Friday, October 17, 2008

AF MIA

The plan, it was grand. The plan was so well-formulated that I had my cd3 baseline ultrasound appointment already lined up for Wednesday morning (my day off-perfect!), with the IUI to fall sometime around Halloween. At least that's what I had lined up in my head. Reality and what my body manages to do is a different story altogether. Because as I type this, it is Friday and I have been spotting for almost 5 days. FIVE. Not normal. Where was that perfect 28 day cycle I had last month, back when it was completely irrelevant? Well, I'm not sure, but I'm staring cd32 straight in the face and she doesn't seem to be giving it up either. Maybe I need to take a few long jogs around the block or have marathon sex (don't tell Mr. S. or he'll hold me to it) to coax her out. I've read this has been going around, this AF MIA epidemic. Damn contagious if you ask me.

It got me to thinking about my periods, a subject Mr. S. tells me I am way too open in discussing at length nowadays. I've always had at least 2-3 days of spotting before full flow. Worst case scenario is what I'm facing now. I looked it up and the consensus is that this is likely due to low progesterone. I have a history of low progesterone, right from the very beginning of our IF treatment, so this makes sense. But to be honest, except for my first blood work with an RE and my pregnancy, there hasn't been any monitoring of this. I've also had suspiciously short luteal phases (even on clomid they manage to be around 10 days). For a long while I've been at the conclusion that I likely have a luteal phase defect. (this is based on my ever-handy self-diagnosis tool, much to many doctor's chagrin)

When I was pregnant, we watched my progesterone along with my betas. While my betas doubled beautifully in the beginning, my progesterone stayed quite low, even with suppositories. It was low enough to where I was told to be on 'miscarriage watch' as it appeared that it might not be viable. It finally picked up and jumped into low-normal ranges, but in reading studies on this, it has been found that progesterone at the beginning of a pregnancy is somewhat correlated to pregnancy outcome in that women who had higher levels were more likely to carry to term. And yeah, if I were a participant in that study, I would've further proven the hypothesis. Low progesterone=no baby. Not that this is definitely a singular cause, but I'm wondering out loud now. Did a possible LPD cause my miscarriage? The literature is varied, but it could be likely.

As I understand it, there's some controversy with the use of progesterone suppositories. A little chicken/egg conundrum, if you will. Some docs think that the progesterone is low because the pregnancy was not viable to begin with and therefore treatment only prolongs the inevitable. Then some docs believe that low progesterone is a result of a possible LPD and that it is quite treatable, but if left unattended, could cause a miscarriage. I think I might vote for the possibility of both, depending on individual cases. Not sure where I lie on that one.

Treatment is as follows: Suppositories. Check. Clomid or injectables. Check. You could also do some over-the-counter things, but the former is the gold standard. I did all that and still no baby. I think it's important to note that this Mother ship likely has faulty wiring here. Did Baby #1 go away because my body could not support him/her? I know that it's not useful to drive myself nuts with these questions, because all that could have been done was done. But every time I see AF stave off for several days, it will remind me. My body is dysfunctional. My body was unable to keep my baby. Will it ever be fixed enough to hold baby #2 all the way, if they should ever make it into the picture? Only time will tell. I just need AF to get here to help answer these questions, and more.

Follow-up: The ship has landed! Within hours of posting this, AF came to town in all her glory. I had no idea I had the power to summon her via blog!

21 comments:

Lost in Space said...

Uggghh on the witch messing up your plan. She is almost done visiting me so I'm sending her your way. (My DH tells me that I talk about this much too openly too.) (:

I wish I had an answer for any of your questions. This whole IF journey if full of so much mystery and confusion. I hope one day very soon that you are holding baby #2 in your arms. Huge hugs, Shelby.

Nikki said...

My DH says "Put two women together in the same place, and even if this is the first time they meet, within the first 5 minutes they will be discussing their gynecological details with absolute ease with each other" Oh well...

Sorry AF is being difficult. I am now on CD 44 and she's yet to show her face. Let's all do the AF dance and get her to move her butt, shall we?

I'm not sure if LPD could cause your m/c but I do trust our doctors to take good care of us. If suppositories will help, we'll do it. If injections help, we'll do them. Anything to get our bodies to do what they're meant to do, right?

Good luck Shelby - hope Spot turns to Flow soon!

Lorraine said...

Soooo frustrating that you're finally ready to go and suddenly there's another obstacle. I hope that aunt gets it together soon and you can move forward.

