Hi, all... TTCAL doesn't seem as active, so I thought I'd try here.
I just completed a miscarriage (first pregnancy)-- stopped bleeding a couple of days ago... Long story short, baby stopped developing around 6-6.5 weeks, I finally started bleeding at 9+ weeks, passed baby/sac at 10+ weeks and I would be 12 weeks today, if I were still pregnant.
I just came off the pill in November, and the ~3-4 luteal phases I've had have been borderline short (mostly 10-13 days, with one 6-day)-- IF you didn't count the fact that I spotted during them. If you count the day before the first day of spotting as the last day of my LP, then all of mine have been 3-8 days long (!)
My HB MW agreed with me that low progesterone could be an issue, but as she doesn't deal with preconception a whole lot, she asked her consulting OB for his opinion. He got back to her with the following advice-- I should TTC, and then, when I am 5 weeks pregnant LMP (or 3wpo), he will give me a blood test to check for my progesterone surge. If my level is below 15, he will prescribe natural progesterone suppositories through week 10 or so.
Here's what I think I understand, based on my limited research...
-There is minimal risk to taking the natural progesterone in general (my MW agrees with this), and many people with known low progesterone start taking it within a couple of days of ovulation.
-If I start taking it within a few days of ovulation and don't get PG, it could kind of push my cycle out and extend the time it takes me to eventually conceive. I'd basically wait until I was 14-16 dpo and if no BFP, go off the progesterone so I could get AF and start a new cycle.
-This is slightly complicated by the fact that I still have some HCG in my system-- as of today, I'm only getting a faint line when I POAS (when I was PG, it was way dark-- darker than the control line!) Because it can take a while for the HCG to completely clear out, it might be a little questionable when I test this next time.
-OTOH, it's probably "okay" to wait to take progesterone until I'm 5 weeks, as it's my understanding that it's not super-likely, even if I do have low progesterone, that I will miscarry before then (due to low progesterone).
My MW is pretty low-intervention (I have the same philosophy, which is why I chose her!) and she only really has professional relationships with docs who are also low-intervention. So, I feel like I'm looking at two fairly low-risk courses of action, but I need confirmation...
It SEEMS to me (assuming for a moment that I could get someone to prescribe whatever I want) that I am choosing between:
A) Starting progesterone shortly after O, which has some drawbacks, but IF I can get PG right away, is probably the "safest" course of action in terms of preventing miscarriage, as we don't "know" I have low progesterone, but there's a decent chance.
B) Waiting until 5 weeks to test and start progesterone, which probably (?) doesn't present a far higher chance of miscarriage than option A (this is my big question), and certainly, if I test fairly high WRT progesterone, saves me at least 5+ weeks of dealing with yucky suppositories, etc.
I just need some clarifications on the risk of either course. Honestly, I feel like we should be acting as if I have low progesterone, as my history is pretty suggestive of it. I kinda wonder if my MW didn't present it to the OB as if I was only "borderline," and either way, if he doesn't like to hand scripts out like candy (generally a good thing, in my book!), that he might not think of my case as all that dire, as I've "only" had one m/c, YK? So he'd rather wait and see...
My thinking is, I'm 34, my husband is 42, I wouldn't say I'm terrified of having another m/c... but what's one step below abject terror?
What I'm wondering most of all is why people with low progesterone start taking it just after O... is it because, hey, we know they have low progesterone, so why not? "That's the way it's always been done?" Or are there actual studies showing it's a much safer option than waiting a couple of weeks? Because, like I said... If there are no major complications likely to result, I'd rather be treated as if we already know I have low progesterone.
Any help, anecdote, link, etc.-- and any alternatives to these courses of action-- would be GREATLY appreciated!
P.S.-- Although it's not my typical MO, as a third choice, I'm tempted to try an OTC progesterone cream shortly after O, as "insurance," before being tested.