Hormone levels question « Back to Group Discussions

[mymary]

Hi everyone....

Went to the doctor yesterday and wanted to get checked out for some lower pelvic sharp pains.
Lab work and ultrasound done. Freaked out about the ultrasound- reading some stuff about dangers of early ultrasound which I guess is not proven?

Ultrasound could not find anything in uterus or tubes! Hmmmmmm. I'm pregnant but there is nothing there. Bizarre. Ok, seems like should be seeing something already!

Betas are 656 and progesterone levels are 6.7.

Here's the thing, I chart my cycles, temp, etcccc...... LMP was 6/2, we only had sex on the Day 11 and day 15 no protection. I'm pretty sure I ovulated anywhere from day 17 to 19. Temp rise started on day 21 that I charted.

Any ideas, what the heck is going on here? I should be 6 weeks 3 days according to LMP, but with ovulation on day 17 to 19, could put me earlier by what? 4 to 5 days at the most?

Does this seem right? Are the levels low? Wouldn't they have seen something in the uterus? A blip of something? What am I missing here?

She wanted me to start taking promethium, but I think I am just going to see what happens....

ThAnks

[ClumsySugarPlum]

Bizarre! Bumping this to see if anyone has a clue. Let us know when you get your numbers back.

[Tear78]

mymary, I'm sorry you had an unsettling exam! I know that when hcg levels are below a certain level then it's too early to see something by u/s. I would think that by 6 weeks there should be something to see, but I don't know about the timing. It's possible you ovulated later and didn't know it. Do you chart? Are you going to get a follow-up bloodwork to see if the hcg levels are rising? By the way, we had an ultrasound a week with DD and she's healthy and wonderful. I wouldn't worry too much. Keep us posted!

[kalamos23]

At levels of 656, you will not see anything but thickening in the uterus. You will see the sac at about 1500 and the yolk sac at about 2000-2500, iirc. That being said, your progesterone is dangerously low, and could be why your levels are low for dates. I would put you at about 5w5d yesterday because you count ovulation as the day of the temp rise. 656 is low for almost 6 weeks. 

That being said, I would go on the Prometrium (is it pills? if so, insert them vaginally, they are better absorbed that way) and have your levels drawn in a couple of days. If it is a viable pregnancy, the prometrium will help, if it is a loss, it won't stop it. 

((((hugs)))

[mymary]

Ok, so had my new levels tested today, will get the results tomorrow.

Woke up feeling good today, so does that mean its going down hill for me?

Actually, I feel good knowing that I dont know anything if that makes any sense. Somehow it relieves me from the pressure of having to do anything about it. I know God is in control of what happens here and this baby is either gonna make it or not.

Have not filled the prometrium. I do remember my midwife having me take the cream progesterone on the inside of my arm with my first or two pregnancies, because I always spot usually in the first trimester when I am pregnant.

Now, having said that my husband and I just attempted to have sex and I started spotting. It looked like a lot of blood, but when we realized what was happening, I wiped more and it pretty much stopped. This seems a lot like what happens to me when I am about to start my period. When we have sex close to my period, it makes me bleed, so I end up catapulting into my period. TMI, sorry.

So, I dont know what to think now. I have to research the prometrium, and I dont quite understand what the point of taking it is and the side effects....

One, if the baby stopped growing or the pregnancy is not right, will the prometrium change that-no right? Then in fact what IS the point of supplementing with prometrium?

I thought I read somewhere that prometrium had dangers to the baby?

Thanks for all your help.....

[happylemon]

I am so sorry you are dealing with all this. It is stressful. I took Promitrium with my last pregnancy and the baby turned out fine, but do the research to see your comfort level with it. I am still waiting for my numbers to come back, and then the stress of 'interpreting' them... the first trimester is just not fun!

[mymary]

No it's my least favorite compared to the stress of the last days of pregnancy......

[Xerxella]

Alright, I have suffered 2 miscarriages and my feelings are that I just want to know one way or the other. To me the truth is always easier than "false hope." So, I'll tell you what I think, it doesn't look good. Let's go by your temp rise and say you ovulated on cd 20. That would put you at 5 weeks 4 days or 25 days past ovulation. (I think my math is right.)

This chart (which is the most gernerous I've seen) gives the average HCG of 2637 at 24 dpo, but a low of 540.
http://www.advancedfertility.com/earlypre.htm

Betabase.info (http://www.betabase.info/showBasicChart.php?type=Single) is the largest database I know of and it gives an average of 4298 for 25 dpo.

At 5 weeks they should be able to see a sac in the uterus and by 6 weeks they should be able to see a heartbeat (if done by transvaginal ultrasound).

Honestly, all of your numbers are low and that's a bad sign. A good progesterone is above a 9 and the general consensus is that below a 5 is a miscarriage. You are correct in that if this is a loss anyways, taking progesterone won't make any difference. There are studies linking synthetic progesterone with an increase in some minor birth defects (hypospadias). If your HCG numbers were good and the only problem was low progesterone and you were going to miscarry because of the low progesterone alone, than taking the progesterone might save the pregnancy. But, honestly, that doesn't sound like where you are.

What were your numbers for today? In the end the most important thing is the doubling time of 48 hours or better, so hopefully your last HCG was at 1200 or higher. If all your charts are off and you ovulated much later than you thought this could still be a viable pregnancy. Good luck. Please update.

