Monday, February 27, 2012

18dp5dt blood work results are back...and I'm in trouble



Blood work results are back.

Beta HCG looks fine at 7,681.

Estrogen also looks fine at 844.

Progesterone though is a problem. It has dropped to 11.5. Down from 38.68 at its highest and 28.2 on Friday. It should be above 20 at a minimum, since I am on the PIO.

My local clinic suggested maybe there was a lab error, but based on my strong menstrual-type cramping, I'm doubtful (based on how I feel, I can't believe I'm not bleeding, but I just checked and I am not...yet...).

The Denver clinic is being very aggressive. I will go up to 1.5cc of progesterone daily + 3x/day suppositories (I've been on 1cc every other day + 3x/day endometrin suppositories).

I also put a call in to my reproductive immunologist. Not that I put a whole lot of stock in what he says, but I'll give anything a shot at this point to try to hold on to this pregnancy.

I have a really bad feeling about this. I hope I'm wrong.

Mo


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71 comments:

  1. Praying so hard for you. You caught it early, so hold onto hope please.

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  2. Oh geeze...I hope you are wrong, too. C'mon #7...hang on in there. I'm praying for you and your family, Mo. Fingers and everything else crossed. Please, oh please let the extra meds work. You are doing great, Mo...hang in there and never lose hope.

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  3. I don't know if this will comfort you at all, but my progesterone got as low as 6 after my FET. I also started spotting at that point and CCRM got really aggressive with my progesterone as well. They really do know what they're doing - My pregnancy went on to be successful. Your beta looks SO good and that's really the most important thing! Progesterone can be manipulated. Unfortunately, the anxiety does not get better until your pregnancy is over. I was in the ER weekly because I just knew "it was over"! I totally convinced myself many times. Hang in there, I know it is rough.

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  4. Glad you went in for bloodwork, Mo. Are there any theories about why progesterone would go down? FWIW, my clinic used 2cc PIO as standard for FET or DE cycles (but I convinced my RE to do 1cc + 400 prometrium). Beta's holding steady. That's good. Really good. I'm not the praying sort, but yeah, I want the universe to let this baby keep growing.

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  5. Good for trusting your gut and going in and getting this checked. Fingers and toes crossed. Will bed rest help? I do'nt know, throwing out straws here. Praying praying praying for you. What do they think of the prog falling? *hugs* hang in there. You're doing good and we're all here sending the positive vibes you way.

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  6. Praying for you Mo. I feel like a drop in progesterone is far less of a worry than HCG or estradiol. I've heard of other people who have had that and they just upped their intake and it eventually corrected itself. I'm really hoping that will do the trick for you...hang in there!!

    Mo, I am wondering if I can ask you a question. I am wondering where you are doing your 6 and 8 week ultrasounds. I've called around a bit and it seems that most OBs don't want to see you until after you've been released from RE's care. So I guess I could just go to a radiology lab and do it there? if you have any thoughts would be greatly appreciated.

    I am really hoping you get to the 6 week mark soon so that this fear and anxiety can go away. Hang in there, you are doing so well!

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  7. I agree with sprogblogger, this is what supplementation was made for. Thank goodness your docs are all over this and being aggressive. What ever it takes to keep things cooking. Your beta looks beautiful by the way!

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  8. Newbie, my local RE here in nyc agreed to do all my monitoring until I am released to an OB. if you've done any local cycles, maybe try that office? or yeah, you could probably go to a radiology group and have it done.

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  9. With my current pregnancy (I'm 29 weeks today) my progesterone at 9 weeks was 6.3! I had had a couple of instances of spotting.

    They put me on Prometrium and my levels never went about 11.

    Hoping and praying all you need is to up the supplemental progesterone.

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  10. I just want to say I know I have read several other blogs where this happened -- their progesterone dipped down to as low as 6 or even lower and they did go on to have a healthy baby -- just increased the PIO injections just like you are doing. So glad you went in for a check and so glad you are getting your dose increased. Praying hard.

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  11. OH MY WORD< I soooo hope you're wrong.

    But I'm so glad your intuition is so good and you got it checked.

    I am praying HARD!

