Low Early Pregnancy 'Hormone' Levels: hCG and Progesterone
Saturday, December 22, 2007
Kenneth F. Trofatter, Jr., MD, PhD
• At Thu Dec 20, 03:24:00 PM 2007, siniamejia said…
I am approximately 5 weeks pregnant, and had my levels of hCG checked (because I was bleeding). My doctor said my levels were really low and also my progesterone levels were low and that it looks as if this pregnancy will not turn out to be healthy. My levels were 114 Saturday and only 145 today (5 days later). He says that I should have a D&C but I refused, so he told me that I will miscarry or should. I am so upset right now because I do not want to be the one to make the decision to have that done. I feel like maybe there still is hope and maybe a couple of days from now the bleeding will stop and the numbers will increase. I am still praying and I still have hope that my baby could still make it, but my doctor really doesn’t think so. I am so hurt, I never even imagined this. I have a 8 year old son and a 5 year old daughter, which were both high risk pregnancies. My son was born at 24 weeks and weighed 1 pound at birth. He is completely healthy and normal. With my daughter, I had early contractions the whole pregnancy, not to mention that I couldn’t hold food down and needed an IV everyday in the hospital. Could this mean that my husband and I can’t have anymore children. I am still young and I lost a lot of weight. I exercise and maintain a healthy life, why could this be happening to me? It’s so painful, emotionally. Please help. Thanks.
• At Fri Dec 21, 05:54:00 AM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…
To siniamejia Dec 20: There is always hope, but I am afraid your doctor is correct in telling you this pregnancy will not make it. Your hormone levels are not only low, they have not risen appropriately. You have had two other children, and even if those pregnancies were complicated, that probably has nothing to do with what is going on with this pregnancy. The most common cause of an isolated miscarriage in a woman who has previously had successful pregnancies is a chromosomally abnormal baby. Fifteen to 20% of all pregnancies miscarry and MOST of those are babies that are not chromosomally normal. It is still your baby, and I know you will be sad and you will go through wondering about what "could I have done to prevent this and what could have been", but this is certainly no reason to think that you cannot ever have another baby.
With regard to a D&C, as long as you are not bleeding heavily or have any evidence of infection, you are not in any danger and don't need to do anything else at this time. Waiting is just fine under these circumstances. My only other concern is with your history of weight loss and hyperemesis with your last pregnancy. Some women who lose an excess amount of weight (and I do not know if that is true in your case) will become nutritionally depleted and/or hormonally ‘imbalanced’ and not ovulate regularly. This could also deleteriously impact your pregnancy success but if you are having regular cyclic periods, then this is not likely to be the issue in your case. My best wishes to you and thanks for reading.
Dr T
• At Thu Dec 20, 10:58:00 AM 2007, Anonymous said…
Hi, my wife just miscarried our 7 week old baby. Her hCG levels were about 2,000 at that time. The doctors said that her levels were pretty low when we did the first the pregnancy test two weeks ago. My question is could we have been able to prevent this miscarriage if they placed her on progesterone supplements early on in the pregnancy? Could there have been anything we could have done to prevent this miscarriage?
• At Fri Dec 21, 06:00:00 AM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…
To Anonymous Dec 20: Progesterone probably would not have helped at the point it was found to be “low” and may actually have been contraindicated. If you have had other children, the most likely reason for the miscarriage is that the baby was chromosomally abnormal. Most of those babies are lost in first trimester. If this was a first pregnancy, or if your wife has any other medical problems, there may be other explanations - usually hormonal or immunologic in nature. I am sorry for your loss, but this is one situation in which you should not kick yourselves for having done anything 'wrong.' Miscarriage is always sad - wondering what was, what could have been, and what could we have done different, but if there are no underlying medical conditions to have contributed to the miscarriage, then the odds are you will be successful in the future. My thoughts and best wishes are with you. Thanks for reading!
Dr T
*******
As a focus for further discussion related to these queries, let’s start with progesterone. Following ovulation, what’s left of the follicle (the corpus luteum) begins to make the hormone progesterone that helps to prepare (decidualize) the lining of the uterus (the endometrium) to receive the fertilized egg, aiding attachment and implantation of the early embryo. With implantation, the fetal trophoblast cells start producing the hormone hCG that sends a ‘message’ back to the corpus luteum to ‘stay healthy and keep making progesterone.’ Production of progesterone by the corpus luteum is necessary to support the development of the placenta during the first 7-8 weeks of the pregnancy. After that point under normal circumstances, the placenta itself takes over progesterone production at a level sufficient to maintain the pregnancy.
Decreased progesterone production following ovulation or inadequate production of hCG or placental progesterone has been found to accompany pregnancy abnormalities that result in miscarriage. Defective production of these hormones may precede by weeks the identification or loss of an abnormal pregnancy (Hahlin, et al., Hum Reprod 1990;5:622–626) or ectopic (tubal) pregnancy (Yeko, et al., Fertil Steril 1987;48:1048–1050; Ledger, et al., Hum Reprod 1994;9:157–160). Indeed, there is good evidence to suggest that serum progesterone measured in early pregnancy is the most reliable single predictor of pregnancy outcome in natural conceptions (Al-Sebai, et al., Br J Obstet Gynaecol 1995;102:364–369; Daily, et al., Am J Obstet Gynecol 1994;171:380–383) even in the absence of a pregnancy detected by ultrasound (Elson, et al., Utrasound Obstet Gynecol 2003;21:57–61). Ioannides and colleagues (Human Reprod 2005;20:741-6) demonstrated that even in IVF pregnancies supplemented with progesterone, a single serum progesterone on day 14 post-oocyte retrieval and fertilization (4 weeks gestation), could “highly (but not completely) differentiate between normal and abnormal pregnancies.” Women with viable intrauterine pregnancies “had significantly higher serum progesterone levels (median: 430, 95%CI: 390–500 nmol/l) compared to those who had either an abnormal pregnancy (72, 48–96 nmol/l; P<0.001) or failed to conceive (33, 28–37 nmol/l; P<0.001).” It is interesting to point out that as the result of their findings, they hypothesized “that endogenous progesterone is already sufficient in viable pregnancies and that exogenous progesterone administration will not rescue a pregnancy destined to result in a miscarriage.”
