Intro & advice needed

[graceanne]

Hi ladies - it is w/ a heavy heart that I find myself going through another early pregnancy loss.  We saw the baby's heartbeat last Thursday and the very next day I started bleeding.  I have bled like a bad period through the w/e and today.  I go to see my OB again tomorrow where I am sure they'll confirm the miscarriage.  I was 6 weeks + 4.  My first loss was a CP.  I'm sad & angry over this loss.  It took us a year to get pregnant after our CP and I'm 38 and know my risk for mc increases w/ age.  What I find upsetting about this loss is that I had asked my dr to check hormones levels etc tested after my first loss b/c of AMA.  She said that wasn't necessary until I've experienced 3 consecutive losses.  I'm sure this is common practice. But w/ this current pregnancy I started spotting over a week ago and of course it was over the w/e so I went to the ER to get checked out and asked them to check my progesterone level as I was afraid that might be the cause.  THey said they don't do that in the ER and to ask my OB.  The monday after the w/e I saw a different dr in the practice where I go who did a pelvic exam and said that spotting in early pregnancy can be normal and sometimes we never know why...she didn't see any further bleeding going on.  I told her that I didn't spot in my first pregnancy (which resulted in healthy baby girl) and that it was very concerning to me.  I asked her if we could check my progesterone. She was very dismissive of that.  She said that they would check my HCG levels again and make sure they doubled from the level they were at when I was checked in the ER.  She did say she wld schedule me another u/s for later that week since we only saw a gs in the ER and she figured I was just too early to see anything.  That was when we saw the baby's heart beat.  Unfortunately, we learned at that appt that my HCG levels were increasing but no where near doubling.  I then reasked my dr if we cld check my progesterone level and she didn't think it was necessary but agreed to do so to give me some peace of mind.  Today I find out that my progesterone was low a 2.0 - s/b over a 10.  I so upset!  I blame myself for not advocating more strongly for myself and my unborn child.  It just breaks my heart.  I don't understand why that wasn't a concern from my dr's especially given my age, my slow rising hcg levels, and the fact I was spotting.  Please help me understand.  I see my dr again tomorrow and I just want to go in there clear headed and maybe I need to be educated on this but I just don't understand their lack of follow through.  Am I wrong?  This is my second early pregnancy loss.  I now understand that low progesterone played a part in this but where do I go from here?  Any advice and feedback is greatly appreciated.  

[PiradicalMaid]

I am so so sorry for your loss. I don't have any experience of expertise to offer re:progesterone. I think you should see if your provider can explain to you what your level means in terms of what happened with this pregnancy.

I know something that helps me go in clearheaded to an appointment is to write down questions as I have them before the appointment. Also to remember that I am allowed to take my time and make sure I understand everything I can before I leave. I hope your OB can answer some of your questions.

I do completely understand the want and need for answers. Pregnancy loss is so unfair. I understand that there aren't always answers to be had, but it always seemed cruel to me to wait until someone has suffered multiple losses before checking for a cause. I think it is normal to wonder what if things had been different and so understandable to be angry.

Of course it is heartbreaking to wonder if you could have done more, but please remember that you did the best you could in the circumstances you were in. You *did* advocate for yourself and your child or else you wouldn't have had the test at all and now it can maybe lead you to some answers.

I'm sorry I couldn't provide you with more information. I hope your appointment tomorrow is helpful. Please try to be gentle with yourself and take care of yourself as much as you can in this difficult time

[babyzebra]

I'm really sorry for your loss. I don't have any advice or experience regarding progesterone. I agree with PiradicalMaid that it is helpful to write down questions for your doctor ahead of time. I always forget everything I wanted to ask as soon as the doctor comes in the door. I hope that you can get some answers and that you can start healing soon. ((Hugs))

[graceanne]

Thank you Ladies for your kind replies. I'm so sorry for your losses as well.

[nikolie93]

I am so very sorry for your losses *hug*

I totally agree agree with the other ladies when they say to write things down.

This is just my opinion but I would really push to see an RE. It can usually take up to a year for a healthy couple to get pregnant but with 2 losses, your age, and the fact it took you a year to get pregnant this last time, I would want to get the ball rolling with more testing.

I would be pretty upset if I went through that with my Dr. I think, even if you don't go to an RE, maybe you can look for another Dr?

[Deleted]

I'm so sorry for your loss... please try not to blame yourself - I know that's easier said than done. Progesterone is a complicated issue - it can be low because you have a hormonal imbalance which needs supplementation, or it can be low because there is something wrong with the pregnancy and the levels are falling naturally in order to initiate a miscarriage.

My first pregnancy was going well until I began bleeding at 8 weeks and some change. I was lucky enough to fall into the practice of an OB who specializes in high-risk pregnancies, and the first thing he did was order a progesterone test and call in a prescription for progesterone supplements. My progesterone levels came back at 3.5 - I had started supplements too late in the game, and ended up losing what had looked to be an otherwise normal pregnancy. I was devastated and so very angry that my body could've done that to me - I felt tremendous amounts of guilt for not getting my levels checked sooner and felt like somehow, my negligence essentially killed the baby.

My OB told me not to feel guilt - that we couldn't have known that it would happen, and to come in ASAP with my next pregnancy to begin progesterone monitoring and supplementation. I came in with the next pregnancy and began supplements at 3w6d. My levels were continuing to fall as the weeks went on (from 13, to 11, to 10) and my OB kept increasing my dosage. I knew that there was something wrong and pushed and fought for additional blood draws and finally for an early ultrasound. In the end, we found out that my levels had been decreasing because I had had a mmc (the baby ended up having severe chromosomal issues according to the pathology report).

So I've had one pregnancy where the supplements might have helped, and one pregnancy where nothing could have helped. The terrible part is, you just won't know; however, there are many doctors who are willing to go above and beyond to take their patient's concerns seriously and who are also willing to prescribe progesterone supplements even as a "just in case" measure if you feel that it's something that would give you peace of mind. If you don't feel that you received appropriate care, there are many professionals out there willing to provide it. Huge hugs and I hope that your appointment tomorrow can give you some answers.

[muscari]

I'm so so sorry for your losses. Have no real advice to offer other then to repeat what has been suggested by others before me.. Sorry that you have found your way here but am glad you found us, welcome, and I hope you'll find the support here that you're looking for. ((hugs))

[crazygirl82]

I also sorry for your loss. Big hugs and prayers to you. It my understanding that progesterone and estrogen can only help and are pretty standard for the first ten weeks of any ivf cycle. I was also on baby aspirin to help blood flow to the uterus. Obviously that didn't help me in my pregnancy which leads me to believe mine may have been a chromosomal issue.

I would recommend you see an RE. In my experience OB's don't seem to want to do anything outside of the box. Even if you aren't interested in Ivf or Iui an RE may be willing to help monitor and medicate your pregnancy. They also have much more experience handling tough pregnancy issues.

This last pregnancy I was very disappointed w my OB who told me I was only five weeks along even though my RE and every website I googled said I was 7. I just don't trust OB's like my RE. If I get pregnant again I'm definitely sticking with my RE as long as he'll have me.

Good luck to you! I hope it works out next time.