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  12. Hi Mo,

    I just wanted to reassure you with my story. At 5 weeks I had a lot of cramping and thought for sure my cycle was going to start. My hcg was over 8000 but my progesterone was only about 10. Doctor immediately put me on the progesterone suppositories 1 time a day. At my next appointment I found out I was having twins. I stayed on progesterone until 16 weeks and now I'm 19 weeks pregnant. I did lose a twin, but that was not due to progesterone. I eventually changed over to the prometrium by mouth which was much better.

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  13. I did have spotting from the other twin at 10 and 13 weeks but the other baby was fine. Be encouraged! Stay prayerful! I know all will work out the way it is suppose to. Enjoy this time because it goes quickly. I know it's easier said than done because I'm a worrier but I knew that this was out of my control. Good luck and blessings your way.

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  14. I'm with the other ladies. I've seen this happen quite frequently on other blogs I've read. They caught it early (like you) and went on to have healthy pregnancies. I'm super hopeful for you.

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  15. My progestrone was 10 and that's when I started bleeding. It sounds like CCRM is doing whatever it takes and I hope all goes well. Thinking and praying for you all!

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  16. I am not sure if the suppositories show up in your bloodwork right? I had my progesterone go down to 13 and nothing bad happened so please hang in there. It ain't over till it's over.

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  17. Mo - my progesterone was below ten and increasing the amounts is what it took to bring it up. Mine never did go high - I think it hovered around 16 until week 11. I'm sorry for your worry, but at least you caught it early! Hang in there!

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  18. How terrifying; I'm so sorry. I know there are lots of stories about how things can work out just fine even with low numbers; I know you know them too; I'm sure they don't help (much?). I hope though, very much, that you become one of those stories, where someone thought all was over and it turns out not to be. Thinking of you and wishing there were something else to offer comfort. Sending love,
    Elizabeth

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  19. Sounds like they caught it early (thanks to you!) and are being aggressive. Keep on keeping on, Mama. We're all here, willing that baby (or those babies, as the case may be) to get comfy for a nice 9 month stay. Continued good thoughts headed your way.

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  20. Keep the faith Mo. Progesterone levels vary greatly & increasing your doses will help. Your beta looks awesome. Take a deep breath & hope that time will go by quickly until that first ultrasound! Thinking positive thoughts for you.

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  21. It sounds so incredibly stressful to be cramping and worried about low progesterone. I hope that the doctors are able to reassure you soon and that everything turns out wonderfully. Until then, I'll keep you in my thoughts.

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  22. This exact same thing happened to me at about 5.5 weeks. My progesterone and estrogen dropped and my nurse at CCRM told me it was 50/50 at that point. I called my local RE, who reassured me by telling me that estrogen fluctuates and if you are on suppositories, progesterone is hard to measure in the blood as well as the fact that because it was a FET and so early, the hormones were all artificial as the placenta had not kicked in yet. Once I started bleeding (the next day), my local RE put me on PIO. I had an ultrasound at that point that showed two sacs, both with yolk sacs. Both levels continued to fluctuate over the next few weeks and I was on progesterone support through 14 weeks. However, I have healthy 17 mo. old twins now from that pregnancy (my seventh transfer, after 5 miscarriages). Hang in there, I know how miserable this rollercoaster is.

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  23. Uhhh, Crap. Don't know what to think. What is the most bizarre to me is that your levels were normal to start with and have been falling, so there is some truly strange stuff going on, but it does NOT mean game over.

    First thing, you are taking lots of progesterone. Secondly, menstrual pain-like cramping means nothing. Its a really common NORMAL symptom in early pregnancy, found in plenty of women with high progesterone levels, so one probably had nothing to do with the other. Thirdly, there are plenty of instances where women with low progesterone carry to term, with no issues.

    Hang in there Mo. At around week 9, progesterone production becomes the placenta's responsibility-I think there is a very good chance that the supplemental progesterone you are taking will do the job till then.

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  24. Dear Mo and WIll,
    I am hoping as hard as I possibly can that this resolves and that your pregnancy continues.

