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!