[mymary]

Thanks for all ur help. Got results today of 250 something Hcg, 2.0 progesterone. U were right. Doesnt look good. Wonder if I ever was above 600's? How long have I been dropping? So many questions. Starting spotting after sex yesterday and continued today. Have not even filled one pad, but have had some tiny clots.

My biggest question is how does this work? This is my first miscarriage. I am scared of bleeding heavily while alone with the kids..... Since they never visualized a sac or baby, will it be not as bad or can I still have problems? I do want everyone to tell me the truth, so I know what to expect.

Md was very kind and told me all the statistics and stuff....guess it gives u something to blame it on, right? I'm over 35 and miscarriage and chromosomal rates go up after that age.

The other thing I am struggling with is guilt. This was my fourth pregnancy, and husband and I just got rid of the crib. I was starting to get into really good shape, and honestly was a little upset that my plans were going to be put on hold. I resigned to God that it was absolutely in his hands and still is, but I feel so guilty for thinking even an iota of a bad thought about this baby. My mom says this is normal and I know that I tend to take a little while to accept and embrace my pregnancies. But when I do, you couldn't find a more Attached mom. I still feel bad, but I do feel good that it was so early and helps me to think it never materialized into an actual visual baby. Basically, it's very weird going through this, and brings lots of emotions.

Thanks for listening.

Also, md told me to go to ER if there is heavy bleeding or cramping. How heavy, how bad of cramping? She said I may need a D&C in that case.....any thoughts on this? And what are the bad parts of a D and C. So many questions, so sorry.

Another question, when is it safe to resume sex? After all bleeding has stopped? I checked my cervix, closed and it's like mush, super soft.

[Tear78]

Mymary, I'm so sorry. Please don't blame this on any thoughts that you had. Your thoughts were normal, and there was nothing that you did to cause this! I was told with my mc that heavy bleeding was if I was filling a pad every half hour (or was it hour)? I had heavy bleeding where the blood was dripping steadily into the toilet, and I didn't call my ob, and she was mad at me later. I say if you're in doubt call. I did have a d and c. Most people have no complications and after a d n c they may have some bleeding but mostly it's all over. For me, I had the heavy bleeding above after about three days, which was not normal. However, I still think going with the d and c takes away the agony f waiting for thing to happen n their own. I guess it's a personal choice. I would ask you doc about sex, but definitely wait until all bleeding has stopped. Since its fairly early, it may be like a heavy period, but I dont have experience to know. I'm so sorry, and please lean on us for support and keeps us posted! There's also a loss forum on Mac that is very supportive if that feels more comfortable to you.

[Chapsie]

I have had two miscarriages.  I am so sorry for your loss.  It is such an emotional roller coaster!  

My second loss was early-- about 6 weeks.  U/S only showed a small gestational sac and my hormone levels were similar to yours (HCG in the 500s).  I wound up bleeding like a moderate period for a month.  I was crampy and slightly uncomfortable, but it was ok.  Just hormonal and emotional!  ::HUG::   You should be ok.  I wouldn't worry too much about complications since it doesn't seem like the pregnancy was too advanced.  With this loss, I took cheap dollar store HPTs at regular intervals to see when they would come back negative.  It took a month for the HCG to go down.

If you have heavy bleeding ("filling a pad in an hour or less"), lots of pain, or signs of infection (fever, etc.) call your provider or go to the ER.  Otherwise, surround yourself with people you love and wait it out at home.  God Bless.  

[Xerxella]

I'm so sorry for your loss. There are no right or wrong choices here, just do whatever will help you heal the most. A D&C gives you the opportunity to schedule it and be done. Sometimes the waiting is horrendous. I DID choose to let things progress naturally with my 2 losses. My first was a blighted ovum missed miscarriage, so on the ultrasound it was just a large empty sac. I bled for a while and things picked up and I passed the placenta pieces and then things got better. Truthfully, I just put a TV show on for the kids and went to the bathroom and managed everything. It was like a mini birth.

With my 2nd loss, it was earlier (7 weeks) and nothing was seen on the u/s. It was more like a heavy period that lasted for 2 weeks. Blech.

Please take care of yourself during this time. Please know that nothing you did had any impact on the events.

[mymary]

Any ideas on what I can eat or take to counter the blood loss?

Thanks

[Chapsie]

Floradix iron and herbs is a great liquid iron supplement that is very easy on your gut (no constipation and very effectively absorbed). You can buy it on Amazon.com. I love the stuff, it is so effective.

My first miscarriage (@12 weeks), I hemorrhaged and lost half my blood volume. Even after 4 units of blood, I was anemic. I finished one bottle of floradix (a month's supply) and my hemoglobin went up 3 points!!! (from 11 to 13.3!). Amazing!

Black strap molasses is also supposed to help, but it tastes gross, haha. Some say floradix tastes bad, but I actually really liked it. My midwife jokes that you love the taste if your body needs it and you think it tastes bad when you don't need it anymore.

Good luck and God bless! Let every feeling flow and be gentle with yourself.

[jodieanneanton]

So sorry for your loss, mymary.  A miscarriage is one of the worst things a woman can go through.  ((HUGS))