Although progesterone is highly effective at differentiating normal from abnormal pregnancies, it is still not routinely used at most institutions for this purpose because of the expense, inexperience of provider interpretation, and the more widespread availability and high reliability of quantitative hCG testing. hCG can usually be detected by routine blood assays within 10-11 days following conception (7-8 days by highly sensitive assays) and in the urine at 12-14 days (just preceding or coincident with the time of expected menstruation). Serial quantitative blood testing of hCG is a useful approach to evaluation of early intrauterine pregnancy viability and ectopic pregnancies. In 80-90% of normal pregnancies, hCG levels will double every 48-72 hours, peak at 8-11 weeks gestation and then fall off to a stable lower level for the rest of the pregnancy.
If hCG levels are low for a calculated gestational age, this can indicate a nonviable or ectopic pregnancy. However, it is generally recommended that decisions regarding viability not be made by a single hCG level alone. It could be low simply because the pregnancy is not quite as far along as expected (e.g., in circumstances when women ovulate later in their cycles than expected or are not “sure” of their last menstrual period) or as the result of normal variation in hCG levels in different women and different pregnancies. More ominous are situations in which the hCG is not rising appropriately over time.
However, at low levels of hCG, the woman is rarely in immediate danger, even if she has an ectopic pregnancy, so the prudent approach in situations in which the pregnancy is desired is to simply wait, repeat the hCG levels periodically, every 2-3 days, and perform an ultrasound to look for evidence of an intrauterine pregnancy when the hCG level is at the point where that becomes possible. Usually a gestational sac can be seen within the uterine cavity between 4 and 5 weeks and when the hCG is in the range of 1000-2000 mIU/mL. By 6 weeks, a ‘fetal pole’ is usually visible and the hCG is > 5000 mIU/mL; and by 7 weeks, fetal cardiac activity is readily detectable and the hCG is > 20,000. I can relate many personal experiences with patients who started out with an unexpectedly low hCG that went on to have normal, healthy pregnancies, so patience is a virtue under these circumstances.
Labels: early miscarriage, hCG, progesterone
332 Comments:
At Sat Dec 29, 08:11:00 AM 2007,
Anonymous said…
Dear Dr Trofatter,
Thank you very much for your informative and sensitive blog. Might I seek your opinion on my situation?
I am 24 years old. In the last year I have had a missed miscarriage (9 weeks) and two early miscarriages (5 weeks). No previous successful pregnancies. My clotting blood tests, taken just after the 2nd miscarriage, were normal. We are awaiting the peripheral blood karyotyping results. Thyroid function and CD3 / CD21 bloods normal. Laparoscopy excision of stage 1 endometriosis from the uterosacral ligaments; some endo left on bowel. HSG shows both tubes clear. Hysteroscopy and ultrasound confirm no structural uterine abnormalities.
We are terrified that we will never have a successful pregnancy. Aged only 24, this is an especially unexpected outcome to face. Consequently, I have two questions:
In your opinion, do I have a chance of achieving a successful pregnancy?
During my next pregnancy, what kind of prophylactic protocol might be considered? I live in the UK and there is basically no provision for the treatment of RPL. However my husband is a General Practitioner and his colleagues are willing to prescribe and help in any way they can e.g. with heparin, progesterone, prednisone and such.
Many thanks for your time and in anticipation of your response.
Liz Evans (United Kingdom)
At Sun Dec 30, 10:24:00 AM 2007,
Anonymous said…
When I was pregnant with my son, who is now 19 months old I had several problems and was not provided with any answers. I recently had a miscarriage at about 6 weeks so I am growing increasingly concerned about the causes. The complications were as follows. I had the quad test done and was told I had a 40% chance of having a baby with downs--I opted to have an amnio done and that ruled out any chromosomal abnormalities--I was never told which levels were off. Then at about 26 weeks I went into premature labor and was told my placenta was beginning to calcify. I was able to hold on with the help of medication until 37 weeks. During the course of the pregnancy I had biweekly ultrasounds due to the lack of fetal movement. My son was 5 lbs. when born. I was never given any answers and I am starting to become increasingly concerned that I will not be able carry another pregnancy full term. I am just hoping you can provide any insight into my situation. Thank you!!!
At Fri Jan 04, 06:20:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Liz Dec 29: Thank you so much for writing Liz. At your age, do not panic. The overwheming odds are that you will achieve a successful pregnancy. The reproductive endocrinologists with which I work firmly believe that endometriosis contributes more to recurrent early pregnancy loss than most practitioners realize, so that may or may not be the problem in your case. Your doctors might consider 6 months of Lupron therapy to shut your ovaries down and help shrink the endometriosis and/o ovulation induction with letrazol (an aromatase inhibitor.) Another alternative is to simply begin, as empiric therapy, taking a baby aspirin (81 mg) daily with supplemental folic acid, using progesterone support starting in the second half of the cycle (even before confirming a pregnancy) and starting heparin as soon as a pregnancy is confirmed. If that gets you through first trimester, you can stop the progesterone at that point and probably stop the heparin by 20 weeks. These are just some thoughts. Good luck to you!
Dr T
At Sun Jan 06, 06:23:00 PM 2008,
purrpplee said…
I have PCOS, Anti Cardiolipin Antibodies, Anti Thyroid Antibodies, and MTHFR.
We have been TTC for 2 years. I suffer from early miscarriage and I am currently going through my second one.
The first baby was conceived on Clomed and then when we lost that baby we started IVF treatment in the hopes that it would be the answer to the issues.
The second try was right after my IVF egg retrieval and they put 2 embryos in. I had taken an HCG injection for the retrieval so I couldn't do a pregnancy test for 2 weeks. I never really knew if I was pregnant because 2 weeks is all I need to conceive and miscarry and after the 2 weeks the test came out negative.
The third try they put 2 more embryos in and I didn't have to take HCG since it was a FET so the pregnancy test came back positive in 8 days. I am loosing this pregnancy as well 12/28 was day 8. The HCG was 107 on 1/2 and 74 on 1/4.
