IVF with Dr. C - BFP but ulimately ended in M/C - Issues w/ P4 & E2?

IVF with Dr. C - BFP but ulimately ended in M/C - Issues w/ P4 & E2?

MargieD
MargieD

February 29th, 2012, 12:21 pm #1

I did IVF with Dr. C's office. I got a BFP which ultimately ended in m/c. I want to discuss my P4 & E2 issues. See below for numbers.

3 dp3t - bloodwork shows P4 at 23.8 & E2 at 135 - was told to increase P4 suppositories to 400 mg 2 X a day

14 dp3t - BFP! Beta at 106, but P4 dropped to 10.5 and E2 dropped to 63. Was told to increase P4 suppositories to 3 X a day and to add promentrium at bedtime. Ordered from F.reedom

16 dp3t - Beta - 236, P4 still low at 18.4 and E2 at 94 - Told to add 2 CC of PIO along with 400 mg of P4 2 X a day and promentrium at bedtime

20 dp3t - Beta - 673 (not good doubling time), P4 only goes up to 52.1 and E2 at 89. Told to take 2 mg of estrace 2 X a day

Too late...

22 dp3t - Beta - 731, P4 - 46.3, E2 - 150

Told to stop meds. Worried about ectopic pregnancy. All numbers - including beta - went down in next bloodwork.

With all that meds - it took a LOT for my P4 & E2 levels to rise and it didn't even rise as it should.

Been thinking several things.... 1) poorly functioning corpus luteum?? 2) body did not respond well to the meds (with that much P4 - shouldn't my levels have been higher??)?? 3) Egg quality issue??

Other theories?

Are there any supplements you'd recommend for this particular issue? I've read that B6 can help with the luteal phase defect.

Also - this is a stupid question... but is this considered a "chemical"?
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jmassage
jmassage

February 29th, 2012, 1:10 pm #2

I'm not too sure about your numbers. It seemed as though your hcg started out good, but sort of stalled. I've had a few chemicals and my hcg never went above 500. The numbers don't matter so much though. It's a chemical if you miscarry before you make it to first u/s, and if you do, there isn't anything in the uterus. When there's a sac in uterus then it becomes a clinical pg. Chemicals suck because they give you that faint bfp but then don't progress. So yes, I do believe this is what you had. I'm so sorry for your loss.
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jmassage
jmassage

February 29th, 2012, 1:12 pm #3

I did IVF with Dr. C's office. I got a BFP which ultimately ended in m/c. I want to discuss my P4 & E2 issues. See below for numbers.

3 dp3t - bloodwork shows P4 at 23.8 & E2 at 135 - was told to increase P4 suppositories to 400 mg 2 X a day

14 dp3t - BFP! Beta at 106, but P4 dropped to 10.5 and E2 dropped to 63. Was told to increase P4 suppositories to 3 X a day and to add promentrium at bedtime. Ordered from F.reedom

16 dp3t - Beta - 236, P4 still low at 18.4 and E2 at 94 - Told to add 2 CC of PIO along with 400 mg of P4 2 X a day and promentrium at bedtime

20 dp3t - Beta - 673 (not good doubling time), P4 only goes up to 52.1 and E2 at 89. Told to take 2 mg of estrace 2 X a day

Too late...

22 dp3t - Beta - 731, P4 - 46.3, E2 - 150

Told to stop meds. Worried about ectopic pregnancy. All numbers - including beta - went down in next bloodwork.

With all that meds - it took a LOT for my P4 & E2 levels to rise and it didn't even rise as it should.

Been thinking several things.... 1) poorly functioning corpus luteum?? 2) body did not respond well to the meds (with that much P4 - shouldn't my levels have been higher??)?? 3) Egg quality issue??

Other theories?

Are there any supplements you'd recommend for this particular issue? I've read that B6 can help with the luteal phase defect.