The progesterone question is always a struggle - my current RE says that I can use the endometrin suppositories instead of the injections, that the efficacy is the same. But so many studies show that the PIO is the most completely absorbed that of course if I don't do them I will always second guess myself if I think it turned out to cause a problem..

Martha said...

Yeah for AF making her appearance! The power of blogging! Here's to Happy Hormone Levels! ((HUGS))

Just Me. said...

GRRRRR!!!! I hate that damned witch. She visits me on time, every time, without fail, which is why till today, I still count my dates and I countdown worriedly, she may just show up! I'm gonna whip out my Baygon AF Spray down your way. (hmmmm...somehow that didn't come out right, but u know what I mean!..:) oh, babes thinks I talk way too openly about AF, our cycles and what's not.

Michelle said...

I think I may have the same problem. We are going to try progesterone with my next injectible cycle. Good Luck with yours.

Hoping for our own Peanut said...

i came across your blog by clicking around and couldnt resist commenting. :)

that was me just a few weeks ago. i was waiting FOREVER to get my period. i went to get acupuncture on day 39 and an hour later it came!

now you can move on with this month and get to making that baby!

good luck!

Erin

luna said...

2 sure ways for AF to arrive:
(1) blog about being late
(2) pee on a stick

Hope2morrow said...

Stupid AF. Glad she finally arrived though......

Tara said...

I am glad she finally arrived. I tried progesterone this time and I think it's really just a mess. I'm not sure if I believe in it.

On to CCRM - holding my hope for you!!!

chicklet said...

On the power of blogging about it - it's happened to me almost every time. Except last time, which pissed me off, cuz I was TRYING to get it over with!

Shelby said...

If it's true that blogging about AF makes her evil little head appear, is the same true for being PG? If so, you'll be seeing posts from me on the hour!

Of course, I'm sure it doesn't quite work that way... :P

I Believe in Miracles said...

Hubby says, if you complain, it'll happen. Maybe not always, but it usually works with stop lights. Glad to hear it worked with AF.

I wonder about my progesterone too. I spot prior to AF from anywhere from 2-11 days but have never been on progesterone supplements. I wonder if we had been if I'd be doing IVF. Oh well. No looking back, no regrets, right?

Here is (imagine my lifting up my cup of tea) to a next good cycle for you!!
**HUGS**

courtney said...

I agree with you. I spot regularly beforhand and my LP is usually 10-12 days long. I asked my Dr about testing my hormones at the end of my cycle to see if the progesterone is the issue, and he is of the opinion of your first comment, that the low progesterone is caused by the 'non viable' or in my case 'non existent' pregnancy.
He said he doesn't have to test any other hormones at the end of a cycle because a period always comes. If there were no period, than there would be other testing. But I still have wondered that if an embryo has tried to implant but couldn't produce enough progesterone, how would I ever know?
You just let me know what you figure out, because our IF sounds similar, and I'm interested in progesterone suppliment information.
Good luck with starting a new cycle.

MamaSoon said...

YAY! AF is here! You must ask more by blog if this is how it works. Heck, I better too! So will you still make your appt on wed?

MamaSoon said...

YAY! AF is here! You must ask more by blog if this is how it works. Heck, I better too! So will you still make your appt on wed?

Mary said...

I'm gonna go try to blog about being late right now....maybe she'll show....

I doubt it though. I hope this cycle is it for you. I too have fears that I'll get pg again and my body will never be able to hold onto a baby.

Cara said...

Huh! I found a couple times last week - I wrote it...then it happened!

The blog is..some powerful!!!

ILCW

Kristin said...

I could preach long and loud on the subject of LPD. I start my suppositories at 3 days past ovulation and that worked wonders for me. Have you talked to your doc about the progesterone in oil shots?

ICLW

bendingbackwards said...

I am sorry to hear that AF is being less than cooperative.

E thinks that women discuss their 'female health' as he calls it way too much. Yeah boys.

Here from ICLW.

April said...

Found you on ICLW.

All during my IF treatments my AF has only been two days max. I have ?LPD and have a lot of the same concerns that you do. I wonder if the low progesterone helps to cause the LPD and it ends up being a negative feedback system of sorts.. hmmm.... i think about it every month, but I am always VERY willing to use the extra progesterone...I will do whatever it takes. (and every little bit helps!!!)
:) xo, april