Beta Update

HCG: 24 and Progesterone: 9.7

Follow up b/w and u/s will be next week. Will continue with Prometrium. I feel like I am still in a wait and watch mode!

IUI # 3 - Progesterone Check

I went to the clinic this morning for my progesterone b/w and just got a call back from the nurse. It is 7.9 (Atleast I know I O'ed since its above 5)! The last two cycles it has been 6 (at 3-4 DPO). I start Prometrium suppository today (4 times a day) untill beta. So what does this mean? Am I doing better than before or it is an insignificant increase? Is it just higher because I had more follicles this time as compared to IUI # 1 & 2? Is there something wrong (quality?) with me (my eggs/follicles) which is leading to the lower numbers, which in turn is also leading to BFNs? How does my progesterone level impact a future IVF? My progesterone levels during beta for IUI # 1 (with Ovidrel) was 6 and for IUI # 2 (with Prometrium) was 9... how much progesterore is required for implantation (I have read anything above 9) and for sustaining a pregnancy? Do I need to increase my dose?

I guess, I need to discuss this with the RE/nurse... or am I just making a big issue out of it!? I just don't feel very positive about this thing! :(

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Update: I guess I was just having a panic attack because I was seeing the same pattern that I have had for the past two failed IUIs. I felt like I knew what the answers were to most of my questions, but just needed some reassurance! Though any new detailed information is always welcome!

I spoke to the nurse later on and she said... progesterone level up from 6 to 7.9 is not a significant change, they like to see a 9; she has seen BFPs for women have had progesterone levels as low as 4-5; progesterone levels do not indicate quality of the egg; Prometrium should help with implantation (if pregnancy occurs), since its still early in the DPO. She encouraged me to discuss this issues with the RE when I meet him next week.

Dr. Google mentioned that progesterone levels can fluctuate from day to day and is not always the best indicator... though the doctors prefer giving you supplement if it appears low. It seems checking progesterone 3-4 DPO is also not the norm... but thats what my RE does!

IUI – Cycle # 2

…And so, day 35 came (of the break cycle) and I decided to go to the RE’s office and get my bw & us done to see what’s going on! Guess what, just like January end/February beginning, my lining was thin and hormones were low enough for it to be considered day 3 (without AF). So here we go… IUI # 2! I was still afraid that my cyst would pop up again and we would have to cancel the cycle. I wasn’t at peace till my day 7 us (which is when they found the big cyst during the previous cancelled cycle). Day 7 arrived and things looked okay. In fact, one of my follicles had already started growing in my right ovary (by day 7 us) and was 12 mm and estrogen was 63 units. That was a quickie as compared to the first IUI cycle! It had taken me almost over 8 days to respond last time. During this cycle, I took 75 IU Follistim for 8 days followed by 150 IU for the next 2 days. I triggered on day 13 (of the so called non AF cycle) using Ovidrel. The “big follicle” kept growing up to 18 mm before I triggered. Only 2 more follicles in my right ovary were around 12 mm before I triggered (none >10 mm in left ovary). I forgot to ask about estrogen on the day of the trigger. I know things can be very different every cycle, but I still asked my RE as to why I had such less follicles… he mentioned that this is normally what they expect (& not the "n" number follicles I had last time). I was ready to deal with all the side effect of Ovidrel (with last IUI cycle experience). But fortunately (?) things were much better this time. Slight tiredness, slight cramping and the rest was smooth sailing. I had mentioned to my nurse about my OHSS like symptoms from last time and had asked if I could take an Ovidrel alternative for my progesterone boost if required. I was told that I could take Prometrium (http://www.drugs.com/pdr/prometrium.html) vaginally if the progesterone was not as per the standard requirement (of 9 units or higher).

IUI (insemination 1 & 2) went well. Sperm count was great and it looked like I had one healthy egg (for sure)! With the (minor?) aches and pains that keep coming with all the medication, I wasn’t very successful in telling if I had ovulated (couldn’t identify ovulation symptoms). 5 Days past first insemination, I went in for my progesterone check… level was 6 units (just like IUI # 1). I was prescribed Prometrium vaginally 4 times a day till my next bw (pregnancy test). So, currently I am at the 2WW!

This progesterone suppositories– Prometrium is supposed to help with implantation (progesterone > 9 units for implantation). It’s very easy! Just that it can be messy. Progesterone from the pill is supposed to be absorbed by the vagina/uterus, though some of the ingredients leak out. (Sorry, if it’s TMI!) A panty liner is a must.

I am hopeful, yet even more cautious this time. I am trying hard to not look up every symptom online… trying harder to not look at online (baby) shopping websites… and trying even harder to not be disappointed, frustrated and bitchy! My ovaries have not cramped much this time, though I have felt some twinges once in a while around my uterine area. I feel a little something in my chest/throat… may be heart burn… I am too scared to call it nausea. My inner thigh (mainly right) feels strained. I am hungry a lot and get tired very easily. Approx 7 days past ovulation (DPO), my cervix is soft & low, and my body feels warm. I think my brain is on an overdrive... it’s probably all the medication! May be the next time I will learn to ignore these new symptoms as well (though I truly hope that this is the lucky cycle)!

My Acupuncture routine is the same as IUI cycle # 1. Twice a week while on Follistim; followed by day before and of the insemination; and once a week during 2ww.