For so long, I had prayed for and desperately wanted answers, but as today drew near, I found myself becoming apprehensive. Did I really want to know? What if the news was all bad: that we should give up on having a biological child? On the other hand, my frustration with our RE stemmed almost completely from a lack of answers and the approach of just pushing my reproductive system harder rather than fixing what is wrong.
Regardless of what I thought or wanted, our follow-up arrived this morning; here is what we learned.
According to Dr. P, my pre-ovulatory hormones are okay. Estradiol should be around 260 - 300 around ovulation; mine was 132, so I am not producing a good quality egg (type 3 ovulatory defect).
Post peak is even worse, though. I tried to write down all the values mentioned, but I missed one of the expected estrogen values for either P+7 or P+9.
Estrogen Expected Me Progesterone Expected Me
P+3 88 46 P+3 9.4 8.3
P+5 108 63 P+5 14.4 12
P+7 120(?) 63 P+7 15.7 14
P+9 120(?) 82 P+9 13.6 7
P+11 98 78 P+11 8.1 4.8
My FSH and prolactin were normal. Vitamin D levels were very low, 21, where normal is 50 -75. TSH was 1.93; I missed what normal is.
Here's the plan: I need to start taking 4,000 IU of Vitamin D-3 daily. Next cycle I will start on Femara, 6 tablets on day 3, taking Mucinex to maintain/improve CM, and post-peak HCG injections (P+3,5,7,9). I'll be doing P+7 blood work every cycle. We were cautioned not to expect treatment to work right way; it could take 2 -3 cycles before I return to anything like normal fertility. If we do not succeed within 6 cycles, it will be time to consider diagnostic laproscopy. As of right now, there is no plan to put me on thyroid hormones.
My thoughts and reactions: Eep! I was expecting post-peak progesterone to be low, especially given how many days of spotting I've been having, but I didn't expect the low estrogen values. I can't say I had really thought about my vitamin D levels at all, so that was also unexpected. I wasn't at all prepared to jump straight to post-peak HCG injections; I thought I'd get to start out with progesterone pills. While I'm not needle-phobic by any stretch of the imagination, I can't say I'm eager to dive into regular injections. Add it all up, and I'm definitely feeling overwhelmed by it all. On the positive side, it does seem like our doctor is taking everything seriously; there isn't time wasted putzing around. He clearly considers this protocol one with a good chance of success. I can't help but wonder if I have always had all of these problems; while my earlier sympto-thermal charts weren't beautiful, they weren't anywhere near as much of a mess as my CrMS charts have been. Is age starting to take a toll on me? There's no real way to know, so that speculation doesn't really do any good. All it does is make me more nervous and apprehensive; somehow I have to let go of it.
Regardless of what I thought or wanted, our follow-up arrived this morning; here is what we learned.
According to Dr. P, my pre-ovulatory hormones are okay. Estradiol should be around 260 - 300 around ovulation; mine was 132, so I am not producing a good quality egg (type 3 ovulatory defect).
Post peak is even worse, though. I tried to write down all the values mentioned, but I missed one of the expected estrogen values for either P+7 or P+9.
Estrogen Expected Me Progesterone Expected Me
P+3 88 46 P+3 9.4 8.3
P+5 108 63 P+5 14.4 12
P+7 120(?) 63 P+7 15.7 14
P+9 120(?) 82 P+9 13.6 7
P+11 98 78 P+11 8.1 4.8
My FSH and prolactin were normal. Vitamin D levels were very low, 21, where normal is 50 -75. TSH was 1.93; I missed what normal is.
Here's the plan: I need to start taking 4,000 IU of Vitamin D-3 daily. Next cycle I will start on Femara, 6 tablets on day 3, taking Mucinex to maintain/improve CM, and post-peak HCG injections (P+3,5,7,9). I'll be doing P+7 blood work every cycle. We were cautioned not to expect treatment to work right way; it could take 2 -3 cycles before I return to anything like normal fertility. If we do not succeed within 6 cycles, it will be time to consider diagnostic laproscopy. As of right now, there is no plan to put me on thyroid hormones.
My thoughts and reactions: Eep! I was expecting post-peak progesterone to be low, especially given how many days of spotting I've been having, but I didn't expect the low estrogen values. I can't say I had really thought about my vitamin D levels at all, so that was also unexpected. I wasn't at all prepared to jump straight to post-peak HCG injections; I thought I'd get to start out with progesterone pills. While I'm not needle-phobic by any stretch of the imagination, I can't say I'm eager to dive into regular injections. Add it all up, and I'm definitely feeling overwhelmed by it all. On the positive side, it does seem like our doctor is taking everything seriously; there isn't time wasted putzing around. He clearly considers this protocol one with a good chance of success. I can't help but wonder if I have always had all of these problems; while my earlier sympto-thermal charts weren't beautiful, they weren't anywhere near as much of a mess as my CrMS charts have been. Is age starting to take a toll on me? There's no real way to know, so that speculation doesn't really do any good. All it does is make me more nervous and apprehensive; somehow I have to let go of it.
I am glad you got some answers finally! I am sorry it is overwhelming right now. We went through a few months of trying different "cocktails". I hope one of them works for you. I will pray that you find peace in the midst of all of this. In other news, I sent off your chaplet today, but doh! I forgot the other thing. I will send that separately.
ReplyDeleteYay for some answers and a good plan of action! Praying that everything goes smoothly for you!
ReplyDeleteWhat a good feeling to have a plan of action. Hope the injections go smoothly! I was surprised when my post-peak #'s were low too.
ReplyDeleteI am glad you have some answers and a Dr. who is taking it all seriously. We don't often think of our Vit. D levels but they play a key role in our reproductive system, did you know it is a hormone. Women w/ low Vit. D are at greater risk for miscarriage. I have very low Vit. D despite the fact that I take 2,000-4,000 ius a day and I live in southern Ca! Praying everything goes smoothly with your new plan!
ReplyDeleteThe HCG injections aren't bad - but I hear ya on not being overly excited about them. And about all the speculation that is not helpful, but hard to stop...
ReplyDeletePrayers for you as you begin this next step!