Need some advice - what would you do?!
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  1. #1
    Community Host ChristaM's Avatar
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    Default Need some advice - what would you do?!

    Hi All:

    I need some advice on what to do next. I'm confused on what might be the best approach. Go back to my OB, try a second opinion from another RE, or just be patient and work with the naturopath/acupuncture. Do nothing?!

    I'm currently experiencing my third loss in the past year. After the second, I went to a RE for labs and a plan. The RE after my labs were done suggested clomid (I do ovulate on my own) with IUI. My husband and I thought that was a bit aggressive, so we asked about clomid with us trying on our own. He said no. My labs also showed low post O progesteron and I do have a history of LP defect; so I asked about progesterone supplements - again, he said no. Indicating that he would give progesterone if I got pregnant and my labs showed it was still low.

    So, after this, I took my labs and went back to my OB. The OB gave me progesterone (100 mg 2x/day) to take post ovulation. He also gave me a script for clomid that I filled but didn't use yet -- instead I went to a naturopath for another opinion first.

    The naturopath warned that my issue is likely just age related, but said my metabolic panel showed low vitamin D and protein. She also said my vitamin A is low based on physical exam. She prescribed vitamin A, vitamin D and told me try and modify diet towards the blood type dieat (I'm A, so that would be vegetarian for the most part).

    Well, low and behold I ended up pregnant this past cycle (second cycle on vitex and progesterone supplements). Went back to the RE for beta testing. My HCG was low but was doubling within the 48-72 hour window, but my progesterone was falling. The RE who didn't know yet that I was on progesterone wouldnt prescribe it since the HCG hadn't doubled. Well, my next lab (yesterday) showed both the hcg and progesterone are falling and I was told to stop all meds (none from them), so I confessed that I was taking progesterone from the OB.

    I'm wondering why if progesterone seems to be my issue he wouldn't give it to me. From what I've read, it wouldn't hurt and could have possibly helped (wondering if after BFP I might have needed a higher dose). I'm not sure if it's true, but from what I've read if the pregnancy was going to fail, it would regardless, so I'm not sure how giving the progesterone would hurt?

    Anyway, I'm debating my next step and would appreciate some thoughts. Feel free to ask any questions you think relevant. I'm including my supplement list and my lab results for reference:

    September 3 (CD3) Labs:
    Estrogen: 56
    FSH: 7.5
    Prolactin: 3.82
    LH: 3.96
    AMH: 0.63
    7 Early Follicles

    September 9
    saline HSG all clear

    September 23 (6 DPO):
    progesterone 7.94

    October 2 (CD4)
    Started vitex and royal jelly

    New cycle November 1

    November 5
    first naturopath appointment; started vitamin A and lipotrepein

    November 14:
    started vitamin D

    November 21:
    Post o progesterone 23.5! We thought this was 7 DPO, but then FF moved my cross hairs and made it 5 DPO. This lab was done by the naturopath.

    November 25
    faint BFP - confirmed November 27 with digital beta.

    November 27
    HCG 25.7 and progesterone 13.8

    November 29
    HCG 41.8 and Progesterone 10.3

    December 2
    HCG 15.5 and progesterone 8.55

    Supplements
    ? Prenatal: thorne research brand; per naturopath

    ? Omega Fatty Acid (taking a combo 3-6-9 oil)

    ? Calcium 500mg + Vitamin D 400 iu

    ? Vitamin A 25,000 IU 2x/day; stop once BFP is confirmed per the naturopath

    ? Vitamin B complex / Folic Acid; I take one pill that contains 100% RDV of all B vitamins. The extra folic acid is good for me since I'm slightly over weight and also to help with both my history of luteal phase defect and severe morning sickness.

    ? Vitamin C 500 mg/day

    ? Vitamin D - 10,000 iu/day. I'm taking a mega dose right now per the naturopath since my level was at 50% of recommendation. My dose will reduce once I'm done with the first bottle.

    ? Vitamin E - 400 iu/day

    ? Lipotrepein; gentle liver cleanse; per my naturopath

    ? Wheatgerm oil 2x/day: high in vitamin E, Folic Acid and vitamin B; per my acupuncturist

    ? DHEA (25mg 3x/day); I was doing this 3x/day, but reduced to 1x/day per the naturopath

    ? Co-Q10 (200 mgx2 / day)

    ? Ubiquinol (concentrated form of CoQ10; 200 mg/day)

    ? Pycogenol (100 mg/day); Taken from start of cycle until ovulation.

    ? L-Arginine (500mg 4x/day); Taken from start of cycle until ovulation.

    ? Royal jelly (2000 mg/day); Taken from start of cycle until ovulation.

    ? Vitex (400 x2/day) Take once a day in the morning on an empty stomach (half an hour before breakfast);
    should be used all month long without a break. Once a BFP is confirmed ask the naturopath how to continue.