The pregnancy tests always come back positive with in 8 days and then by the 12th day my HCG levels are diminishing. I don't get it. I am on Lovenox, Foltx, PNV, Baby Aspirin, progesterone in oil shots, estrogen and synthroid.
I have 2 large bio hazard boxes with all of the needles I have been stuck with in addition to all of the bruises on my stomach and butt. I am tired of being told it is the baby when only 1 out of every 3 babies has a genetic defect that causes early term miscarriage. I have had 5 babies in me and all of them have died! There must be something missing from my treatment plan. I have 6 more frozen embryos and I don't want to put them in me if they are just going to die. Please help. Jaime
At Mon Jan 07, 03:31:00 AM 2008,
archie said…
Dear Dr Trofatter, I cannot thank you enough for your extremely informative blog. It would be great if you could give your opinion regarding my condition: I am 27 years old, with a history of irregular periods. However around the 29th of december i had some spotting. Doing a home pregnancy reflected a negative result after which i met my docter who prescribed progesterone tablets to be taken thrice a day for 5 days.she said it could be to early to say anything, so after five days of medication i started bleeding but its been very light and I also have cramps. Wat would you suggest the best thing for me to do? Is something wrong with me.
At Mon Jan 07, 11:15:00 PM 2008,
Kirdler said…
Hi Dr T,
Thanks for providing a great Blog. Here's my story:
I first got pregnant in Dec 06 only to discover in Feb 07 that I'd had a complete Molar pregnancy. Unfortunately even after 2 D&Cs my hCG kept rising (it was around 500,000 at one stage) and I began IM shots of Methotrexate which lasted for 4 months. I was finally given the all clear in May 07 and told to wait 6 months before trying again. In November 07, I took a faint positive home test and went to the Dr. My hormones never went above 35 before starting to drop again, and I had a couple of days of very light bleeding. We were advised to wait until my hormones returned to normal, especially given my history - however my husband and I decided to take the risk and leave it to the gods that be. My hCG went from 35 to 30 to 22 to 12 each week and then rose up to 59. I was quietly excited as I assumed I was pregnant once again, before I had even menstrated from the last miscarriage. 3 days later they were 116 and nearly 4 days after that they were only 216. One full week later they are at 817 and my ultrasound today showed nothing but a very tiny 3mm 'something' in my uterine lining. There was no sign of an ectopic pregnancy either. I would expect to be at 6 weeks pregnant at the very least so this does not seem normal - but what could be happening?
I have an appointment with my Oncologist/Gyn tomorrow who is looking after me given my Molar history. I expect I will need more blood tests over the coming weeks before we really know what is going on.
Any thoughts?
At Thu Jan 10, 09:17:00 PM 2008,
Anonymous said…
Dear Doc,
I am so relieved after reading your blog. I had a USG at 7.2 weeks. Baby was perfectly normal with a good heartbeat of 154 bpm but my doctor told me about my deficient corpus luteum and put me on Susten 200 once daily for upto 14 weeks of pregnancy. SO i was really worried about the future of my pregnancy. But after reading your blog, i am really relieved as now i know that it might have started shriking in the 6th week itself. Thanks a lot. Doctor, can you please tell me what are my chances of continuing because of defficient corpus luteum.This is my 9th week of first pregnancy.I am 25 yrs old.
At Sun Jan 13, 08:18:00 AM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Purppllee Jan 6: I understand your frustration and what you have had to go through. You have lost all of these pregnancies VERY early. This suggests that there is something that something is going on that is very unfavorable to even early implantation. You could have endometriosis or some structural abnormality of the uterine cavity that is contributing to this. If you haven't had hysteroscopy done within the past year, that can be considered a place to start. If you have not been placed on metformin, that is another place to start. The REI folks I work with have found that aromatase inhibitors (letrozole) to induce ovulation(sometimes used after 4-6 months of ovulatory suppression with Lupron) can up-regulate key receptors in the endometrium and increase your chances for a successful implantation. If that failed, you might consider one of the older methods for modulating the immune response to pregnancy, prednisone therapy, white blood cell transfusions or IVIg therapy. Discuss those options with your doctors. Of course, you might actually be one of those rare cases where there is a 'genetic' incompatibility with your partner and pregnancy will not be successful. I would probably try some of the other things listed above, however, because of your PCOS, before I considered donor sperm. BTW, I am presuming you and your husband have had chromosome studies done? Best of luck to you. I know this has been rough. Dr T
At Sun Jan 13, 08:24:00 AM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Archie Jan 7: It sounds like you arre miscarrying a very early pregnancy. If you have irregular periods, there IS something wrong with you, but that is not usually something that cannot be overcome with treatment. Irregularity of menstrual cycles can put the time of fertilization out of synchrony with the 'preparation' of the endometrium (the lining of the uterus) to receive a fertilized egg. If there is a 'hormonal imbalance', that can also affect endometrial receptivity. You should probably have your doctor look for simple causes of ovulatory dysfunction, such as thyroid conditions, PCOS, elevated prolactin levels, etc. as a place to start prior to conceiving again. Thank you for reading and best wiishes to you in the future. Dr T
At Sun Jan 13, 08:28:00 AM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Kirdler Jan 7: It could be an early (but probably not normal, unfortunately) intrauterine or ectopic pregnancy. My greater concern, and I am sure that will be the concern of your oncologists, is that this is a return of your choriocarcinoma (hopefully NOT). If no pregnancy is seen by the time the hCG is in the range of 2000-5000, they will probably recommend restarting your chemotherapy. I really hope that is not the case. Thanks for reading, your questions, and the kind words. Dr T
At Sun Jan 13, 08:31:00 AM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Anonymous Jan 10: eyond 9 weeks, the corpus luteum contributed very little to support of the pregnancy because the placenta should be large enough to take over that function. The success of your pregnancy from that point on will depend on whether or not the placenta has implanted and grows properly. Sounds like you are well on your way to a successful pregnancy, so best wishes and thanks for reading. Let us know how things turn out! Dr T
At Sun Jan 13, 08:14:00 PM 2008,
Anonymous said…
Dr. T.,
I am writing to see if you have any suggestions that my RE might not have mentioned.
