Concerned about progesterone levels - spotting 3 days before AF with low temps

good luck!! :) Do you guys have long enough together to get closer to ovulation?
 
well, i should be ovulating next weekend and i will be with him next weekend. the earliest i've ever ovulated is CD16 and that will be friday. i will see him saturday and sunday for a few hours. so it's all just up in the air! :)
 
Hi Lisa,
Please help. Ineed your input - please brainstorm with me. I am totally alone in this as far as support of RE or OBGYN goes... Here's my story...

When I was 34 I became pregnant for the first time. That was the first time we tried. My DH is a few years younger than me and is in excellent health. Neither of us are overweight. We don't smoke, drink, or do drugs. We are healthy young professionals. We decided to get pregnant last year and were overjoyed that we became pregnant right away. At 10 weeks I miscarried. It was apparrently a blighted ovum or embryo that stopped developing around 5 weeks 3 days and my body only started to recognize the embryo demise.. which must have diminshed and reabsorbed into the body.

The docs let me miscarry naturally which was devastating and gross. Large pieces of tissue and placenta passing through the vagina was a very strange sensation and not one I'd ever want to repeat. It was absolutely devastating for us. We only had a qualitative blood test done that said "yes you are pregnant" around the 6 or 7 week mark.

With that first pregnancy it took an entire week for a postive HPT to show. I didn't think much of it. Anyway... the obgyn told us to wait three cycles before we tried again. So we did. We waited until January 2010 to try again and BAM we were preggers again!

Everything was going great until about 5 weeks 3 days when it all went to hell. Another devastation. This time however, I took notes of every body symptom that I had. I was charting and using LH detecting stips (ovulation predictor strips) so I knew when I had my LH surge that I would ovulate within a day or two... I seemed to be ovulating around day 16 on a 27-28 day cycle. I noticed THIS time however... based on my bbt chart and based on implantation spotting... that I was IMPLANTING LATE... My implatnation happend at 12dpo... much much to late... I read online somewhere that implantations that occur at 12dpo have an 85% chance of miscarrying. I confirmed implantataion by two things...

1.) When I implant I get the night sweats. I wake up in the early morning with soaking wet clothes and bed sheets... sopping soaking wet... I know right then and there I am pregnant because the same thing happend when I became pregnant in 2009 (which I didnt realize what was happening at the time! I thought I was going through an early menopause with hot flashes because I had a night of night sweats and then no period for a week after its due date... AND my hpt was NEGATIVE until an entire week after period was due.... so I was like... am I dying? Menopause? Cancer? What the heck? Turns out it was a late implantation... with a resulting preganncy that ended in a miscarriage.

2.) Implantation bleeding the next morning... very slight also confirmed that implantation had occured.

So here we are again... back to March 2010 when I miscarried once again... it was awful... Then we decieded to go see an RE... I went througha battery of tests...

EVERYTHING CAME BACK NORMAL. I have normal karotype, normal FSH level (at 9.1) normal estraoil, normal prolactin, normal thyroid, normal everything!!!! I even have normal uterine shape, no fibroids, perfect uterine lining thickness and a ripe follicle in the cycle. I have plenty of EWCM everymonth and that's usually my method of knowign when to BD.

Cut to September 2010... I get preggers again and this time I am equipped with progesterone suppositories that I am supposed to take starting 2 days after my LH surge. I had TO BEG for the SUPPOSITORIES from my RE!!!! BEG FOR THEM... Then after all this begging - what does she prescribe for me???

only 100mg of progesterone ONCE A DAY at bedtime!? What??!! I've read a gazzillion posts and reports online that you need like 400mg of preogesterone like TWICE a day... not 100mg once a day... what gives? I explain the logic to my RE who doesnt want to hear it and doesnt want me to tell her how to do her job... and thats that. She wont prescribe more than that. She siad I need to "trust the process"

So I trust it. I take the progesterone after my LH surge on day 16 in my August cycle 2010... I get pregnant... and at 5 weeks 3 days... I MISCARRY again.. that was the THIRD consecutive miscarraige.

Very differnet m/c this time around... becayse of the progesterone??? I still got the night sweats... AGAIN on 12 dpo... too late for implantation so that was a tell tale that it was all going to go to hell again... and this time around... the only thing done differnetly was progesterone suppositiory... HOWEVER I noticed that my boobs NEVER got sore, NEVER got bigger and I LOST 6lbs in the first few weeks of pregnancy without changing my diet or exercise... What gives?? They tested my HCG and Progesterone a couple times this pregnancy. My progesterone was supposedly at a 21 but my HCG was really low at 60. It never made it up past 60. :(

In the other two pregs that resulted in mc I had very big swelled up boobs and felt very tired. Didnt happen with the progest. That worries me.