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  25. My progesterone was between 7 - 12 for much of my first trimester. I was on Endometrian 3x's a day. I was weaned off when I was still only at about 20... I have faith for you, even if it's hard for you to believe yourself right now.

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  26. The same thing happened to me with my last two pregnancies that ended in live babies. You know what they say about evidence based medicine? Yeah. I didn't do any of that. I became a full on progesterone junkie. I did the PIO, 4x/day suppositories, AND oral twice a day. And bed rest. Strict bed rest actually (self imposed & needed because of the drowsiness caused by the oral progesterone) until my numbers came up. And they did come up. And the babies were safe. But holy cow the panic for those 4-5 days.

    There actually is a very good progesterone level/supplementation recomendation chart from an RE out there. I'll email it to you.

    Hang in there chickie!

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  27. Oh, Mo, I'm so sorry you've got this crappy number to worry about. Praying like crazy for you and your baby(ies).
    Hugs...

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  28. I'm very encouraged by all the comments about pregnancies that survived this sort of progesterone drop and I hope you are too. Regardless your HCG went up, and it went up beautifully, considering how it should be slowing down. As other people have said, progesterone is something you can increase, so this is the best of the bad things that could happen.

    Right now, you're still pregnant. Hoping you stay that way.

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  29. Mo & Will,

    I'm praying so hard for this pregnancy to stick and end w/a healthy baby!!!!! I've even asked some of my friends to add you to their prayers...friends that don't even know you. :-) Well...I don't *know* you either, but I feel like I do!!! Keep us posted and hang tough!!!!

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  30. Mo, I have been following your blog for such a long time although I think this is my first comment. I am praying HARD for you and have been thinking about you constantly all through this cycle. I don't have much to share on the progesterone end (although it really does sound like this is pretty common, so I wouldn't worry too much.. easy for me to say I know). I did want to just share though that I am currently 28+ weeks pregnant and for the first 12 or so weeks, I was having BAD menstrual cramps. I remember going to the ER at 8 weeks just "knowing" there was absolutely no WAY I was still pregnant. The cramps were so horrible, but somehow the baby was ok. Anyway.. I am really praying for you and just hoping for the best with this. I have a good feeling!!

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  31. I agree with what Deana said...with your HCG levels as good as they are, and the added immediate progesterone support, I am hoping all will be fine.

    As others have said, YAY for intuition and for going in again to have things checked.

    With the drop happening just between Friday and today and it still being over 10, I really do think all will be well. If you have multiple beans in there, they need all the P4 support they can get until the placenta is producing on its own.

    Please keep us posted.

    And, you are doing EVERYTHING within your power. Please take solace in that.

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  32. Thank goodness you caught it so early, and hurray for all your readers/commenters with similar experiences that ended with take-home babies. My best wishes are out there along with all the others', and it's about time karma paid you back DAMMIT!

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  33. mo,
    it seems as if this happens enough that it is not an absolute sign of doom. and, it happened to me too... ccrm FET of 2 ccs blasts, progesterone hovered at 6-10 for the first 2 weeks... i was on 1cc 2x/day, then 1.5cc, PLUS pills AND 3 supps. sometimes the levels just don't show as well, and/or your body metabolizes the different forms differently. so, what is going on with you right now does not mean that anything and everything is done and over- that pregnancy for me went the distance. i stayed on pio thru wk16 and then switched to 17p for the remainder of the pregnancy.

    i assume you are going to get your e2/p4 levels daily now, since you have access to a lab?

    take it easy, maybe take some short days at work.

    and the beta is GREAT, mo. you have a great beta. try not to allow your self to completely let go of hope. i know that is so hard, but you will know more soon...

    and, because i was *very* uncomfortable with my low p4, i tended to take my pio shots a little early each day, just to make sure there was always a fresh influx, like, monday, 6pm, tuesday, 5pm, wednesday, 4pm... just my way of feeling like i was doing *something* more to help. and i am not a pray-er, but i prayed with each one of those shots. i know how you feel, mo, this is so hard on you.

    but really, even in the face of all this stress, please try to get some rest, some sleep, and stay very well hydrated. you have done all you can, and then some, and then more, too.

    thinking of you...