    ? Ovex x2 (Days 1-12)rovides a synergistic blend of nutrients for ovarian support and helps balance female hormones.Contains Cytosol? extract from bovine ovary, calcium, magnesium, and vitamin C. Per my acupuncturist

    ? Utrophin PMG x2 (days 7-21); provides bovine uterus PMG and key minerals for uterine support. Provides
    uniquely derived nucleoprotein-mineral extracts that support cellular health. Per my acupuncturist.

    TIA if you made it this far!
    Christa
    Me: Christa, 41
    DH: Craig, 47 (Married: 8/19/05)
    DD: Kendall Evelyn (10/6/06)
    DS: Quentin Vincent (4/14/09)

    : November 2012@ 10 weeks (due date: 6/22/13)
    : June 2013 @ 7-1/2 weeks (due date: 2/10/14)
    : December 2013 @ 4 weeks (due date: 8/9/14)
    : April 2014 @ 4 weeks (due date: 1/1/15)
    : July 2014 @ 4 weeks - Chemical (due date: 3/5/15 )

  2. #2
    Posting Addict CamelNoodle's Avatar
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    I am sorry for your loss.

    My OB said that Clomid is not a great drug for staying pregnant. It makes the lining of the uterus thin. I would ask for Femara instead.
    William 10/6/2004
    Visit his CaringBridge
    Joseph stillborn 01/08/2007
    Thomas 05/05/2008
    John 6/5/2010
    m/c 12/23/2012
    m/c 01/02/2014 twin angels

  3. #3
    Posting Addict tink9702's Avatar
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    Basically the less time I had and the more I wanted to have another baby the sooner I'd do something other than supplements. Honestly, the RE you've seen sounds like an idiot. from everything I've heard and read there is no reason not to give you progesterone if your #'s are low and you have a confirmed BFP. Also, they should have not suggested clomid if you already ovulate. With three m/c's you aren't having trouble getting pregnant, you're having trouble keeping pregnant. Have you had thyroid testing done?

    Also check out this website, they seem to have a LOT of information all in the same place. Multiple Miscarriage RESOLVE: The National Infertility Association

    last, Hugs! What you are going through is NOT easy.
    ~~Mel

    Ethan - June 21, 2009
    Olivia - December 5, 2010
    5w3d - October/November 2012

    My Ovulation Chart

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    Prolific Poster UpBeachMom's Avatar
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    Sorry, I have no experience here but sending hugs
    Julie

    Georgia Grace ~ Nov 15/07
    Colin Eric ~ July 30/10



  5. #5
    Community Host ChristaM's Avatar
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    Quote Originally Posted by tink9702 View Post
    Basically the less time I had and the more I wanted to have another baby the sooner I'd do something other than supplements. Honestly, the RE you've seen sounds like an idiot. from everything I've heard and read there is no reason not to give you progesterone if your #'s are low and you have a confirmed BFP. Also, they should have not suggested clomid if you already ovulate. With three m/c's you aren't having trouble getting pregnant, you're having trouble keeping pregnant. Have you had thyroid testing done?

    Also check out this website, they seem to have a LOT of information all in the same place. Multiple Miscarriage RESOLVE: The National Infertility Association

    last, Hugs! What you are going through is NOT easy.
    Thank you for the link -- I'm going to read up! As for the thyroid, my OB did a thyroid test after the first miscarriage. It came back at 2.05. I think he only tested TSH.
    Me: Christa, 41
    DH: Craig, 47 (Married: 8/19/05)
    DD: Kendall Evelyn (10/6/06)
    DS: Quentin Vincent (4/14/09)

    : November 2012@ 10 weeks (due date: 6/22/13)
    : June 2013 @ 7-1/2 weeks (due date: 2/10/14)
    : December 2013 @ 4 weeks (due date: 8/9/14)
    : April 2014 @ 4 weeks (due date: 1/1/15)
    : July 2014 @ 4 weeks - Chemical (due date: 3/5/15 )

  6. #6
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    I am sending hugs and prayers as well.

    I think you should get a different RE, but I don't have any experience with them so I don't know if what your RE is doing is normal, I usually find when in doubt a second opinion can't hurt.





  7. #7
    Contributor KateyD32's Avatar
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    I'm very sorry about your loss. Like you, my AMH was on the low/normal range at .71. We started out on just clomid but since my low AMH I would just get one follicle and BFNs. We did this for 3 cycles and my RE wanted to be much more aggressive with treatments. I did injectables this cycle and had 4 mature follies at time of O. We also did IUI to boost our chances. I was nervous to do injectables but my RE said that we had to be aggressive with the treatments because I was considered a low responder. You need to get a new RE in my opinion, one that will listen to you and understands your point of view! Also, I had a m/c after my HSG in March and my RE put me on 200mg of progesterone 2 times a day just to be safe---he also requires I take a low dose baby aspirin. The only other supplements I took was omega 3 s and COq10.
    ~Katey~

    DH: Jonathan 9/29/07
    DS: Dylan 8/28/09

    After almost two years of TTC our second baby we have a BFP!