In the meantime, the RE told my husband and I to take a 15 day dose (each) of doxocycline as a precaution against any hidden bacterial stds that we might not be aware of - this is standard protocol in a fertility work up. either of us had previous partners but we decided to take the antibiotic as a precaution anyway...


So we took it back in October.

Cut to NOW... here we are November 2010... right... this cycle was a little wonky for me. I went in for a hysterosonogram ... very similar to a hysterosalpinogram but with saline instead of dye and ultrasound instead of x-ray... the damn RE couldnt get the catheter through my OS (the opening of the cervix) so she said... well lets do the next best thing.. we'll just do a transvaginal ultrasound... she did that and said OMG... your uterine lining is wayyyy too thin to support a pregnancy... we'll need to knock you out and do a hysteroscope to see if you have scar tissue in there...

I said... there's no way I have scar tissue. I've never had a procedure like a d/c done before... I've never had an abortion... I dont have scar tissue... she said that if I ever needed to get artificial insemintation or i.u.i or a test to see if I had 'asherman's' syndrome (uterine scarring) that they'd have to knock me out to do it!

I said... whoa.. back up the damn bus here lady... could it possibly be that maybe I'm just ovulating LATER IN MY CYCLE!? She said that was apossibility and to come back the day I test positive for my LH surge...

A week later I got my LH surge on CD19... which means that two days later I was going to ovulate... or something like that... she did an ultrasound on me and my uterine lining was FINE ..and perfect according to her - it measured at 10mm and had the three strip pattern... i also had a nice fat mature follicle at 18mm that was ready to go in a day or two... so great... ovulation confirmed... and endo lining is perfect.

Well that was a week ago... last friday November 5 2010.. since then my dh and I have been BDing like mad rabbits... all last weekend... i waited until Tuesday November 9 to start the progesterone suppository... once a day at bedtime... only 100mg...

And wouldnt you know... I woke up wit the NIGHT SWEATS on Friday morning... November 12... yesterday.... which would put me at approx. 6dpo?? I think... if that is in fact... what happened....

NOW... here I am at 7dpo... and I'm taking the progesterone suppository once a day at bedtime 100mg... and my boobs are still pretty small. They look like normal.. they arent particulary tender... and I know with progesterone your boobs should be tender... but mine aren't really... yet... maybe its too soon to know... or maybe this progesterone is WONKY.. .I dont know...

I do know that I have been SPOTTING for THREE DAYS prior to the start of a full on period... that my periods are usually almost always 27-29 days long... and that I ovulate GENERALLY around CD 16 I get the LH surge... but this cycle it didnt come until CD 19...

Any thoughts Lisa? Please help. I tried to get my RE to prescribe a high dose or more frequent dose of preogesterone and she poo poos me and says she is the doctor and she knows that 100mg is more than enough once a day...
My theory is that once a day is not enough.... wouldnt that cuase the progesterone lvels to fluctuate and eventually fall and trigger the endo lining to shed thus causing another m/c? RE says no... the 100mg once a day at bedtime is more than enough for 24 hours worth of progesterone and that progesterone levels fluctuate normally throughout the day and the cycle anyway...

Also- my dh hasnt been tested yet for sperm quality or karotyping. There are two cases of autism in his family (children of his two uncles). He also had an undescended testicle as a child but nobody seems to think that could be a problem. I wonder about a varicose vein or a vericole or whatever its called that is in the scrotum that might be overheating the sperm and causing them to be deformed?

But there is a theory that if I couldnt GET pregannt they would look more at him... but since I CAN get preggers and I KEEP MISCARRYING that the 'problem' is with me... thoughts???

Thank you.
 
Hey, I'm so sorry for what you're dealing with.
I'm not a doctor or anything so all my information is from my own research, my own experience, and what I've been told by doctors.

I'd say its possible you had a progesterone issue with the spotting etc, BUT, your lining reached the right thickness prior to ovulation and when you did miscarry, it wasn't your falling progesterone levels that caused it. The typical progesterone deficiency would be the HCG levels going up but the progesterone so low that the lining sheds on a healthy pregnancy. Since you had a missed miscarriage and your progesterone levels got up just fine, it seems less likely that you have a typical progesterone problem.