Here is my history: 2/3/05 I had a healthy baby girl via c-section with no complications during pregnancy, 1/06 I had a misscarriage at 9 weeks and no chromosomal abnormalities were found with the fetus, 10/06 I had a miscarriage at 5 weeks and no fetal tissue testing was done bc it was so early, 8/07 I had a miscarriage at 11 weeks and no chromosomal abnormalities were found with the fetus. I have had chromosomal testing done on myself which came back normal. I have also had my prolactin, TSH, cardiolipin, and lupus anticoagulant tested and they all came back normal. I have also had a hysterosalpingogram (sp?)done and that showed nothing abnormal with the uterus and both my tubes were open.
I suspect that something is not allowing my pregnancies to form correctly, altho it has been proven that it is NOT due to a chromosomal abnormality. They have been able to tell at each of my miscarried pregnancies that something was wrong when they did the first ultrasound at 8 weeks. My RE also does not think that progesterone levels are the cause either.
Do you have any thoughts on what is causing my miscarriages or any more tests that I should have done?
Thank you for your response.
Robin
At Sun Jan 13, 11:54:00 PM 2008,
Anonymous said…
Dear Doctor,
Anonymous here again. Thank you so much for your reply. I had USG again today. The baby is perfectly fine with a good heartbeart of 169 bpm and 22 mm CRL at 9W1D. Also, they have found corpus luteum of 2*2 cm in my right ovary though it may not be needed now. So i am really happy now.I can't thank you enough for relieveing me in my tough time:)
At Tue Jan 15, 10:32:00 AM 2008,
coupleinlove said…
Dear Doctor T,
My wife is 41 years old and has had miscarriages (3) in the past. The last pregnancy went to 12 weeks and the baby's heart stopped beating. A D&C was ordered. We are currently overjoyed at being pregnant again. However during her second blood test to check Hcg levels, were told that it had only risen from 4600 to 4700. We are in week 7 day 1. We are doing are best to keep positive but with past history this is very difficult. She has another blood test scheduled for next week and we will see the Dr at that time as well. We are absolutely afraid of losing our baby. Is there any information you can offer concerning her age and level of Hcg and its meaning if any.
Thank you so Much for your time.
Jesse and Rosie
At Tue Jan 15, 11:35:00 PM 2008,
Kirdler said…
Hi Dr T,
Well low and behold following my nervous last post regarding my low hCG levels and possible returned choriocarcinoma, my hCG levels have gone from 817 to 5000 and now to 22,700 in just over 1 week and my scan today has revealed an intrauterine pregnancy dated at 5 weeks 5 days. We didn’t see a heartbeat (which of course would have been nice) but there was a gestational sac with volume 0.7ml, containing a yolk sac and possible early fetal pole (the previous ultrasound also showed a smaller gestational sac of only 0.1cc 4 days earlier).
I just wanted to update you on my news as the excitement is slowly creeping in as I allow myself to think that I may have finally achieved a successful pregnancy. I know I still have the usual risks of miscarriage however ectopic and molar pregnancies have been ruled out, so my Oncologist is happy to refer me back to my Obstetrician for regular follow-up in 2 weeks time. There’s nothing much more we can do now other than wait!
Thanks for listening - I hope to report back with more good news in the coming months!
At Wed Jan 16, 07:22:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Robin Jan 13: I am not sure Robin. Is the father of your child the same as that of the pregnancies you've lost? Do you have any other medical problems? Did you go to the RE because of your losses or was he/she treating you for other causes of 'infertility.' Do you have regular periods? Have they tried any kind of empiric therapy to date to help you get through first trimester, e.g., aspirin, heparin, folic acid, metformin. Our RE folks firmly believe that subclinical endometriosis is a more common cause of early pregancy loss than has been previously recognized. They will oftern try 'ovulation induction' with letrazol as a form of 'empiric therapy', or a six month course of Lupron to suppress ovulation (and presumably endometriosis) followed by letrazol. I wish I could be of more help right now, but if any of that sounds good, ask your doctor about these options. Best wishes! Dr T
At Wed Jan 16, 07:23:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Anonymous Jan 13. Glad to hear it Girl! Let us know how things turn out. Best wishes. Dr T
At Wed Jan 16, 07:26:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Jesse and Rosie Jan 15: I am afraid that would be a rather low hCG for 7 weeks and I am especially concerned by the lack of normal increase. I think you =r doctor could answer the question with an ultrasound at this time ratehr than more blood tests. I hope I am wrong and best wishes to you both. Dr T
At Wed Jan 16, 07:29:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Kirdler Jan 15: Thanks for letting us know the good news. Sounds like you've successfully 'dodged a bullet' (at least more methotrexate!). Let us know how things turn out. I will be waiting to hear back from you! Dr T
At Thu Jan 17, 08:02:00 AM 2008,
Anonymous said…
Dr. T.,
Hi, it's Robin (Jan 13) again! I just wanted to respond to some of the follow up questions you had for me on Jan 16.
Yes, the father of the babies is the same person for all of my pregnancies. No, I do not have any medical problems. I was referred to an RE because of my 3 consecutive miscarriages, not for infertility. I have regular menstrual cycles, ranging from 29-32 days in length and ovulating every cycle between days 14-16. The only time I have every gone over 32 days was because I was pregnant!
Here is an important update to my situation since I last wrote you...I am pregnant again! I am currently 5 weeks along. This will be my 5th pregnancy including my one surviving daughter. The only thing the RE has put me on is progesterone suppositories. They have also been monitoring my HCG levels which have been doubling every 2 days like they are supposed to, so that is a good sign. However, when they measured my HCG levels with my last pregnancy they were at 22,000 at 9 weeks and there was no viable pregnancy and I subsequently had a D&C. So, I will not feel comfortable with this current pregnancy until the first ultrasound, which will take place in 2 weeks.
I just wanted to update you on my new pregnancy but I am still interested in finding out your opinion about my situation. My doctors have never mentioned endometriosis to me. How is it diagnosed? Would they have been able to see it on the ultrasound or hysterosalpingogram that I had?
Also, my RE has not mentioned putting me on aspirin. Would it be beneficial to talk to my RE about taking that now even though I am already 5 weeks pregnant?
Also, what would the purpose be of taking letrazol for ovulation induction since I already ovulate regularly on my own?
