Hormone blood tests after m/c - questions & need advice!

[ABC.2606]

Most of us by the time we get to kid #3/4 have had them but a couple gals walked into the appointment and had the shock of their lives. The things we do for our kiddos.

My doc called today. My AMH came back at either 4.4 or 4.8 (I forget which he said). My FSH was 5-something and my estradiol I believe he said was 29. My tsh was down to 1.3 which is great since it was 3.6 when he put me on synthroid a year ago. So everything is normal so far I guess.

I just read though that AMH over 4 may indicate PCOS. Is that true or in line with what you've seen?

Sent from my SM-G900T using Tapatalk

[atomic sagebrush]

The higher the AMH the greater the possibility for PCOS but you are barely over normal and I would not worry about it. https://www.ncbi.nlm.nih.gov/pubmed/24593938

We can do the alternate PCOS diet if you wanted to. It may be better for egg quality anyway.

[ABC.2606]

The higher the AMH the greater the possibility for PCOS but you are barely over normal and I would not worry about it. https://www.ncbi.nlm.nih.gov/pubmed/24593938

We can do the alternate PCOS diet if you wanted to. It may be better for egg quality anyway.

Thanks atomic - you already had me on the PCOS version bc of signs of insulin resistance (mainly acne & little bit of weight issues). I started out pretty good on that version but after 6 months I've slipped into more of a regular LE diet (more sugar/refined junk). Will try to get stricter on the PCOS version again.

Do you still think with these initial numbers that he'll still end up giving me Clomid? I have the follicle ultrasound on Friday and my annual exam on Monday and I think I might ask directly this time about meds.

Sent from my SM-G900T using Tapatalk

[atomic sagebrush]

Oh I'm sorry sometimes I get mixed up over time.

Yes, let's do tighten back up again on the alt. diet just to see if it helps. (can't hurt, either for fertility or for swaying, although it is harder to stick with)

I know it's weird but doctors really don't give or not give Clomid based on the numbers. The tests are something they seem like they think they have to do but then they will generally give anyone Clomid who has been TTC for a while without success. FXFXFX (and honestly - don't ask until the end of the appointment. Let him/her come up with the idea on their own, because they 90% likely will suggest it anyway, and then that way you don't burn your bridge if they were gonna prescribe it for you anyway.)

[ABC.2606]

Update: I had my follicle ultrasound on Friday. It showed a 17 mm follicle on right ovary and "pre-ovulatory" thick lining. I also got positive OPK on Friday afternoon. However, as of this morning (Monday), I have not had a temp rise (at ALL - temps keep going down actually!). This is pretty normal for me though as I usually don't see a temp rise until a few days after +OPK.

I saw my doctor today (for my annual) and explained to him about the +OPK on Friday (CD10) and the fact that I have not had a temp shift as of today, CD13, and that I always see a very clear temp shift at ovulation. I reemphasized that I always ovulate between day 13-15 of a 24 day cycle, and normally don't get a positive OPK until day 11 or later. He confirmed that the initial blood tests and ultrasound were normal but based on what I'm telling him about when I ovulate and my cycle length, I probably do need either Clomid or progesterone supplements. He said for now though he is leaning towards progesterone. I didn't push it as I still haven't confirmed O, and I still need to do the progesterone test and let him know when my period starts.

Should I try to nudge him in the other direction, towards Clomid, and how? Next time I talk to him will likely be when he calls me with my progesterone results (I'm getting the blood draw on Friday so it would be early next week). Is there a way to tell him, no, I'd rather you give me the Clomid versus the progesterone (or do both)?

Also - He mentioned that his big concern with Clomid is the increased risk of multiples (he gave me the numbers - 10% risk of twins, less than 1% of triplets). I think I read somewhere that when taking Clomid when you ovulate on your own consistently (which I do), you're at higher risk of multiples than someone taking it who doesn't ovulate on their own. Is this true? Would I be at higher risk?

[Pbn3]

That seems abit backward to me, the progesterone supps before trying clomid, especially as you don't even have your results for prog yet? When you speak to him I would say you've been looking into clomid and feel for you that the benifit would outweigh the risk of twins (which really isn't that high) get upset if you need to () and say you've been at this so long and you want your best chance so please give the clomid or both.....

Sent from my SM-G900I using Tapatalk

[ABC.2606]

That seems abit backward to me, the progesterone supps before trying clomid, especially as you don't even have your results for prog yet? When you speak to him I would say you've been looking into clomid and feel for you that the benifit would outweigh the risk of twins (which really isn't that high) get upset if you need to () and say you've been at this so long and you want your best chance so please give the clomid or both.....

Sent from my SM-G900I using Tapatalk

Yea, I guess he may be one of those docs that more closely guards the Clomid scripts! He's thinking progesterone bc he says I may just need the extra hormone support for maintain a pregnancy with my short LP but he's also said that I may need help in ovulating "better and sooner" ie Clomid. I do think it's worth pushing for it though since I don't think it's right that it takes me a full 2 weeks to ovulate in a 24 day cycle. I feel like I do need a "better and sooner" ovulation!

Another question, do lower doses (like 50 mg) make multiples less likely?

Sent from my SM-G900T using Tapatalk

[atomic sagebrush]

I know that people say that online but the biggest group of people who are not ovulating and on Clomid have PCOS and it is THEY who are the highest chance of twins on Clomid. Twins can happen on Clomid, it's a fact, but regardless it's 8-10% (depending on the study) across the entire population and not really drastically more for some than for others.

What you can do is try to nudge him in the direction of the Clomid if you want to or try the progesterone and tell him that you had really bad side effects from it and they'll give you the Clomid. That's a bit sneaky, of course, but I just hate seeing anyone given the %&^& progesterone since it has been proven to be nothing more than a placebo.

[atomic sagebrush]

Yea, I guess he may be one of those docs that more closely guards the Clomid scripts! He's thinking progesterone bc he says I may just need the extra hormone support for maintain a pregnancy with my short LP but he's also said that I may need help in ovulating "better and sooner" ie Clomid. I do think it's worth pushing for it though since I don't think it's right that it takes me a full 2 weeks to ovulate in a 24 day cycle. I feel like I do need a "better and sooner" ovulation!

Another question, do lower doses (like 50 mg) make multiples less likely?

Sent from my SM-G900T using Tapatalk

Since he's saying stuff like that I would honestly try to play it real cool here because he's probably gonna give it to you anyway. I am obviously not a doc but I do think it's medically indicated for you.

Yes, 50 mg makes multiples less likely.

[ABC.2606]

Thanks Atomic. I will try to play it cool a bit longer but I really am starting to think Clomid is the right path - not just for my sway, but b/c I think I really DO need it! I got a +OPK on Friday and STILL have not seen a temp rise as of this morning!! I'm guessing I ovulate today, which at CD14 would be completely typical for me, but why does it take so long from +OPK to O? It would seem to me that my body just needs a good "nudge" to get ovulation to happen earlier - and progesterone is not going to help that!

That's reassuring about multiples and not necessarily having a higher risk b/c I ovulate on my own. I would definitely want a lower dose of Clomid if I do get it - and I'm guessing that would be what he'd recommend since my fertility issue isn't severe.