luteal phase defect?

[hoping4baby]

i can't believe we are even thinking about ttc again after this 2nd miscarriage. but we want children just so very much. i know everyone here knows exactly the confusion we're going through.

so far i have had 3 pregnancies (1 full term, 2 miscarriages) and in every one i have had low progesterone and was put on prog. suppositories AFTER pg was confirmed. this is making me wonder if i have a luteal phase defect.

in 2003, after ttc for 4yrs i was finally able to conceive on 200mg of clomid. i found out i was pg at 5wks. i was put on progesterone suppositories at 6wks until i was 12wks. i was able to carry my baby girl, Mia Marvelle, to term but, unfortunately, i was hit with a whole other set of problems. she was born with a birth defect and we lost her after 5days of life.

with my 2nd and 3rd pg, again, i had low progesterone and was on the suppositories. they both ended in miscarriage. the first was a blighted ovum and the second we hope to find out at our next doc's appnt.

my question: would you agree with me that i suffer from a luteal phase defect? i have always had irregular cycles and before my 1st pg i needed provera to induce my cycles.

i have my follow appnt after the D&C on feb 11th. we don't plan to ttc until may. i want to let my feb,march,april cycles go by before we ttc again. but for the may cycle i'm going to ask my doc to give me clomid again. i know that worked for us before so i'm hoping it'll work again. what do you think? thank you for all of your help and any input you might have.

--------------------

Zinnia
mommy to Mia Marvelle (03/11/04 - 03/16/04)
Mia's photo album: http://www.picturetrail.com/gallery/...07&uid=2080375

mommy to Baby m/c July 2004
mommy to Baby m/c January 2005

"A moment in my arms, forever in my heart!" ~ mommy loves you, baby girl!
and now
"A momment in my womb, forever in my heart!"

[tle]

Zinnia,

((((hugs)))) on your losses amd heartache and heartbreak. Like you, I often can't believe all we have gone through and how we STILL can think about pursuing treatment, but we want to be parents.

As for your question, I don't know if it's luteal phase defect or not. There could be other factors at work, too. Have you had any testing at all? For example, has your thyroid been tested, and is it functioning normally? Have you had any immune tests done?

I wish I had a simple answer for you, but I don't. For what it's worth, as an IVF patient, I'm on progesterone from shortly after ovulation (egg retrieval) until after beta. A simple approach may be to start your progesterone once ovulation has occurred. That would at least be a starting point.

Wishing you some simple answers and reassurances from your dr., and peace as you go through all this heartache.

Take care,

tle

[hoping4baby]

thank you all for your replies, warm thoughts and prayers. your replies have really gotten me thinking towards the LPD even more.

i was tested for PCOS twice and both times the results weren't conclusive. i do have some symptoms but not enough to say definitively that i have PCOS.

the last tests we did tested for: FSH, HGB A1C (glycohemoglobin), LH (luteinizing hormone), prolactin, T3 Uptake, T4 Free, TSH levels. also checked for a lupus anticoaglant panel, progesterone levels, cardiolipin and the glucose 2hr check.

thyroid was fine and nothing to conclusively indicate PCOS again. the only thing my doc said he was worried about after those tests was my low levels of progesterone. they were at 5.

i've tried charting before but didn't really stick to it because it was so difficult for me to do. i ended up just using OPK every day until i got a + and then i finally got pg in 2003. since we're going to wait to ttc for 3mo i'll chart for those months to confirm LPD for sure.

thanks for all the help. i hope to get some kind of news about this last miscarriage at my next doc's appnt on feb. 11th.

~ Zinnia
mommy to Mia Marvelle (03/11/04 - 03/16/04) Mia's pics:http://www.picturetrail.com/gallery/...0375&members=1

mommy to Baby m/c July 2004
mommy to Baby m/c January 2005

"A moment in my arms, forever in my heart!" ~ mommy loves you, baby girl!

"A momment in my womb, forever in my heart!"

"I BELIEVE IN MIRACLES...I'm a mommy to a couple of them!"

[Blondie8]

Zinnia,

My heart goes out to you and I marvel at your resilience.

With respect to your questions, I believe that the definitive test for luteal phase defect is an endometrial biopsy to ensure that your lining is "at" the same day of cycle that it should be based on your LMP and date of ovulation. This is more accurate than your testing progesterone level post conception. The biopsy needs to be done at a specific time in your cycle (can't remember exactly, it was in the second-half some time) but I'm sure your OB/GYN can explain it better than I.

Another suggestion is to have a hysteroscopy, this will rule out either scar tissue, or defects in your uterus or conditions such as Asherman's syndrome. I had a second trimester loss in June 03, then conceived in August 03 which I m/c'd at 11 wks. A hysteroscopy in Feb 04 showed Asherman's, (essentially scar tissue in/around my uterus) which most likely developed after the June 03 loss. There was therefore very little chance that the Aug 03 pregnancy could have succeeded given that there scar tissue impended the proper implantation of the fertilized egg in my uterus. Most cases of Asherman's are treatable and my treatment was successful. (Drug treatment plus precise cauterization by a skilled GYN Surgeon with lots of experience treating the condition.)

Like Trish suggested, your thyroid should be checked as well as basic immune screens for APA's and ANA's. Problems here can also lead to early loss (see the Immune BB for more info.)

While we had no problems with conceiving (I realize how lucky we are) unexplained recurrent loss is very painful and I'd encourage you to create a list of "things" or conditions you want checked out before trying again. I know that for me, pausing to do research, see the right Docs and then have the right tests and procedures was very difficult, especially as the big 40 was creeping closer and closer (I'm 37). But without it I don't think I could have coped with another loss and at least we knew what the problems are and what we could do about them.

IF there is anything I can do to help please let me know.

[Jewels]

Zinnia
I just wanted to give you words of encouragement, you have been through so much. Your photo page is so beautiful and my prayers are with you ,your husband and beautifiul Mia.
Jewels

[Monica2]

Dear Zinnia -- {{{{{hugs}}}}} to you on all you've been through hon. I don't know whether it's LPD or not, but I would ask your dr. whether you should just go on progesterone following ovulation every cycle that you're trying and then take a pg test at the right time. That way you know you're getting the progesterone support you need. I take it with clomid you would get an HCG shot to ovulate? You could start the progesterone after that. With our FETs and IVFs we have been on progesterone in oil intra-muscular shots following transfer. That is what a hard-core clinic does when they are not fooling around. You could even go that far if you wanted. That way you know you are getting real progesterone support. As I understand it, after much doubt in the medical community there is now some data supporting progesterone support to prevent early mc. {{{hugs}}} to you again and good luck.