Thank you for your response and I will be sure to update you with the results of my ultrasound in two weeks. Fingers crossed!
Robin (Jan 13)
At Thu Jan 17, 11:46:00 AM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Robin Jan 17: Well, congratulations, that IS good news. For the time being, just ask your doctor if it's okay to take the aspirin. I will answer your other questions if this pregnancy doesn't work out! Hopefully, I won't have to! Best of luck to you. I have my fingers crossed too, so let us know what happens! Dr T
At Thu Jan 24, 05:02:00 PM 2008,
Anonymous said…
I am also have a question on this topic. I am 39, have tried for almost 4 years to get pregnant with my husband with no + until now. We went to 2 RE's, did several rounds of clomid and IUIs. All the testing came back normal except for a slightly lower sperm count - so unexplained infertility. Because of our lack of pregnancy, our last RE gave us a 1% chance of getting pregnant on our own and suggested IVF with doner eggs. I have 2 children ages 11 and 13 with my previous husband (no problems conceiving and only pre-eclampsia with the first) and an 18 yr old stepdaughter who live with us. We decided IVF wasn't for us. However, I did a pregnancy test a around the 14th of Jan after a few days late, got a positive, made an appointment with the doc and got in on Tues. They did an vaginal ultrasound and saw nothing - so they said it could just be too early, did a pap, and then took my blood for a HCG test and progesterone test. My results yesterday on the HCG were 582 and my progesterone was at 3.2. They prescribed 1 200 mg prometrium pill by mouth every night before bed. I started the progesterone last night. I went in today to do the second blood tests and they won't be in until tomorrow. However, earlier this afternoon was the first time I ever spotted in or outside a pregnancy and was really scared (although haven't had cramping and the spotting has stopped). When I called the doc, I was told most likely I would miscarry. Just wondering what the odds are of miscarrying and if so, what our chances are to have a child in the future without IVF? (assuming now I must need progesterone to sustain a pregnancy) I thought we had hit the jackpot with this 1% pregnancy, but crushed that I am not really given any hope for now or the future with this latest news. I asked if I should take a progesterone pill in the evening and morning, but was told no, they didn't think it would help. Do you think it would help now and if I do miscarry, what tests should I get or when should I take progesterone after we start trying again - 21 days from LMP? (I am really regular with 26-29 day cycles). Is there anything else that might help or I should try?
Thanks for any help you can give! It is really appreciated.
Trisha
At Fri Jan 25, 11:36:00 AM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Trisha: Right now I would have no other sugegstions. The hCG level was appropriate and I would not have expected to see a pregnancy at that level of hCG. he spooting does NOT mean you are going to have a miscarriage at this point. many women will have 'implantation' bleeding early in pregnancy. So, take a deep breath, continue the progesterone, and what happens will happen. Why don't we hold on your other questions until we see how this pregnancy turns out. I wish you the best of luck! Dr T
At Sat Jan 26, 03:19:00 PM 2008,
Anonymous said…
Thanks again for your help. Two days later the results were 728 HCG and 4.3 progesterone and today 726 HCG - so it for sure is a miscarriage. The doc wants me to come in on Monday to discuss DnC unless I miscarry before then. Hopefully we will hit the 1% chance the last RE gave us again.
Thanks again, Trisha
At Sun Jan 27, 07:29:00 PM 2008,
Anonymous said…
Hello Dr T:
First I have to say this is one of the few web sites I have found that actually gives some sort of hope, here is my story, I have a very healthy 7 year old girl, who I concived with no problem at all, but bleed right threw the pregnancy(didn't even know I was pregnant for three months), then Jan of last year found out I was pregnant again, but lost the baby only 2 weeks later, had a D&C and everything was fine, well we "tried" every month for the year and then Dec 23 I found out I was pregnant again, I had an HCG at 8w4d and my level was 151 thousand, had an u/s and the tech said she saw the babie and there was a good heartbeat, but did not tell me what it was, my question for you is with my level like that and seeing the heartbeat, is the risk of miscariagge less?
At Mon Jan 28, 06:03:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Trisha Jan 26: I am sorry Trisha. Let us know how things finally turn out. Dr T
At Mon Jan 28, 06:05:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Anonymous Jan 27: With a normal hCG, a normal size baby, and a heart beat, you are well on your way to a successful pregnancy. Chance of loss from this point on is probably only about 1%. Congratulations and let us know how things turn out. Dr T
At Tue Jan 29, 06:04:00 AM 2008,
shreya said…
Dear Dr.Trofatter,
I am 25 yrs old. Right now iam i my 6W4D. I did the urine test and it came negative. When i did a blood test i got a HCG of 185. Dr sait it is very low. She wrote a scan on coming saturday. Is my pregnancy at risk. This is my first pregnancy.
At Tue Jan 29, 05:48:00 PM 2008,
Anonymous said…
After 2 days of really bad cramping and spotting, I had a doc appt today and they first did an ultrasound and couldn't find a sac or remains anywhere. She also examined my cervix and found it closed. The Doc recommended a D&C since they still weren't sure if it was ectopic or not. When I got to the outpatient sugery today, they checked the HCG levels and they were 364. I am now on Ibuprofin (pain) and methergine (to shrink the uterus). After resting for the last 5 hours since getting home, physically I feel much better, emotionally I am still a wreck. I am hoping this random crying stops soon. I have a follow up apt with my doc next week and the following week. She is recommending another RE and said to not bother waiting any time to try again. Our first RE was wonderful, then we moved a little over a year ago found another that wasn't. After one visit with the one in the town we moved to, we had completely given up. Looking forward to talking with this RE and if we aren't able to get pregnant again, then we have given it one last shot. If we ever get pregnant again, I will be sure to comment again and until then, really appreciate all the information you give. Thank you,
Trisha
At Tue Jan 29, 07:53:00 PM 2008,
Anonymous said…
Hi Dr. T!
It is Robin again. I had my 6 week ultrasound today and I just wanted to give you an update on how this pregnancy is going...
The RE saw a gestational sac but had a really hard time seeing if there was an embryo inside of it. Once in a while he thought he saw a flutter which could be the embryo's heartbeat, but it was so faint he said it could also just be from me breathing/moving.