I hear so many girls put on totally different doses of progesterone also. Lots get put on 100mg 2x a day, I got put on 200mg once a day. To be honest, the suppository did not make my boobs hurt. I'd taken it on 2 other cycles where I wasn't pregnant. When I was pregnant, my boobs only started to hurt at 5 weeks or so and went on to hurt through week 8 or 9 even though I was on the suppositories through week 13. Unless you are having spotting, your progesterone is probably fine.
Also, my doctor didn't want to put me on it until he'd tested my level on its own... at 7 days past ovulation.

the only problem I could think of related to progesterone is if your lining doesn't get prepared adequately so that implantation doesn't happen well/easily. Did your doctor ever test your progesterone levels 7 days after ovulation? (without the suppositories to interfere with the results?)
However, I'm not sure the sac would get up to the 5w3d point with poor implantation. In fact, since you're getting implantation symptoms much earlier after your HSG, I'm wondering if the procedure helped dilate your tubes and help the blastocyte get through your tubes faster?

The heart is supposed to start beating at 6 weeks and the fetal pole is developing right about then. I'm going to assume you are on folic acid daily? There is a condition where your body doesn't absorb folic acid correctly and they can test for that. Green tea is also known to inhibit your body's ability to absorb it.
They tested you for clotting issues, correct?

There are some chromosonal things that either of you could carry that could cause you have a high chance for miscarriage, but the fact that it keeps happening at the same time, and before 6 weeks and the heartbeat etc.. it seems like there is something very specific going on. If it does happen again and you miscarry, will they test the tissue to see what might have been wrong?
 
Hi lisa, I hope you don't mind but I've just seen this thread and thought I'd ask you a couple of questions too :)

I think I may have low progesterone. We've been trying for 22 months, I have pcos and had a lap & od in August. I usually have spotting for 4 days before AF arrives, and I have very heavy clotty periods.

The only thing is, I think my temps look ok. Do you mind having a look at my chart please?

https://www.fertilityfriend.com/home/2feb05


Congratulations on your pregnancy :D It is so lovely to see that you eventually got there xx
 
Thanks! I felt so justified in finally getting my BFP on the first cycle where my progesterone levels were normal, lol! I love being right :rofl:

I peeked at your chart and its a little tough to tell what normal is for you (and heck, my charts were different almost every cycle so who am I to talk:haha:).
Your July cycle looks crazy with that short luteal phase, though you had the procedures done then so hmm...
On your Sept cycle I kind of think you ovulated one day later than FF says (your CM, getting another positive OPK and even your temps kind of indicate this to me). This would move your coverline up a bit and show that you hovered near it. This would also shorten your luteal phase a little.

I think its worth getting a progesterone test done! Things like spotting and low temps don't always mean low progesterone, but a blood test done 7 days after ovulating should give you a definite answer on what your progesterone levels are really doing. Make sure the test is done 7dpo... if your doc insists on CD21 tests, ask for both (I went along with the CD21 test when they insisted on it despite knowing I ovulated late, and then when the results were low, my doc looked at my chart and said it was low because it wasn't done at 7dpo :dohh:).
 
Thank you for taking a look for me :)

I actually have an appointment with my fs on 22nd Nov, so I will ask for 7dpo bloods then. I hope he agrees to do it - I hate how it always feels like a constant battle! If he says no, I'll ask my GP instead :haha:

Thanks again, xx
 
No problem! hope they give you the blood tests. Its too bad you can't get the blood tests done this cycle. Any chance of calling in and asking?
 
I phoned them a few weeks ago and asked, but they said they couldn't send me for bloods without having my next appointment :( So I'll have to wait until my next cycle - that's if they send me for them at all..

I might try ringing my GP on Monday morning and ask if he'll send me for them, so my results will be ready for my fs appointment the following week. I'll hopefully get my own way :haha:
 
Lol, hope your GP does it for you! It makes so much more sense to have the blood results to review with your FS!
 