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  34. Sending love and all the sticky vibes I possibly can. I know that sounds cheesy, but I mean it with all my heart. I have read the above comments and hope you find them as encouraging as I do -- this is NOT a death sentence! I am not doubting how well you know your body, not at all. But maybe this is a case of it working for your advantage, for once? You caught it early, and you are doing everything you can. I hope with everything in me that this pregnancy holds on.

    Hugs,
    Jo

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  35. Oh goodness. Fingers and toes crossed for you sweetie pie.

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  36. Hang in there. The P4 from supoositories doesn't reflect in your blood as significantly as the PIO does but seems to have better outcomes. Your HCG os awesome and your E2 so try to relax till Friday. Keep drinking your water and get as much sleep and rest as possible
    Xo
    Ocgal

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  37. I agree with the others. Without a corpus luteum driven by the HCG to pump out hormones, I'm not sure I'd take a falling P4 as a harbinger of doom. Of course, I also don't know why it would be dropping on the same levels of supplementation.
    The vaginal suppositories won't be showing up in your bloodwork like the PIO will, so I'm sure the embryos have more of it around than you think.
    I hope the added PIO will bring the levels up again so you can relax.

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  38. Lots of prayers coming your way. Glad you caught it now and hope the added supplementation will fix things. Great HCG number, which is so important!

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  39. Oh Mo -- I'm hoping and praying along with everyone because for heaven's sake, you don't need this sort of stress. That said I remain of the "cramping means nothing" school and also am 99.7% certain the suppositories don't show up in the b/w but work. So I really remain in the "it all looks good" camp but I understand it doesn't feel good (and I don't mean physical cramping, though obviously that too). I hope and pray all is well and that the external measures of that, too, will shape up.

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  40. You are in my thoughts and in my heart, Mo- and if you need someone to come over there and shoot you full of PIO, I'm there. I'm with everyone else- if a number has to go wonky on you, it's best for it to be the number that you can do something about. Throwing a shit ton of hope your way.

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  41. Oh Mo, I'm so sorry. But as others have said, this is not the worst. You caught it quickly, and that is a lot of progesterone you are now taking. I hope you can get monitoring done soon to see your levels rise. Hang in there!

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  42. Mo...I was on the P4 rollercoaster from Hell too upon LN10's transfer. I know how scared you must feel right now...but here's hoping that your ovaries wake up soon and start pumping out some P4 too. I was spotting during this time as well. It wasn't looking good. But I know NOTHING will make you feel better until you start seeing a rise in P4. My lowest P4 was just over 5 and then they added PIO. I know you are already on PIO and just so glad they caught this now. You are DEFINITELY in my prayers tonight Mo...hang in there!! If you like, read my P4 stories filed in my November 2010 folder. Sorry Mo you are faced with some discouraging news. Hang in there...

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  43. stay strong M, I am so hoping for you that everything is ok. Hang in there.... Here and very close by if you need anything

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  44. stay strong M, I am so hoping for you that everything is ok. Hang in there.... Here and very close by if you need anything

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  45. Hey there Mo,
    I have had 3 miscarriages and with the 2 I had on my own, my hcg levels dropped dramatically.Also, I am currently pregnant at 22 weeks, and I had HORRIBLE cramps. I have realized that part of the cramps are from constipation, but it is hard to distinguish. Hang in there girl!

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  46. Oh Mo, I have nothing to add to what all the ladies said. I just want to congratulate you tremendously for you staying on top of things, having an amazing intuition and for making everything possible to make this work. You are such and inspiration. While sometimes it would be nice to just lay back and not worry about a thing, you are doing the best to keep this pregnancy going and I really do think you will be successful. Big hugs to you. xoxo

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  47. Mo...could be twins! I had early spotting with my twins and REALLY low progestrogene, measuring below 10 for several weeks. It took me until 10 weeks to get it over 30. Hang in there!!!

    Also...my RE added in more estrogen when my prog was so low...you probably know this with all you have been through but higher estrogen levels help the prog come up too. In fact, that was all he added which at the time had me very worried. 844 is not bad...but it's not "high" either!

    Thinking good thoughts for you guys!