He wants me to go for yet another blood test tomorrow just to make sure my hormone levels have not dropped or stayed the same (which would be a sign of miscarriage). The RE said he could just be having trouble seeing the embryo on the ultrasound because I am not very far along yet so he wants to give it another week to form. So, I have an appt for a repeat ultrasound on Monday and hopefully he will be able to see things a bit better or at least tell if this pregnancy is viable or not.
So, once again it is just another waiting game. This is so frustrating! Please continue to keep your fingers crossed!
I will be sure to update you after Monday's ultrasound.
Thanks,
Robin
At Wed Jan 30, 07:11:00 AM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Shreya Jan 29: Yes, the hCG is very low, but there is always the possibility that you rare not quite as far along as you thought either. That's what I am hoping at this point. Firts pregnancies are at greater risk for miscarriage, but keep you chin up and let us know what you find out. Thanks for reading. Dr T
At Wed Jan 30, 06:07:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Robin Jan 29: All fingers and toes are crossed. You should have your answer in a week. Keep your chin up, Girl! Dr T
At Thu Jan 31, 04:17:00 PM 2008,
Anonymous said…
I am 7weeks 6days and my levels tripled for first week or so and then stopped. Have only gone up by 1000 in 3 weeks.
So was told to expect m/c 3 weeks ago, but with only a little spotting went back to doc to schedule D & C and scan showed pregnancy with heartbeat of 156 normal growth and size. Said only thing that looks wrong is the sac around the baby only measured 6w1d.
Have not had HCG levels done for a week so not sure what happening...
My doc said he is surprised with HCG levels only around 4000 that baby developed at all. He also said that corpus cyst thing looks healthy.
So I have had a little brown discharge and some bleeding after scans but nothing even near a normal period. Not enough enough to fill a pad in a whole day.
What do you think?
At Sat Feb 02, 05:10:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Anonymous Jan 31: Odd sequence of events. I am wondering if you were not quite as far along as expected and actually started off with a twin pregnancy and subsequently lost one of the babies very early. We frequently see 'vanishing twins' early in pregnancy. Anyway, I certainly wouldn't do anything more right now other than wait to see what happens. So, let us know what does! Dr T
At Mon Feb 04, 09:47:00 PM 2008,
Anonymous said…
Hi Dr. T., it's Robin (Jan 13) again!
Here is an update to my situation...
I had my follow-up ultrasound today and it was not good news. The RE stated that I have a blighted ovum, the gestational sac formed but the baby never really formed (although he thinks he did see a little fetal tissue on the ultrasound). I have stopped the progesterone and am waiting a week to see if I start to miscarry on my own. If I don't I will have to decide if I want to take the medication to help me miscarry or if I want to go in for a D and C. I have done both of those things before with previous miscarriages and they were both fine, so I am not sure which one I will choose this time.
The doctor stated that most blighted ovums are caused by a random genetic abnormality. So, here is my question to you...given my history of 3 consecutive miscarriages before this current one, do you think this one (#4) is due to a genetic abnormality or do you suspect something else? 2 of my previous miscarriages were tested and no genetic abnormalities were found. They will also be doing testing on this miscarriage as soon as it occurs.
In the meantime, thank you for all your comments and I will be sure to let you know about the genetic results on the fetal tissue as soon as I receive them.
Thanks,
Robin (Jan 13)
At Sat Feb 09, 10:00:00 AM 2008,
Anonymous said…
Dr Trofatter - I am a 29-year-old, type 2 diabetic. My last A1C draw 6 weeks ago was an astounding 8.9 (highest ever for me), but for the past 4 weeks, my glucose levels are at an all-time low: almost completely normal. I am 4 weeks and 3 days pregnanct; my progesterone level is only 8.7. I have one healthy daughter, but that pregnancy was followed by 2 miscarriages. One we don't know what happened with the first, and the other was a confirmed blighted ovum. My nurse midwife fears that I am facing another BO and assumes that my first m/c was a BO as well. I've all but lost hope here and am fearful to fact a 3rd loss. Is there any hope? Am I experiencing BO's because of my diabetes? Is progesterone therapy a waste of energy?
At Sun Feb 10, 07:16:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Robin Feb 4: I am sorry Robin. From what you have told me, it does not appear the babies have had chromosomal abnormalities, but they could still have been lost for 'genetic reasons' if you and your partner happen to share heterozygous (each of you having one normal gene and one abnormal gene) 'autosomal recessives' (one dose from him and one dose from you causing the baby to have a lethal combination or 'homozygous' (both bad genes) problem. I do NOT believe that that is a common cause of recurrent miscarriage, although it does occur in some couples. In your case, I would be much more inclined to proceed with some 'full court press' empiric therapy (see my post in April of last year on this subject), including ovulation induction with progesterone support, even if your cycles are fairly regular. Best wishes my friend, and thanks for letting us know what happened this time. Dr T
At Mon Feb 11, 12:24:00 PM 2008,
Anonymous said…
Dr. Trofatter,
I had IVF and tested positive after 14 days with hcg of 14 tested 72 hrs later hcg went to 39. What should I make of this?
At Thu Feb 14, 08:59:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Anonymous Feb 9: It certainly could be your diabetes, but there are many other possibilities as well. If you lose this preganncy and are serious about wantimng anothe baby, with the number of losses you have now had, I recommend you see a specialist in Reproductive Endocrinology or in Maternal-Fetal Medicine with an interest in recurrent early pregnancy loss. Good luck! Dr T
At Fri Feb 22, 06:50:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To anonymous Feb 11: Be patient. Even though the hCG levels are low, there was still an appropriate 'doubling' over time. Wishing you the best of luck! Please let us know how things turn out. Dr T
At Thu Feb 28, 09:24:00 AM 2008,
Anonymous said…
Hi Dr. T. It is Robin again! I just wanted to give you an update to my story...
Just to remind you , I have one surviving child from my first pregnancy and have had 4 consecutive miscarriages (all with my husband). Two of those miscarriages were tested and no genetic abnormalities were found and my RE has been unable to find any reason for my miscarriages. I was waiting on the genetic results from my most recent miscarriage (#4).
