Last draw...

Last draw was today.

9 dpo:
Estradiol - 6
Progesterone - 5.8


What's this mean? I'll find out in 2 weeks.

Hormonal Analysis

So I'm now at O + 9 days (aka 9 dpo)....I've had 4 blood draws.

3 dpo:
Progesterone: 7.7   (yup definitely ovulated)
Estradiol: 66

5 dpo:
Progesterone: 13.3
Estradiol: 91

7 dpo:
Progesterone: 17.8
Estradiol: 103
LH: 1.8
FSH: 2.2

So I have no idea what "units" these are in. I know my Progesterone is WNL. But the other 3 are all new to me. I've tried searching on the internet and even asked on my message boards. However, most have never heard of testing LH & FSH except for on CD 3. I think, that they think my doctor is wacko but no just different. ;-) Which is what I need.

So Thursday I will get my levels from today and figure out what "units" these are performed in.

I still don't have a good feeling....I feel defeated and feel I'm doing this for nothing! Its a horrible feeling.

What Testing Can be Done for RPL? #2

Moving onto homronal imbalances, such as FSH, LH, Estradiol, Progesterone, TSH, T4, Prolactin, (Fasting) Glucose and Insulin and Inhibin B.

FSH stands for Follicle-Stimulating Hormone. FSH is secreted from the pituitary gland and is responsible for stimulating the production of eggs and producing a hormone called Estradiol (E2), better known as estrogen, during the pre-ovulatory phase of the menstrual cycle. FSH & E2 are tested on cycle day 3 because typically this is when FSH peaks. If the FSH is below 12 and E2 is below 35 a fertile cycle is likely to occur. However, if the levels of FSH are above 12 and E2 is above 35 an unsuccessful cycle most likely will occur. This can be a good indicator antibodies are at play too.

LH or lutenizing hormone is responsible for giving us positive OPK's. This is because E2 reaches its peak around the day of ovulation which sends a signal to the pituitary gland to secrete LH. LH is responsible for triggering the ovary to release an egg. Normal results vary between 6-30 U/L. Typically LH tests are performed when a woman is going through IVF to determine when ovulation would occur but this could also determine: anovulation, ovarian failure, PCOS (polycystic ovarian syndrome), pituitary disorders and chromosomal abnormalities.

Progesterone (P4) should be low during preovulatory phase and increase post-ovulation. The corpus luteum is responsible for the progesterone after ovulation. The production of progesterone helps in aiding a blastocyte to implant to the uterine wall. Normal P4 values at cycle day 3 should be < 1.5 ng/ml and at 7 dpo should be > then 10-15. Low progesterone may indicate a luteal phase defect, meaning there are too few days between ovulation and menstruation.

Prolactin as many of us know is the milk secreting hormone. Elevated levels when not breastfeeding may interfere with ovulation and conception. Hyperprolactinemia is commonly associated with PCOS. Normal levels at cycle day 3 are <24 ng/ml.

Another important hormone test is thyroid testing which includes TSH (thyroid stimulating hormone) and T4 (thyroxine). TSH & T4 will help determine if hypothyroid (lack TSH &/or T4) or hyperthyroid (produce too much TSH &/or T4) conditions are present. TSH is produced by the pituitary gland and signals the thyroid to make hormones.

Symptoms of Hypothyroidism:

- Fatigue
- Weakness
- Weight gain or increased difficulty losing weight
- Coarse, dry hair
- Dry, rough pale skin
- Hair loss
- Cold intolerance (you can't tolerate cold temperatures like those around you)
- Muscle cramps and frequent muscle aches
- Constipation
- Depression
- Irritability
- Memory loss
- Abnormal menstrual cycles
- Decreased libido

Symptoms of Hyperthyroidism:

- Palpitations
- Heat intolerance
- Nervousness
- Insomnia
- Breathlessness
- Increased bowel movements
- Light or absent menstrual periods
- Fatigue
- Fast heart rate
- Trembling hands
- Weight loss
- Muscle weakness
- Warm moist skin
- Hair loss
- Staring gaze


Signs and symptoms vary due to severity and are different for everyone.

- 10 million AMERICANS have hypothyroidism.

- Approximately 10% of women suffer from some type of thyroid hormone deficiency.


A great resource I found while researching thyroid conditions; www.endocrineweb.com.

The fasting insulin and glucose is a test for diabetes. There are 2 types; Type 1 & Type 2. Type 1 Diabetes typically comes on gradually but symptoms develop quickly. With Type 1 Diabetes your body loses its ability to produce insulin. This increases glucose levels.

Signs & Symptoms of Diabetes Type 1 include:

- Extreme weakness and/or tiredness
- Extreme thirst—dehydration
- Increased urination
- Abdominal pain
- Nausea and/or vomiting
- Blurry vision
- Wounds that don’t heal well
- Irritability or quick mood changes
- Changes to (or loss of) menstruation
- Weight loss—despite eating more
- Rapid heart rate
- Reduced blood pressure (falling below 90/60)
- Low body temperature (below 97º F)

There are actually two types of Type 2 Diabetes; insulin resistant and not insulin resistant. Insulin resistant means your body does not use insulin properly. If you are not insulin resistant it means your body does not produce enough insulin to break down glucose.


Signs & Symptoms of Diabetes Type 2 include:

- Fatigue
- Extreme thirst
- Frequent urination
- Extreme hunger
- Weight loss
- Infections
- Slow wound healing
- Blurry vision

Inhibin B is a protein hormone that is secreted by your follicles once FSH has worked hard to develop those follicles. Inhibin B inhibits the pituitary from secreting FSH and will reach a peak in early-mid follicle phase and then a second peak at ovulation. The test is performed on cycle day 3 as well. This test is a newer test for predicting ovarian reserve or quantity and quality of eggs. This seems to be a more reliable for predicting ovarian reserve over FSH.