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  48. Oh Mo,
    just hoping that this is just a scary emotional detour, but that all is well in there - I am hopeful since the stories of your many commenters are so affirming of positive outcomes.
    I can only imagine being in your shoes right now, feeling as you do, and I am so sorry. This is just so hard and scary and HARD AND SCARY and shit lady, really... I just want you to have a smooth ride.
    Thinking of you and sending love,
    Kate

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  49. Mo,
    I am truly hoping that this is going to be fine. You're doing everything right. Upping the PIOs and the suppositories should take care of this.


    Hang in there!!! {hugs}

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  50. Just started following your blog but I wanted to tell you that during my pregancy my progestrone was WAY low!! I have had 7 miscarriages so I was a nervous wreck but your numbers look really good..I know NOTHING anyone say will help but know that there are people out there thinking of you!!

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  51. Oh Mo. So sorry that it all has to be so hard! As everyone said, your betas are awesome, so I'm not convinced this is doom and gloom either. With my twins, I never got below 10 and they bumped me up 2ml. It happens a lot. I'm still holding faith for #7!

    Many hugs.

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  52. Let me claify and say my progestrone was REALLY low with the baby I FINALLY ended up giving birth to!

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  53. Mo-I've followed your blog for sometime but have never commented. I am regularly amazed by the thoughtfulness in your posts and how you have approached this journey, which I know has taken longer than you could have ever anticipated. I don't have anything more to add to what others have already said except that your story reenforces my belief that you must be your own advocate when it comes to IF. I'm so glad that you trusted your gut and got the bloodwork done today. You and Will are in my prayers. -E

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  54. I haven't heard this anywhere else, but my (not as famous as yours, but still very reputable) RE told me that IM prog shows up really well in the bloodwork but he doesn't think it helps as much, whereas suppositories don't show up well in the bloodwork but because they are so close to the uterus he thinks they are more effective.

    Which is to say, I hope that either the drop doesn't actually mean anything or that the increase in dose takes care of it.

    Hoping so hard for you.

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  55. Mo your Dr.'s are doing the right thing so hang in there. My Immune Dr. always wanted my Progesterone at 40(yes even though 20 is the minimum) I too had to do PIO 1.5 daily and at one point 2 daily. I also used suppositories 3 times a day. This carried on beyond the first trimester. I will just say watch your estrogen, beta, and progesterone at least weekly until you see a heartbeat. Then I would monitor estrogen/progesterone throughout. My Dr. was always adjusting my meds to balance my estrogen and progesterone levels all the way to the end. At different points these labs would be good and then bad. She would monitor them weekly and if they came back wrong or I felt off then she would retest and change the treatment method until they were correct. You are your best advocate so stay on those Dr's. Will be saying prayer for you!

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  56. Saying a pray for you and your embryo/s.

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  57. I was on PIO daily -- fresh cycle, though I don't know if it makes a difference. Hang in there!!!! Both you and the baby!

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  58. I am stumpted by the prog number, but glad that they are going all in. First, your betas look great. My best two early and high numbers were my best pregnancies to date. The idea being that healthy embryos attach sooner and thrive. I'm going to hold that thought for you and hope that your hormones all come in to normal range with smooth sailing from here on out.

    I spotted early with number 8, and thought it was all over for sure. My 7 was perfect, until it wasn't. It's frustrating beyond belief to have no way to do anything to help keep these pregnancies going and growing healthy. Have hope. It can happen. And the signs are still great for this to be your contender.

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  59. heyheyheyhey

    I had scary progesterone with my DE baby. We increased the injections and I quietly freaked.

    All was well in the end.

    Same for you. Man how I want this for you.

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  60. I am so sorry that you have another thing to worry about. Glad to hear the HCG is nice and high, though! Thank goodness for early monitoring and a proactive doctor! Praying that the numbers (ALL OF THEM) go up and your stress goes down.

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  61. Hoping & praying so much for you. On the positive side at least they're watching you closely and hopefully things will start to look up. Sending love and holding hope that good news will begin to flow!