I had a D & C a few weeks ago and I just received the genetic results on this pregnancy. This miscarriage was actually due to a genetic abnormality, the fetus was found to have 95 chromosomes instead of the normal 46. So, my RE described this last miscarriage as a "random genetic event". Given my history, this was very surprising to me!
I am giving my body a few months to rest and then I will be trying to get pregnant again. My RE is putting me on Clomid and progesterone support. I will also be asking him about taking baby aspirin and extra folic acid in addition to my prenatal vitamin.
Thank you for taking the time to read my posts. Hopefully I will have some happy news to report to you in the upcoming months. Fingers crossed!
Thanks,
Robin
At Thu Feb 28, 07:08:00 PM 2008,
Anonymous said…
Update: I ended up having a DnC on Jan 29th. No issues from the DnC and was told by the doc that we could try again after I was checked out at my apt 10 days after the DnC, by that time my HCG had gone to 0. We didn't get pregnant this month as I started my period a few days ago. However, not sure if it is related to the DnC or not, but I barely have any cramps at all with this period. I used to have cramps so bad for the last 20 years that I would have to take 2-4 advil every 6 hours for several days just to function at work. My flow is very similar to how it has always been, but my cramps are minimal. I was just wondering if the change in cramping has anything to do with the DnC, the progesterone I took while pregnant, or something else? Have you ever heard of this before? I am hoping it might make it easier for us to get pregnant again or at least perhaps continue to not hurt as much. Any thoughs are appreciated! Thanks again, Trisha
At Tue Mar 04, 06:51:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Robin Feb 28: Thanks for the feedback. Best of luck to you and please, stay in touch! Dr T
At Tue Mar 04, 06:54:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Trisha Feb 28: There is a possibility that you have 'endometriosis' that caused your cramping and even set you up for your miscarriage. Many years ago, I wa staught that "one cure for endometriosis is pregnancy", so maybe you are correct. The combination of the pregnancy and the D&C may give you a better shot the next time around. Maybe you shouldn't wait too long though! Good luck and please stay in touch. Dr T
At Wed Mar 05, 04:23:00 PM 2008,
Sarah said…
Dear Dr. Trofatter,
I am very confused - I just finish IVF and they transferred two blastocysts. On day 16 my hcg level was 45.8. My doctor had me retest 3 days later an dit was 154. Everything I've read states my hcg should be a lot higher. Am I doomed to have a miscarriage? Why didn't my doctor say anything? Please help!
At Thu Mar 06, 11:01:00 AM 2008,
Anonymous said…
Hello,
I am 9 weeks and 6 days pregnant and about a month ago when I went to my first visit they drawed blood to run the tests they do and yesterday that I went to my second doctor's visit, my doctor told me that the results for my hormone level was low. He prescribed me progesterone vag. suppositories and he told me I had to take those up till I turn 16 weeks. But should I be worried? I did have an ultrasound yesterday and I saw the baby's heart beat. The doctor told me that everything looks good. Thanks.
At Thu Mar 06, 08:20:00 PM 2008,
Anonymous said…
Dear Dr,
I want to tell my case.
I am 8 weeks 2 days of pregnancy. I discovered I was pregnant when they performed some blood tests. The lab test showed that my levels of progesterone were high but HCG was negative even though my urine test showed positive. My last period was on January 8th 2008, and my first blood test was performed on February 2nd . The general doctor suggested me to go directly to the gynecologist.
My first visit was February 18th, I told my history to the doctor and he thought I was experiencing an ectopic pregnancy he inmediately order a blood test that day and another one on the 21st, and an ultrasound on the 22nd.My first results showed that my levels were of 11,900 and my second one showed a decreased 11,500. He performed an ultrasound and he saw two sacs and discard an ectopic pregnancy. The doctor told me that this pregnancy was not viable but he order another blood test on the 28th with an other ultrasound on the 29th. My results were as follow; The HCG levels increased to 14,000 but still the doctor could not see any fetuses inside the sacs so he suggested me to perform a D&C this week but I did not do it because my HCG levels were still increasing.
I have seen a new doctor this week on Monday 3rd an another blood test was performed. My results of this last blood test showed that my HCG levels increased to 16, 234 but on Wednesday of this week I started experiencing some lightly spotting (lightly brownish spotting) no pain, no fever, without symptoms of miscarriage. I am concern if I am experiencing a miscarriage or there is still hope. I talked with the nurse today and she order new blood tests, I will have an ultrasound this coming Monday but I am still concern about my situation as far as I know if my HCG still increase , that shows that I am not experience a miscarriage instead this level should decrease. Could you please let me know if this still could be a normal pregnancy and if my hormone levels are normal increasing and if it is normal to spot .
Thank you so much
At Fri Mar 07, 04:41:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Anonymous Mar 6 11:01: The placenta usually makes enough progesterone by 10-11 weeks that you do noot need to take addirional progesterone. However, what you are taking shoul not hurt the baby either. I think it is a good sign that the baby is growing well and has a normal heart beat. The odds sre in your favor that things will turn out alright. Be patient and please let us know what happens. Dr T
At Fri Mar 07, 04:47:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Anonymous Mar 6 08:20 PM: You will be more than 9 weeks at the time of your next ultrasound. If no baby is seen at that time, then this was not a successful pregnancy. Under normal circumstances, the hCG may continue to rise for awhile even if the baby does not develop. The hCG is made by placental cells called trophoblasts that may survive and continue to grow for awhile without the baby. I wish you the best of luck, but I am afraid what you have told me so far is not good news. I'm sorry. Dr T
At Sat Mar 08, 04:52:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Sarah Mar 5: Those are relatively low hCG levels, but you had a normal increase in the hCG on a percentage basis over 48-72 hours. Perhaps your doctor is hopeful that the pregnancy just got off the ground a little late and is going to be alright. Stranger things have happened in this business! Please let us know how things turn out and best wishes. Dr T
At Fri Mar 14, 08:16:00 PM 2008,
Anonymous said…
i have 2 kids one 5 and the other 3 both bys but the past year i have had 3 miscarriage's the first one at 13 weeks but the baby stoped growing at 6 weeks the other towo were before 6 weeks and were already lost before i ever knew i was pregnent. it took me months of avoiding people i knew were pregnant and rethinking everything i had done wondering what i could have done different. well about 2 weeks ago i found out i was pregnant and the tested my blood and my hcg levels were grest but my progestrone was 13 and they said they wanted it to be about 20 so i take progestrone 2 x a day and take a baby asprin and i go in 13 days to get a ultrasound to see if they can find a heart beat so my questin is i am only 6 weeks was my progestrone levels already to low and am i heading down the same road again? or could my baby still be alright ??