hi ladies, iv recently had some blood work done due to my letual phase being only 10/11 days and occasional spotting before that and made a very interseting discovery...i have an UNDERACTIVE THYROID. Basically your TSH(thyroid stymulating hormone) level is at its safest below 2 and mine was 4.79 . My progesterone was checked and it was normal and i was definatly ovulating. Since being diagnosed with this i have read ALOT about it on the net and discovered that if your thyroid isnt working as it should then your whole body and its hormones are out of sync causing lots of problems and symptoms that you wouldnt think to relate to that,a short luteal phase being one of them and if you did happen to fall pregnant there is a strong possibility of misscarriage. Apparently it is said tio be the main cause of misscarriage,premature birth,still birth and pre-eclampsia but as its not tested as routine then its never picked up on. My doc sais that under normal circumstances it wouldnt be treated untill it gets to level 10 but as im ttc and its causing problems then she has put me on a 25mcg of levothyroxine to bring my level down,the reason they dont like to treat it untill it gets to that level is probably because here in england if your diagnosed with it then all prescriptions are free and the medication is for LIFE as once the thyroid is over or underactive then it never gets better on its own ot only get worse and has to be kept under control with meds(1 tablet evry morning). I have been taking them for 12 days now and i have to say i feel fantastic and i have already ovulated a day earlier,im yet to see if has had an effect on my luteal phase but it takes time to get themeds right for each person it may have to be increased or decreased etc to get the levels within the right range,im due for another blood test in 5 weeks to see how im doing,i am no longer ttc untill its down to at least level 2. I was having symptoms for a coupke of years and have been told iv got stress/anxiety, dandruff(i know!) when my hair started to fall out more than usual, IBS because i was getting cronic constipation. Now i realise it was all down to that. here is a list of SYMPTOMS: Tiredness,sleeping alot/ depression/ constipation / thinning hair/ brittle nails/ weight gain,fluid retention/ memory loss,confusion/ brain fog/ dry skin/ aching muscles/ feeling cold/problems concieving/ feeling you cant cope with stuff/ loss of sex drive.
I have had all this for along time but hadnt connected it with anything and started to get usee to feeling like i did and thought it was normal and its not untill i started the meds that iv realised how tired and depressed i actuallty was, i feel great now,iv got my energy back,my nailos have started to grow,my dry skin has got better,my brain,thinking is much better, everything feels better and im really optimistic about ttc now whereas before i was so negative that it wouldnt happen and i felt sad all the time and ready to give up . Nornmaly docs wont give the test unless you either ask for t or your symtoms are that bad that its suspected,by alot of the time its bypasses and the sypmtoms are treated rather than the cause. luckily i have a young female doc who is all for testing and understands the heartache of ttc with no luck. GET TESTED! even if its just to rule it out xxxxx
 
P.S whe your pregnant the demand on your thyroid is alot higher and has to be tested every 4 weeks if your on meds for it to make sure it stays normal because for the 1st 12 weeks the baby doesnt have a thyroid gland and is dependant on yours and if its underactive then it can cause misscarriage. xx
 
Great info sam!
Funny though, at least at my doctor's and most of the US girls I know, testing the thyroid is one of the first things a doctor does. My doc tested it before letting my try clomid. I had many of the same symptoms you listed, but they must be unrelated because my thryoid was fine! (I almost wish I had a thyroid problem because then all those symptoms would be fixable! :dohh:)
 
Really,maybe its just here in england then,maybe because it means free medication and prescriptions for anything for the rest of your life when normally we would pay for it,i dont know the way the goverment works in england is so wrong with alot of things.
well maybe if someone reads that hasnt been tested then it might prompt them to. Now im thinking though if you had the same symptoms as me and it wasnt your thyroid i may have other issued aswell as that and the meds might not do anything for my luteal phase..i hope not xx
 
I had low progesterone from repeated tests.. so yours may very well be linked to your thyroid. I have struggled with depression which caused weight gain, lack of motivation etc etc etc etc, lol... its probably not tied to thyroid/fertility for me... just chemical imbalance.
 
Lol, hope your GP does it for you! It makes so much more sense to have the blood results to review with your FS!

Hi Lisa, just to let you know I had a progesterone blood test done today by my GP :) I managed to talk him round :winkwink:

The only thing is I'm only 6dpo but it was the only day they could do it and the only time I could have off work. Do you think 6dpo will be ok? I get my results on Thursday.

Thanks for your help and hope you're well xx
 
6dpo should be fine.. if its the teensiest bit off of 'normal' then you can probably assume it reached normal by then. (if its within 1 or 2 points of normal).
If its much lower then it probably wouldnt' have gotten there at 7dpo anyway.
 
Thanks lisa :)

My doctors surgery was closed this afternoon, so I couldn't get my results. Grr!

Just out of interest what is a normal level of progesterone after ov?

If it's low, should I ask my GP for any meds incase I'm pregnant now (unlikely though!) or just wait until I see my fs on Monday? xx
 
You're in the UK, right? The normal minimum they like to see is 30... if its 28 or so you are probably fine. If its 19 or so, thats 'borderline'... basically ovulatory but low (which was my issue).
If its low, you could ask for progesterone suppositories, but they don't usually give them to you unless you are already pregnant. The exceptions to that are if you have had repeated miscarriages before or have tested repeatedly low for progesterone after ovulation. Once you are pregnant, you can get a progesterone check along with your HCG an see if its in the normal range.. it usually goes up when you are pregnant so it COULD go up to normal levels on its own.

Hope that helps!
 

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