    Lilypie Pregnancy tickers

    9/08; 3/13

  8. #8
    Posting Addict **Tiffany**'s Avatar
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    I wish I could offer better words than I'm sorry. I know they can't convey how awful I feel that you've had a third loss. Big hugs.

    As for my advice I'm certainly no expert but I can offer my experience with losses/ fertility issues. I lost my first, fifth, ninth and tenth pregnancies there was testing on two of the babies but nothing abnormal showed. Anyway to shorten things a bit I really didnt have issues conceiving except that it took 6 mos after my 2nd loss (5th pg) to conceive again and thats with temping/OPKs, seemingly normal ovulation, progesterone, etc. Then we lost our son Noah (9th pg) at 14 wks gestation (we think due to an infection I unknowingly had that caused my water to break) and I had to be induced and deliver him.. We started temping/charting/OPKs thinking we really wouldn't have an issue conceiving again just worried about keeping the pregnancy going. I was 35 dh 34. After 5 mos of BFNs and serious emotional tolls I asked for testing at my OB office even though my charts looked like I was Oing fine. I had been taking OTC supps like maca root, vitex, royal jelly, vit b complex, EPO, pomegranate, vit d, etc. Everything checked out fine. I asked to start clomid even though I was Oing fine bc I knew it would increase my chances of conceiving bc you push out more than one egg. Even though my eggs seemed fine they probably weren't all of great quality anymore. I took clomid for 2 mos responding well to it (the side effects sucked) and got pg with my 10th pg. It wasn't to be as I found out at 8 wks it never made it past 5 wks. My lining was checked and said to be of good thickness so they didn't think it was that. After I healed I went back on clomid for 3 mos and while I seemed to respond well no BFPs. We decided to try switching to Femara as a last ditch effort before referring me to the RE 1.5 hrs away for probable IUI with meds. It worked the first month! And I have to say the side effects were much better on Femara though I still had some they weren't as severe as clomid. I actually conceived twins but one didnt make it passed the 8th week sadly. I'm 25 weeks now and so far things look good! I never thought it would take almost 1.5 yes and 2 fertility meds to get pregnant with what will be our 7th earthly child but it did. I'm glad I did the clomid and Femara I may still be trying if I didn't.
    Tiffany
    Mom to 6 on earth + 5 angels.









  9. #9
    Posting Addict Audgee's Avatar
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    I haven't read through all the other responses - but did want to offer some thoughts.

    I am currently pregnant for the 9th time, hoping to bring home my 3rd child - and I am 43 - so I think I am in a similar position to you.

    - keep in mind your age......you may be ovulating - but you have no way of knowing how "good" that ovulation is - are you ovulating too soon (follicles not getting big enough, egg supply is lower and you need a "good" egg not just to ovulate, kwim?)
    - Clomid can effect your lining - but not always - I have used it before for 4 cycles and only had lining issues twice. That is a big reason why I tell friends to only go on Clomid or any drug while being monitored (u/s and bloodwork) by an RE - your OB can give you the prescription, but they don't check to see how it is even working for you.

    I would also agree, because of age and the high probability that you will not produce excessive amounts of follicles, that IUI is the right choice in your situation.

    You have tried the "natural way" and that has not been working out for you - IUI will mean close monitoring and a better idea of the true "right time", kwim?

    If you walk in and they automatically give you clomid - it would be a red flag to me. SOunds like a plan of trial and error, not a plan of action based on you personally.

    Be 100% honest with who ever you chose to go through, on what you have been taking and for how long. Not all supplements work well together, and a good RE will do a lot of testing (DH included) before giving you a course of action.

    I can probably add to this - but I am at work and am trying to multtask while I type this! So my thoughts may be disjointed!
    Audrey
    DH Sebastian
    DS Sawyer 4/1/06
    DD Payton too beautiful for this earth, born silently 7/19/09 at 33 wks
    DS Greyson 6/29/11
    DS Parker 4/14/14


  10. #10
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    Not having any experience with REs, and actually very little with OBs, I would say that the best advice is to follow your gut. It sounds like you probably feel like you want to go see a different RE. If that's the case, do it. You may also want to get books (buy them, or check them out from the library) about balancing the hormones properly for pregnancy. I have a couple checked out from the library, but I have yet to actually read any of them. :-/ Judging by your list of supps that you take, this may be something you've already done. But, if not, you might want to look into it.

    On a semi-side note, I am so very sorry for your loss. I can only imagine how discouraged you must feel, but I hope you are letting it make you more determined instead. *hugs*
    Last edited by AlyssaDarby; 12-17-2013 at 02:50 AM.
    Alyssa & Aaron TTC #1



    Lap-2/5/08-adhesion removed, PCOS confirmed, no endo found
    August 2010 (5 wks)

    06/06/14 - CD1 of first cycle back at trying.

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