The mean value of Inhibin B for normal women on day 3 of the menstrual cycle is 40 pg/ml and the 95% confidence interval of the mean is 33 to 45 pg/ml. Women undergoing IVF with day 3 Inhibin B concentrations less than 45 pg/ml have a pregnancy rate 70% less than women with day 3 Inhibin B concentrations greater that 45 pg/ml.

- Millenova Lab

Stay tuned for more tests.

What Testing Can be Done for RPL?

Doctors have many different opinions on what types of testing are necessary for RPL. This post is for those who are unsure if they are being "cheated" by their RE or Ob/Gyn and not getting the care that they deserve. I've been there and want to make you aware of what is available. I am NOT a doctor and I am not a know it all. I do this in my free time, reading & researching RPL. Researching the possibilities of why I lost my 4 angels. If no one else is going to give me answers I have to research to hold on to my hope, faith and sanity. This is what I have found and there very well could be more out there. If something is incorrect please leave me a message. If you are looking for more about a particular diagnosis leave me a message and I'll be glad to try and help you.

Let's start with thrombophilia for this post. Approximately 40% of those who have thrombophilia have inherited it. Thrombophilia means a person is prone to develop blood clots due to defect in the process of coagulation. Some interesting facts about thrombophilia related to RPL:

"Inherited thrombophilias have been associated with early and late recurrent pregnancy loss as a result of uteroplacental microvascular thrombosis and hypoperfusion. Obstetrical complications such as intrauterine growth retardation, placental abruption as well as preeclampsia have also been related to abnormal placental vasculature. Genetic thrombophilia are suspected to account for about 30% of these obstetrical complications. Poor pregnancy outcomes are associated with maternal thrombophilia but may also be associated with fetal thrombophilia by inheritance of maternal and paternal thrombophilic genes."

~ Found on the Millenova Lab website

Thrombophilia labs include Antithrombin III, Protein C & S activity, MTHFR, Homocysteine, Factor II and Factor V Leiden.

So what are these tests and what are the tests testing for?

Antithrombin III test is to determine how the amount of AT III in the blood, a protein that assists in blood clotting. When you have an AT III deficiency often times these things may appear:
1) Increased risk of venous thrombosis and pulmonary embolism. Venous thrombosis occurs most frequently in the deep veins of the lower extremities.
2) Thrombotic events begin in mid-late teenage years.
3) Mesenteric veins, inferior vena cava, renal veins are all susceptible.
4) Cerebral vein thrombosis can occur.
5) Events occur with AT activity at 40-60% of normal. Homozygosity is fatal in utero.
6) May be precipitated by provocations such as surgery, trauma, pregnancy, oral contraceptive (OCP) use, or infection.

Protein C & S activity is another blood test that examines the function (activity) or quantity (antigen) of both proteins. The lack of one or the other protein or possibly both (highly unlikely) indicates that you do not produce this substance to help prevent blood clots.

- 1 out of every 300 people has one normal gene and one faulty gene for protein C deficiency.

- Protein S deficiency is less likely and only occurs in about 1 in 20,000 people.

- 20-40% of women who have had two or more consecutive m/c have an incidence of Protein C deficiency.

Next, MTHFR. The full name Methylenetetrahydrofolate reductase. From my understanding a blood test helps to identify a mutated gene. This can be heterozygous (inherited by one parent) or homozygous (inherited by both parents). A defective MTHFR gene cannot process folic acid and B12 properly. As we all know folic acid is very important for a developing fetus.

- The incidence of a heterozygous MTHFR condition in women with RPL is about 25-30%.

- Where as the homozygous MTHFR condition is found in 14% of women with RPL.

- MTHFR is the most common abnormality in women with thrombophilia.

High homocysteine levels are usually found in those who are carriers of a MTHFR mutation. Not all the time is there a connection. People who are deficient in folic acid, B6 & B12 may have high homocysteine levels as well.

Factor II deficiency is is present when there is a lack of Prothrombin in the blood, this creates a blood clotting/coagulation problem. Both parents must be carriers of Factor II to pass it along to their children. Factor II deficiency is most commonly caused by lack of Vitamin K. Some babies are born with a Vitamin K deficiency which explains why a Vitamin K shot is given shortly after birth.

- 8% of women who experience fetal loss have this mutation.

People with Factor V Leiden not only have a higher chance of developing blood clots but have a high chance of the blood clot breaking away from the original site. Some history about Factor V Leiden, it was named after a Dutch professor who discovered it in 1994. I find that interesting since I'm half Dutch. ;-)

"The factor V Leiden mutation is associated with a slightly increased risk of pregnancy loss (miscarriage). Women with this mutation are two to three times more likely to have multiple (recurrent) miscarriages or a pregnancy loss during the second or third trimester. Some research suggests that the factor V Leiden mutation may also increase the risk of other complications during pregnancy, including pregnancy-induced high blood pressure (preeclampsia), slow fetal growth, and early separation of the placenta from the uterine wall (placental abruption). However, the association between the factor V Leiden mutation and these complications has not been confirmed. Most women with factor V Leiden thrombophilia have normal pregnancies."

- Between 3% and 10% of Caucasian people are heterozygous for Factor V Leiden, and a much smaller percentage are homozygous.

- In Sweden the rate of heterozygous mutation may be as high as 15%.

- Approximately 1 in 100 women who have FVL will have a serious deep vein thrombosis (DVT) during pregnancy.

While researching Factor V Leiden, I came across an informative website for those who have been diagnosed with Factor V Leiden. I also came across this article, "Pregnancy, Clotting, and Factor V Leiden: An Overview"

Stay tuned! More info to follow on immune and hormonal blood tests.