At Fri Mar 21, 06:48:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To anonymous Mar 14: Yes, your baby could "still be alright" and hopefully that will be the case when you have your ultrasound done in a few weeks. Best of luck to you, thanks for reading, and let us know how things turn out. Dr T
At Thu Mar 27, 09:40:00 AM 2008,
Anonymous said…
I am pregnant for the fifth time, first four were uneventful through the first and second trimesters. My quesion lies in that I suspect I am about 6 weeks along, my OB/GYN ran Hcg levels becuause dating of the pregnancy has been difficult because of my irregualr periods. When done it was 815 on Friday 1021 on Mon and 1236 today. WIn doing an ulrasound the pictures were unclear because of an extremely retroverted uterus but there apperared to be a gestational sac but not much else could be seen because of the picture quality. The ultrasound was taken last Friday with the first Hcg level. What are your medical thoughts on this pregnancy, could this pregnancy be threatening a miscarriage because of the lack of doubeling Hcg levels??? I am so worried that I may be loosing this pregnancy although I have no spotting or cramping, no history of miscarriage or ectopic pregnancy (none was seen on ulrtrasound)? Pleasse any help would be greaty appreciated!!
At Thu Mar 27, 05:55:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To anonymous Mar 27: It could be that you are not quite as far along as you thought or that this realy is a pregnancy that eventually will miscarry. About 1 out of every 5 pregnancies is lost in first trimester and when that happens in someone that has previously had successful pregnancies, it is often because the baby had a chromosomal abnormality. Your doctor should be able to tell you for sure if this is a viable pregnancy in 7-10 days by another ultrasound, but he/she may need to do a vaginal ultrasound to see adequately if your uterus is retroverted. Good luck to you and let us know what happens. Dr T
At Wed Apr 02, 10:01:00 AM 2008,
IS said…
Dear Dr T,
Thank you very much for your blog. I am 33 years old. My husband and I are healthy and active adults with no known medical issues. We started actively trying for a baby in September 2007 and got pregnant right away. I stared to spot a little at six weeks and rushed to the ER and was told that my HCG levels were quite good but the gestational sac was empty. The ultrasound at 7.5 weeks did show an embryo. However, the age of the embryo was dated at around 5 weeks. I had another appointment with my doctor again at 10.5 weeks. At this appointment my doctor did another ultrasound and found that the baby died at 6 weeks 3 days. There was no blood flowing to the baby. I had a medical abortion two days later. This was in November 2007. My HCG levels took 3 weeks to come down. My HCG level on December 7, 2008 was 6. I got my period three weeks later. My second normal period in January arrived 32 days later. (I normally have 28-32 day cycles). We started trying again in February 2008. However, my period arrived almost a week early this time. This is very rare for me. Things became weird after the period ended. There was little or no cervical mucus (CM). A week after the period ended I started getting dull pull pains in my lower back (Particularly on the sides). For the first time I got one of those ovulation predictors to time our baby making. Although there were days when there was wet CM, the ovulation predicator indicated no LH surge until the 19 day. We did try to conceive that day. My period did not arrive on time. I got suspicious and did a home pregnancy test on day 33. It came back negative. I tested again on day 35 and it came positive. I went to the doctor the next day (3/24) and got my blood work done. The results came back two days later to show every low HCG levels 111. I got another blood work done on 3/28 (five days after the fist). The HCG levels dropped to 26 (progesterone 3). I started to bleed on 3/31 and here I am going through my second miscarriage in a row.
After my first miscarriage I told myself that miscarriages are common and got on my life. This second miscarriage did affect me deeply and left me wondering what went wrong. While the low hormones were not an issue in my first miscarriage, I am puzzled by the low hormones during this pregnancy. Why does this happen?
I am also very afraid about the prospects of the future pregnancies. Could you please advise me on what steps I need to take avert another miscarriage?
Thank you so much!
IS
At Thu Apr 03, 03:28:00 PM 2008,
Anonymous said…
Dear Dr.Trofatter,
thank you so much for your site and most useful information. I am 34 y.o., I'm now in my 6th week and this is my first pregnancy. I did blood test yesterday and beta-HSG came at 9 111 mE/l, progesterone came at 18,4 ng/ml. I was diagnosed with hyperandrogenism prior to my pregnancy (no cystic ovaries though) and my doctor suggests that the progesterone level is too low (the norm for this laboratory is between 9.3-33.2 mg/ml for the first 12 weeks) and I must begin taking progesterone supplements in order to avoid a m/c. Doctor, do you think that the level is indeed low and I really must start this therapy? I realize that giving an answer over internet is rather difficult thing to do but I am just extremely confused- my other doctor says that I should not worry and the level is quite normal. Please, please, please help. Many thanks, Helen.
At Thu Apr 03, 05:22:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Helen Apr 3: Progesterone levels are very difficult to interpret and their significance in different women is different. But, you know what? It will NOT hurt to take it and by 11-12 weeks you won't even need it because the placenta will be making plenty by then. So, consider taking it since it has been offered and you do have some evidence of PCOS that puts you at increased risk for miscarriage. Best of luck to you and let us know how things turn out! Dr T
At Thu Apr 03, 06:01:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To IS Apr 2: You cannot assume at this point that the miscarriages were for the same reason. At your age and with the recent history of delayed ovulation, there may be some underlying 'hormonal' problem, such as occurs with hypothyroidism or polycystic ovary syndrome, that contributed to one or both losses. These are easy things for which your regular doctr might begin an evaluation, or ask to be referred to a specialist in Reproductive Endocrinology and Infertility. Good luck to you. Dr T
At Thu Apr 03, 06:58:00 PM 2008,
Anonymous said…
Hey Doc. Have reviewed these posts at length and found them most useful. Hoping you