Also - this is a stupid question... but is this considered a "chemical"?
I meant to say a chemical is another term for a VERY early miscarriage and I currently had one myself. I'm still bleeding from it
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AJ
AJ

February 29th, 2012, 3:49 pm #4

I did IVF with Dr. C's office. I got a BFP which ultimately ended in m/c. I want to discuss my P4 & E2 issues. See below for numbers.

3 dp3t - bloodwork shows P4 at 23.8 & E2 at 135 - was told to increase P4 suppositories to 400 mg 2 X a day

14 dp3t - BFP! Beta at 106, but P4 dropped to 10.5 and E2 dropped to 63. Was told to increase P4 suppositories to 3 X a day and to add promentrium at bedtime. Ordered from F.reedom

16 dp3t - Beta - 236, P4 still low at 18.4 and E2 at 94 - Told to add 2 CC of PIO along with 400 mg of P4 2 X a day and promentrium at bedtime

20 dp3t - Beta - 673 (not good doubling time), P4 only goes up to 52.1 and E2 at 89. Told to take 2 mg of estrace 2 X a day

Too late...

22 dp3t - Beta - 731, P4 - 46.3, E2 - 150

Told to stop meds. Worried about ectopic pregnancy. All numbers - including beta - went down in next bloodwork.

With all that meds - it took a LOT for my P4 & E2 levels to rise and it didn't even rise as it should.

Been thinking several things.... 1) poorly functioning corpus luteum?? 2) body did not respond well to the meds (with that much P4 - shouldn't my levels have been higher??)?? 3) Egg quality issue??

Other theories?

Are there any supplements you'd recommend for this particular issue? I've read that B6 can help with the luteal phase defect.

Also - this is a stupid question... but is this considered a "chemical"?
First off- sorry again that you're going through this. I completely understand the need to have an answer for why it's happening.

But it's like the chicken and the egg- Does the pregnancy fail because the P4 is low, or is the P4 low because the pregnancy is failing? It's always been my understanding that the quality of the CL relates to the quality of the egg. Now of course, I've learned through all of this that there are no absolutes and there are examples to the contrary. I guess one has to wonder, how long did keeping the P4 elevated sustain the pregnancy? Is supplementing the P4 and E2 delaying the inevitable? I just don't know. I really don't know what role E2 plays in pregnancy and what levels are acceptable.

I hope you get some answers:)
AJ
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AJ
AJ

February 29th, 2012, 3:53 pm #5

For my last m/c, I took P4 and had great betas- up into the 10,000's. I didn't know there was a problem until the first u/s where they found an empty sac. Even after stopping P4 I never bled and had to have a D&C. I think in some cases things sadly, just don't work out. I'm not implying that you shouldn't investigate it further though, just sharing my experience.
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lucy999
lucy999

February 29th, 2012, 4:13 pm #6

I did IVF with Dr. C's office. I got a BFP which ultimately ended in m/c. I want to discuss my P4 & E2 issues. See below for numbers.

3 dp3t - bloodwork shows P4 at 23.8 & E2 at 135 - was told to increase P4 suppositories to 400 mg 2 X a day

14 dp3t - BFP! Beta at 106, but P4 dropped to 10.5 and E2 dropped to 63. Was told to increase P4 suppositories to 3 X a day and to add promentrium at bedtime. Ordered from F.reedom

16 dp3t - Beta - 236, P4 still low at 18.4 and E2 at 94 - Told to add 2 CC of PIO along with 400 mg of P4 2 X a day and promentrium at bedtime

20 dp3t - Beta - 673 (not good doubling time), P4 only goes up to 52.1 and E2 at 89. Told to take 2 mg of estrace 2 X a day

Too late...

22 dp3t - Beta - 731, P4 - 46.3, E2 - 150

Told to stop meds. Worried about ectopic pregnancy. All numbers - including beta - went down in next bloodwork.

With all that meds - it took a LOT for my P4 & E2 levels to rise and it didn't even rise as it should.

