Testing progesterone at CD35 (and only if pregnant)? I thought it was always CD21?

[buko]

Feel free to ignore my other, rambling post on the subject.

Bottom line--

-I have had ~4 cycles after coming off the BCP, with luteal phases of 3-7 days or 10-13 days, depending on whether you count pre-AF spotting.

-I just had a m/c (first and only pregnancy) in which the baby died/stopped growing at ~6 weeks.

-This OB is recommending that I only come in for progesterone testing if A) I get pregnant and when B) I am 5 weeks pregnant (21 dpo or CD35).  If my progesterone is <15, then I get supplements.  This is because "5 weeks is when you have a progesterone surge" and so it's pointless to come in any sooner for testing.

-LITERALLY EVERYTHING I HAVE READ ANYWHERE EVER says I should get tested at CD 21 (7 dpo), and that is when your progesterone surges. 

What am I missing?  Or what is the OB missing?

Please help.  I had been taking the m/c as "in stride" as I possibly could, but I am starting to feel incredibly anxious and desperate.  I am not going through another miscarriage if it's only because some OB had no idea what he was talking about.  (If he really is off on this one, and I am not missing something.)

Thanks. 

[buko]

Hi, again!  I feel soooo much better today, after speaking with my MW yesterday. I told her everything I've read has said to test for progesterone at CD21 (the "surge" day), not "CD35," and she was as awesome about it as I have (or should have) come to expect...

"Well, having a special degree doesn't imbue you with magical powers or anything!  I mean, a doctor can be great, but if he/she only encounters a specific situation once in a blue moon (the consulting OB is great, but he's not a fertility expert), then how does that make him/her so much more knowledgeable than a person who is IN that specific situation, where that thing is such a huge part of her life, and she's giving it such concentrated attention?  You can easily become more of an expert on that specific situation, blah blah..."  Etc., etc.

She was concerned about starting progesterone before I even get a BFP, to which I agreed...  Because if I can't get PG right away, it seems it could mess with my fertility, even just "short-term"-- but while I'm not ancient, at 34, I'm not trying to wait much longer to have my first baby. 

Bottom line, we came to what I think is the perfect middle road-- for me, anyway.  She's going to test me on CD21 (really 7 dpo-- my O comes later than CD14), since that seems to be "the day" to test and get accurate results which can be compared to known results.  If my level is below 15, or maybe if it is even "borderline" (below 20), then we will wait and see if I have a BFP, and THEN give me progesterone suppositories.  Based on my history, I will probably be pretty assured of seeing a clear BFP before CD28 (4w PG), if I am actually PG.  I feel that this is likely early enough to head off problems, particularly because, hey, I got PG once before-- my luteal phase was at least sufficient and progesterone sufficient to carry to ~6w3d before I started spotting (probably coinciding with the fetal demise).  Bottom line-- at this point I am comfortable with the risks of waiting until what will probably be about 3w3-5d to start progesterone, rather than what seems to be about a week earlier (just after O) in a more aggressive protocol.

If my progesterone is really clearly plenty high, then I am willing to wing it and not take any progesterone, bc it is unlikely to make a difference and though fairly low-risk, it can be a PITA.  I am not sure which result I am hoping for, which is weird to say-- I lean towards the obvious: it would be nice if there is nothing wrong with my progesterone levels.  But OTOH, it would make a lot of sense if I did have low progesterone, so there's an odd sort of "comfort" in that, too-- as long as I can overcome the low levels!

I was just in a panic, really, because I had some peace feeling like I either A) couldn't have prevented a miscarriage or at least B) knew what likely caused the m/c and now had a pretty good protocol in place (in my mind) for preventing a future m/c.  But when my MW got back to me with this OB's "test when you're 5 weeks pregnant" stuff, and it didn't jibe with any of my research, that peace started to crumble.  I was terrified of having another miscarriage that might have been preventable, started imagining I'd alienate my MW with my constant contrariness/neediness (and she is such a great MW and there are so few choices for HB MWs around here), and I thought I'd never be able to get someone to test me at CD21, etc...  I just worked myself into a frenzy, because I guess my "holding it together" has been pretty fragile...  YK?  Not that I have not grieved or have been holding my emotions inside, but just in terms of my moving forward, it was predicated on a fairly solid "plan" that seemed to be falling apart.  But I felt worlds better after speaking up for myself and getting additional confirmation that my MW really is that awesome and respectful.