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Author: wrnglrjan Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 2282  
Subject: Well, aren't I a dork? Date: 3/28/2003 9:29 PM
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Three weeks ago I had a bunch of blood taken for various tests. I hadn't gotten any results back, which I took to mean they didn't show anything interesting (read: bad). I figured I'd just ask the doc when I'm there on Monday.


Except, see, apparently I did get some results. Today I spent about 4 hours doing bills and paperwork and all that other stuff that accumulates on my desk while I'm living my life. And there, down at the bottom of the bag I take to and from work (and to and from the post office where I get my mail) was an unopened envelope from my OB/GYN office. I think when I got it I assumed it was a bill and didn't bother to open it right away.

ANYwho ... according to the insert (from the doc's office), my "progesterone is low". The lab sheet's there, too, but I can't make heads or tails of it. But the part I can read says my progesterone is 3.40 H. Whatever "H" is. It also looks to me like it says the "reference range" (which I would think is the normal range) is .28 - 1.22. No H there, though. And below my results it has a little table that says:
Progesterone Reference Ranges:
Follicular 0.15 to 1.40
Luteal 3.34 to 25.56
Mid Luteal 4.44 to 28.03
Postmenopausal 0.00 to 0.73

I had the test done on day 22 of my cycle - anybody know which of these phases (I assume they're phases) I should have been in? And what the heck does the .28 - 1.22 range mean?


I'm off to forget about babies for awhile and do some quilting. Do y'all ever get tired of thinking about all this?


Jan
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Author: bookgrrl Big red star, 1000 posts Feste Award Winner! Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 110 of 2282
Subject: Re: Well, aren't I a dork? Date: 3/28/2003 9:39 PM
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Hi sweetie. Mine is low too. YOU'RE MY FREAKING TWIN! I SWEAR YOU ARE!

Okay, you probably had a "Day 21 progesterone test" when your blood was drawn. That is the time most docs test progesterone levels.

From the time you menstruate until you ovulate, it is your "follicular phase." From the time you ovulate to the time you menstruate again, it is your "luteal phase." Hence, day 21 of your cycle - the day on which you probably had your test - is called "mid-luteal phase."

Each month, during your luteal phase, you must have sufficient levels of circulating progesterone to support a fertilized egg. This is because the fertilized egg cannot generate its own progesterone (necessary for fetal viability) until it has nestled into your uterine lining, set up a placenta, and established a blood supply. Women with low levels of progesterone may have problems getting pregnant.

Of course, none of this explains why you and I - two twins with low progesterone - each managed to have fertilized eggs implant &c. twice, but - whatever.

My doc says that he has seen women with progesterone levels of as low as 11 carry healthy babies to term, although once you are pregnant the docs like to see a level above 25.

Treatment for low progesterone? Some docs prescribe progesterone suppositories (oral progesterone does no good), although the best available medical evidence indicates that it does no good (randomized double-blind clinical trials show no difference in outcome). However, what *does* help is ... Clomid. I don't know why, I just know that it does, or so says my doc.

Lurve you,
BG

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Author: sjfans Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 111 of 2282
Subject: Re: Well, aren't I a dork? Date: 3/28/2003 9:44 PM
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I had the test done on day 22 of my cycle - anybody know which of these phases (I assume they're phases) I should have been in?

Well, I can't speak to the rest of the question but...

The luteal phase of your cycle (if that's what they're talking about) is after you ovulate and before you get your period. If you have a 28-day cycle, you ovulate about day 14 and get your period about day 28. Day 22 should put you in the luteal phase if you have a "normal" one (I think the luteal phase can range from 12 to 16 days and be fine.)

I have no idea what the difference between "luteal" and "mid luteal" is. I would guess the "follicular" phase is when your ovary is popping up a follicle but before the egg is released (ovulation.) And you are obviously not menopausal.

Low progesterone is a possible lead, though. I think it is a common cause of recurrent miscarriages and usually treatable. Here's hoping you might have found the problem (err, well, you know what I mean.)

I'm sure your doc's office can explain it better. Frustrating to have to interpret crazy numbers without much reference or even units of measure, isn't it?

Good luck,
sjfans

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Author: wrnglrjan Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 112 of 2282
Subject: Re: Well, aren't I a dork? Date: 3/29/2003 1:28 AM
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Of course, none of this explains why you and I - two twins with low progesterone - each managed to have fertilized eggs implant &c. twice, but - whatever.

Well, at least you've had trouble getting pregnant.

I, freak of nature girl, have gotten wham-bam-thank-you-ma'am instantly pregnant twice now. With a blocked fallopian tube and low progesterone, apparently.


<whisper>
Do you ever think that they might just be making all this stuff up, and really they don't know anything?
</whisper>


I'm askin' crazyinlovefool over on the Parents board about this. I'm pretty sure her diagnosis was low progesterone and she's about 20 seconds away from giving birth.