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  62. Mo, I hope these comments are helping. Seems like lots of women have experienced this and gone on to have healthy babies with that pregnancy. Please let me know if there's anything at all I can do. Like Danielle above, I would totally come uptown and shoot you full of progesterone. xoxo

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  63. Just letting you know I'm here and keeping you in my thoughts while this gets resolved. Make no mistake about it... it will be resolved for the better! Hang in there sweetie; your beta numbers are AMAZING and I hold all the hope and faith in the world that this is finally it for you guys!

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  64. Just letting you know I'm thinking of you and sending my support. I wish all the peace and good wishes in the world for you all.

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  65. I know how hard this is. You are following my pattern so closely that it's freaky.

    I don't think this is necessarily doomed. A couple of things off the bat -

    CCRM nurses repeatedly told me that P4 levels fluctuate throughout the day, so it could be that you wound up catching the level at a peak one time and at a valley another time.

    Also, was it the same lab every time? Different labs use different assays, and both of my CCRM transfers have almost wound up getting canceled because the local RE I was using for bloodwork prior to traveling to Denver was using a different assay and insisted CCRM was well aware of it (he monitors a lot of their local patients), and CCRM says they've never heard of it.

    Another thing I would suggest is wait until Thursday morning and see what the situation is like at that point. If things are truly going bad (i.e. the P4 is dropping and the cramping represents something bad), I would think that by then, you'd be seeing some bleeding. If you're not seeing bleeding by that point, I think the cramping is actually a good thing - it's a sign of something happening, but not something bad happening. Typically when I've had (or heard of others having) bad things happen, the cramping was followed by bleeding very quickly - within a day or so, not several days later.

    And, FWIW, I had really low progesterone in the beginning of this pregnancy during the 5th week - it was something like 11 and then dropped to 5.something in the span of a few days when I was on just the suppositories. And I was having bleeding.

    CCRM added 1 cc of PIO every day. Oddly enough, they didn't recheck my levels after adding that 1 cc, and I didn't ask them to, but I don't think my P4 levels ever rose terribly high.

    And then once they started to wean me off at 10 weeks (and they took the full 3 weeks to wean me instead of 2 since I was also on PIO), my P4 levels dropped like a rock.

    CCRM wouldn't do anything more at that point since they only care for you through 13 weeks, and my peri refused to even test my P4 levels much less supplement, so thank God for the RI, because they stepped in and put me back on supps for another month, with weekly monitoring. So I was on progesterone support until 17 weeks.

    And even after that, even though the RI assured me my levels were okay (although still on the low side of okay) and there was no need to keep testing, I still worried about it for several more weeks after that.

    And one very last thing - if I remember correctly, you transferred more than one. It is possible to have P4 levels drop, have some bleeding with cramping, lose 1 or more, and still have at least 1 viable one in there. I'm about 95% sure that's what happened to me this time around at 5w0d. We did our first ultrasound at 6w0d and saw a singleton with a heartbeat, so try to hang in there as best you can until the ultrasound.

    Ok, I know this is even more long-winded than usual, but I really hope it helps. I feel for you and Will so much because I know exactly how you feel - it's pretty much identitical to what we went through 7 months ago. I wish there was something more I could do to help you get through these next several days. (((hugs)))

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  66. Oh Mo I am sooooooooo hoping that they can get the 'glue' working. You've battled long enough...forever baby is long over due.

    Thinking of you, sending you strength, hope, and positive-uprising-through-the-roof progesterone scores.

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  67. I am remaining optimistic for you....I know so many women who struggled with low P4 and as long as they got it early and supplemented....they did fine. Lots of good vibes being sent your way!
    kd

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  68. Oh Mo, I am hoping with everything I have that your knowledge of your body helped avert the crisis, and that everything will be okay now that you're on additional progesterone support.

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  69. Mo, I am so sorry for this additional worry thrown your way. Hoping that the progesterone increases again soon and this is just a fluke.

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  70. here is a blog where she had low progesterone

    http://makingmemom.blogspot.com/2010/05/7dp3dt-low-progesterone.html

    but increased the dosage of PI0 to 1,5m/L,
    and she is still pregnant at 24 weeks now

    hope that is of some comfort

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