesterone
d&e due to trisomy 13/hydrops at 15wks
bfp 7.21.19 letrozole + IUI
little girl A born 3.26.20
Opinions?
"It's time to try defying gravity."
Married 6/11/16
TTC Since 6/2016
12/2016 RE appt; 1/2017 SA & HSG results - all normal
3/2017 Dx Hyperprolactinemia; 5/2017 Prolactin levels normal; 8/2017 Low Ovarian Reserve
8/2017 TTA for personal reasons; 10/2017 NTNP; 12/2017 Re-start TTC
7/2018 Clomid+IUI
11/2018 Letrozole+TI
12/2018 Letrozole+IUI
2/2019 NTNP
5/2019 Stopping all TTC efforts; living Childfree
married 11.1.14
ttc #1 since 5.18
bfp 12.22.18 letrozole + progesterone
d&e due to trisomy 13/hydrops at 15wks
bfp 7.21.19 letrozole + IUI
little girl A born 3.26.20
The 2nd month they tested my progesterone on CD22 and it was up to 14 something.
Makes me anxious for my blood work with the RE. I wanna know what's going on!
TTC #1 since 7.2017
Dx: low morph (1%), ANA positive, low decidualization score, high TSH and testosterone, histone antibodies
IUI #1-3 | all BFN
IVF #1 | 6.11.19 | 24R, 17M, 15F, 6B, PGT-A tested - 5 normal, 3 girls & 2 boys
FET #1 | 9.10.19 | BFN "I know you, but we've never met. I'm with you, but I don't know your name"
RPL, Receptiva, & ERA testing | all normal/negative, recommended going on gluten and dairy free diet for next FET
FET #2 | 3.31.20 | Opted to cancelled due to pandemic, continued diet and tried naturally over the summer
2nd Opinion with another RE | 8.20.20 | Not immune to measles (received 1 dose); SA results similar to 2 years ago; decided to move forward with FET #2 redo at start of next cycle
Surprise natural BFP! | 9.22.20 | MC 10.23.20 at 8 weeks
TTCAL naturally | starting 11.22.20
Initial consultation with Reproductive Immunologist | 9.14.21
Decidualization score biopsy | 10.1.21 | abnormal - low score of 1; endometrial scratch recommended and progesterone supplementation
Saline sono | 10.15.21 | normal
Bloodwork | 10.21.21 | high TSH, high testosterone, positive for anti-nuclear antibodies and histone antibodies, high protein S, multiple genetic mutations
BFP! | 11.3.21 | EDD 7.14.22
DS born 7.19.22 after induction
TTC #2 begins 6.2023
Consultation with RI | 6.6.23
Saline sono, endometritis biopsy, skin & eye check | all normal
Labs | high TSH, Factor XIII mutation, high %CD56
Follow up | 8.8.23 | prescribed metformin, prednisone, plaquenil, and levothyroxine
Repeat labs after 3 weeks on meds
Follow up | 11.9.23 | Green light!, increase in prednisone, added lovenox
Repeat labs in 8 weeks
Follow up | 1.16.24 | Green light continues
TTC put on pause
@mamanbebe this particular article suggests that it could indicate being anovulatory, specifically with values less than 8. They mention the gold standard for detecting O is with ultrasound, not just serum levels of progesterone - I’ve screenshotted the section below:
married 11.1.14
ttc #1 since 5.18
bfp 12.22.18 letrozole + progesterone
d&e due to trisomy 13/hydrops at 15wks
bfp 7.21.19 letrozole + IUI
little girl A born 3.26.20
At the same time I'm not sure if it's worth bringing up of my numbers are up that much at only 4DPO. I imagine I would be well in the normal range if they had done it at 7DPO.
TTC #1 since 7.2017
Dx: low morph (1%), ANA positive, low decidualization score, high TSH and testosterone, histone antibodies
IUI #1-3 | all BFN
IVF #1 | 6.11.19 | 24R, 17M, 15F, 6B, PGT-A tested - 5 normal, 3 girls & 2 boys
FET #1 | 9.10.19 | BFN "I know you, but we've never met. I'm with you, but I don't know your name"
RPL, Receptiva, & ERA testing | all normal/negative, recommended going on gluten and dairy free diet for next FET
FET #2 | 3.31.20 | Opted to cancelled due to pandemic, continued diet and tried naturally over the summer
2nd Opinion with another RE | 8.20.20 | Not immune to measles (received 1 dose); SA results similar to 2 years ago; decided to move forward with FET #2 redo at start of next cycle
Surprise natural BFP! | 9.22.20 | MC 10.23.20 at 8 weeks
TTCAL naturally | starting 11.22.20
Initial consultation with Reproductive Immunologist | 9.14.21
Decidualization score biopsy | 10.1.21 | abnormal - low score of 1; endometrial scratch recommended and progesterone supplementation
Saline sono | 10.15.21 | normal
Bloodwork | 10.21.21 | high TSH, high testosterone, positive for anti-nuclear antibodies and histone antibodies, high protein S, multiple genetic mutations
BFP! | 11.3.21 | EDD 7.14.22
DS born 7.19.22 after induction
TTC #2 begins 6.2023
Consultation with RI | 6.6.23
Saline sono, endometritis biopsy, skin & eye check | all normal
Labs | high TSH, Factor XIII mutation, high %CD56
Follow up | 8.8.23 | prescribed metformin, prednisone, plaquenil, and levothyroxine
Repeat labs after 3 weeks on meds
Follow up | 11.9.23 | Green light!, increase in prednisone, added lovenox
Repeat labs in 8 weeks
Follow up | 1.16.24 | Green light continues
TTC put on pause
In my labs that were uploaded to the patient portal, this is the data that was supplied for ranges:
Since my temp has been mostly stable and on the rise vs previous cycles, I had a +OPK, fertile CM and O pains, I'm feeling good that I probably O'd this cycle but I'm definitely so low it looks to puts me at risk of not being able to sustain a pregnancy. Wondering about that and if low progesterone affects the fertilization of an egg, survival of an egg as it travels, implantation of an egg, etc.
If so - mine is lower than that. I was at 109.
Also to everyone else - I realize that it is Nov but we are still posting in Oct lol
married 11.1.14
ttc #1 since 5.18
bfp 12.22.18 letrozole + progesterone
d&e due to trisomy 13/hydrops at 15wks
bfp 7.21.19 letrozole + IUI
little girl A born 3.26.20
It seems like we are both in healthy range for luteal. I wonder how estrogen dominance plays into fertility with estrogen is normal but progesterone is low.