Well, unless she's giving birth right now. Then I probably won't get to ask her. Darned inconvenient, that.


Jan

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Author: heathrita One star, 50 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 113 of 2282
Subject: Re: Well, aren't I a dork? Date: 3/29/2003 8:49 AM
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Low progesterone can be a big cause of miscarriage in the first trimester. A lot of people with PCOS suffer from this, and they have to take progesterone supplements til 2nd trimester.

I don't know if this is the One True answer for you, but I thought I'd offer it up.

Oh, that and a *hug*.

Heather

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Author: sassygirl6 Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 114 of 2282
Subject: Re: Well, aren't I a dork? Date: 3/29/2003 9:28 AM
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<whisper>
Do you ever think that they might just be making all this stuff up, and really they don't know anything?
</whisper>


I don't know about the "making stuff up", but I absolutely agree that they really don't know anything. I am convinced there is little to no organized science behind infertility.

I will stop just short of mentioning how convenient it is that the ob/gyn profession has couples willing to spend thousands and hundreds of thousands of dollars to have babies, often without insurance coverage, which helps to make up for the money they have to spend these days on malpractice insurance. Finding definitive answers would cut off a big flow of revenue.

The alarmist hype put out by the media on women's decreasing fertility just adds fuel to all of this. It's a truly sickening phenomena.


Sassy



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Author: wrnglrjan Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 115 of 2282
Subject: Re: Well, aren't I a dork? Date: 3/29/2003 10:24 AM
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I will stop just short of mentioning how convenient it is that the ob/gyn profession has couples willing to spend thousands and hundreds of thousands of dollars to have babies, often without insurance coverage, which helps to make up for the money they have to spend these days on malpractice insurance. Finding definitive answers would cut off a big flow of revenue.

Ms Sassy, rarely do I disagree with the substance of one of your posts, but I think this is a little "conspiracy-theory" for me.

The ones in practice are not the ones who would be finding definitive answers anyway.

I feel like they're doing the best they can, they just ... don't really know. It all feels like (semi-)educated guesses to me.


I feel the same way about the nutrition/weight loss folks, too.

Jan

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Author: sassygirl6 Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 116 of 2282
Subject: Re: Well, aren't I a dork? Date: 3/29/2003 11:17 AM
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...I think this is a little "conspiracy-theory" for me.

The ones in practice are not the ones who would be finding definitive answers anyway.


I guess that's why I stopped just short of saying it!

Seriously, I doubt there's any ORGANIZED conspiracy trying to keep the medical profession from finding answers to infertility issues. At the same time, I don't think there is a sense of true urgency, either. Nothing like the kind of panic that accompanies the search for cures for stuff like, say, erectile dysfunction. Assisted Reproduction is big business. Big and profitable business.

Authors of books about how women must hurry, hurry, hurry to have babies while they still can probably have NO link to the business of Assisted Reproduction, but they know that its a hot button that will create a big buzz and sell copies. So they do it. And it creates a lot of uncertainty and panic among women that is not deserved or realistic. Yet from my understanding, known causes for infertility can be attributed more or less equally to male and female dysfunction. This fact doesn't create hype, however. Remember the thread a few weeks ago on LBYM about how women need to be less selfish and pop out babies while we're young or we'll end up bitter unhappy barren crones? That dude got SLAMMED, and deservedly so. But there's too many people out there that don't see through the hype.

In recent years, medical research has been much better at providing more resources toward the study and cures of women's health issues, most notably breast cancer. Was there ever a "conspiracy" to let women's issues slide? Probably not, IMO. I'm really not much for conspiracy theories, actually. It just wasn't a priority to the male-dominated field at the time (again, IMO, some will disagree). But women's issues are still decades behind where they could be. I'd love to see a "race to the cure" for many common infertility problems. Why isn't there one?

Meanwhile, there are authors capitalizing on people's desperation. There are doctors and clinics making fortunes capitalizing on people's desperation. And those that do seem to be targeting women much more than men, but the fact that they do it at all is what makes me sick.

I WILL go so far as to extrapolate this opportunism to include individual practitioners such as OB-GYN's who are well aware of how important this is to their patients, yet DON'T stay as up-to-date on the latest research as they could, and who in some cases will have patients take every test under the sun, over and over, and who will recommend procedures that provide little hope of success. For every competent and ethical practitioner there are several who are motivated by more than simply successfully treating disease and dysfunction. Sad but true.

Sassy






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Author: lizmonster Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 117 of 2282
Subject: Re: Well, aren't I a dork? Date: 3/29/2003 11:58 AM
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This is turning into something of a meta-topic; but anyway:

Authors of books about how women must hurry, hurry, hurry to have babies while they still can probably have NO link to the business of Assisted Reproduction, but they know that its a hot button that will create a big buzz and sell copies. So they do it. And it creates a lot of uncertainty and panic among women that is not deserved or realistic.