Been thinking several things.... 1) poorly functioning corpus luteum?? 2) body did not respond well to the meds (with that much P4 - shouldn't my levels have been higher??)?? 3) Egg quality issue??

Other theories?

Are there any supplements you'd recommend for this particular issue? I've read that B6 can help with the luteal phase defect.

Also - this is a stupid question... but is this considered a "chemical"?
more like estrace twice a day. I always poor E2 and Dr, Check recommends it,. Those nurses always tell me no but make sure you tell them to ask Dr. check. I am not sure if i would say it was a chemical? I had one or 2 and beta was 19, then 21 and then 13.

Sometimes, cooper waits to see what happens at 6 weeks and go from there. Ectopic usually has pain, and beta is all over the place. yours was just not rising well but I would have said in hind sight, wait till 6 weeks and see what happens.

Some centers only take 2 betas and that is it till 6 weeks.
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MargieD
MargieD

February 29th, 2012, 6:08 pm #7

I meant to say a chemical is another term for a VERY early miscarriage and I currently had one myself. I'm still bleeding from it
I was told that C.oopers liked P4 50 or higher. I am not sure about E2, but I've heard over 900 is ideal.

Most of the definitions I've read online says that a chemical is a pregnancy that is a BFP one day and then BFN the next - goes up and then down pretty quickly. I was curious how "this" could be classified.

I am sorry for your loss as well. I had been following your story. We transferred the same same and found out the same day.
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MargieD
MargieD

February 29th, 2012, 6:16 pm #8

First off- sorry again that you're going through this. I completely understand the need to have an answer for why it's happening.

But it's like the chicken and the egg- Does the pregnancy fail because the P4 is low, or is the P4 low because the pregnancy is failing? It's always been my understanding that the quality of the CL relates to the quality of the egg. Now of course, I've learned through all of this that there are no absolutes and there are examples to the contrary. I guess one has to wonder, how long did keeping the P4 elevated sustain the pregnancy? Is supplementing the P4 and E2 delaying the inevitable? I just don't know. I really don't know what role E2 plays in pregnancy and what levels are acceptable.

I hope you get some answers:)
AJ
I have been wondering about this the last couple of days. Does a bad CL mean a bad egg?

But then, to play the devil's advocate, why do we preach to practically every newbie to take P4 support?? Why are there so many studies that show that women - not only with high FSH - need P4 support?? These women go on to have healthy babies. Take Mrs. A for example - she needed to be on P4 support for soooo many weeks.

Another thing... I don't quite understand... if my P4 was 10.5 on 14 dp3t on 400 mg of P4 suppositories two times a day - that would have meant that I had practically NO progesterone in my system! Why did the beta go on to double? Why P4 levels thhhhaaaaat bad - why did I just have a simple chemical?

I do plan to ask Dr. C.heck all of this.... but like you say - sometimes these things don't quite make sense...
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MargieD
MargieD

February 29th, 2012, 6:18 pm #9

I typed this as - Why P4 levels thhhhaaaaat bad - why did I just have a simple chemical? - when I mean to say/ask - "With P4 levels that bad/low, why didn't I just have a simple chemical?"

I could also add - "Why not a BFN??"
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MargieD
MargieD

February 29th, 2012, 6:21 pm #10

For my last m/c, I took P4 and had great betas- up into the 10,000's. I didn't know there was a problem until the first u/s where they found an empty sac. Even after stopping P4 I never bled and had to have a D&C. I think in some cases things sadly, just don't work out. I'm not implying that you shouldn't investigate it further though, just sharing my experience.
That would have been interesting to know. Remember - P4 can delay AF. I wonder if your body absorbed the P4 well??

That's one of the nicest things about C.oopers - all the careful monitoring. I learned a lot about this.

Now having my first "real" m/c, I am starting to wonder if I m/c last month. AF is almost the same - although this is heavier - since it's 6 weeks vs. 4 weeks.

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