I would link this to society's general uncertainty about women's changing roles. Anything that encourages the status quo is popular, because it plays on our fears of the unknown. I remember when the big fertility "story" broke - I wondered where the news was. I'd always understood that fertility took a drop at 35+; the new studies seemed to say "No, really - we MEAN it." There were some interesting facts in the data presented; but the manner in which they were presented by the popular media was pure FUD. (They've got poor frissy believing she'll never have kids if she doesn't get knocked up by 27, for God's sake!)

Meanwhile, there are authors capitalizing on people's desperation. There are doctors and clinics making fortunes capitalizing on people's desperation. And those that do seem to be targeting women much more than men, but the fact that they do it at all is what makes me sick.

They do it because they can. I posted earlier about how much we disliked the MD at the IVF clinic, and how we wouldn't go back to him; but you know, I haven't been pushed. Lots of folks out there would do anything and deal with anyone if it got them a child, and I can't blame them.

My chances of conceiving are low because I'm 38. Reality is reality, and the fact that it pisses me off doesn't change the fact that it's reality. But the other side of this reality is that I was in no position to have a child when I was younger. I didn't consciously wait for anything, so these media firestorms wouldn't have changed a damn thing for me.

-lizmonster

P.S. Of course, the other reason I'm pissed is that I brought up the possibility of children with my GYN at my annual, when I was 36, and he said "Well, we can talk about it when you get closer to doing it." Six month later - after I'd turned 37 - when I went it to ask about it, he absolutely FREAKED. "How old are you? 37? You're going to be 38??? And you've never been pregnant? Never???" I felt thoroughly betrayed by this man who'd been treating me for a decade. I haven't seen him since.

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Author: 2gifts Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 119 of 2282
Subject: Re: Well, aren't I a dork? Date: 3/29/2003 4:03 PM
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I, freak of nature girl, have gotten wham-bam-thank-you-ma'am instantly pregnant twice now. With a blocked fallopian tube and low progesterone, apparently.
</I.

Um, there's a really good chance that you have just hit your particular problem. Low progesterone leads to miscarriage because you need progesterone to support the pregnancy. If you don't have enough, the pregnancy ends in miscarriage. And since you've said you do seem to get pregnant, you might just need to take supplemental progesterone to be able to get the pregnancy past the first trimester. The trick, though, seems to be that you have to start right at the 28th day of your cycle and continue til you confirm pregnancy or have your period [I don't remember all the details - check with your doctor].

My hunch is that they may try some fertility drugs like Clomid with you just to ensure you're maturing eggs and such, and that they will give you the supplemental progesterone while you're trying.

Low progesterone was one of my many problems, and I had to use the supplemental progesterone for the first trimester. Interestingly enough, I got pregnant on my own twice after the twins, but due to the low progesterone, I miscarried. The problem, basically, was that if I had known I was pregnant, then I should have started progesterone right away, but as we had so many things wrong and were sure we wouldn't get pregnant again, but the time I would find out I was pregnant, it was already too late to start the supplemental progesterone, so I miscarried.

Anyhow, please ask your doctor. You may be further along on your path than you think.

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Author: wrnglrjan Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 120 of 2282
Subject: Re: Well, aren't I a dork? Date: 3/29/2003 4:56 PM
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Anyhow, please ask your doctor. You may be further along on your path than you think.

I will. Monday.

Actually, now I'm kind of excited to go. When's the last time you could say that about a visit for a pelvic exam? :)


Jan

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Author: bookgrrl Big red star, 1000 posts Feste Award Winner! Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 121 of 2282
Subject: Re: Well, aren't I a dork? Date: 3/29/2003 5:27 PM
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Well, at least you've had trouble getting pregnant.

Um, I wouldn't say that I'm particularly delighted that "at least" that's been the case, but ... whatever.

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Author: wrnglrjan Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 122 of 2282
Subject: Re: Well, aren't I a dork? Date: 3/29/2003 5:45 PM
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Um, I wouldn't say that I'm particularly delighted that "at least" that's been the case

Ergg. Poor choice of words. Apologies.


I just meant there's some consolation in "normal", even if it's in a way you wouldn't like to have.

I've got problems I "shouldn't" have, and don't have problems I "should", according to all the data. This leaves me feeling less like I'm in the hands of competent professionals than a bunch of stabbing-in-the-dark guessers.

Jan

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Author: Selphiras Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 148 of 2282
Subject: Re: Well, aren't I a dork? Date: 3/31/2003 7:25 PM
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(I think the luteal phase can range from 12 to 16 days and be fine.)


My doc, and Mom, said as long as it wasn't less than 10 I shouldn't worry. Mine was 11. But then, I also never got pregnant.

Selphiras

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