What do we want?! High enough progesterone levels to sustain a pregnancy!
When do we want it?! Around seven days post ovulation!
I’ve officially become a fertility-based hypochondriac – which is different from my regular hypochondriacisms because in regular life I’m certain there actually IS something wrong with me and doctors just can’t figure it out, whereas in TTC life I’m just making up problems and doctors are confirming I’m perfectly fine (unexplained infertility, anyone?). As a former math teacher, I’m fond of problems that have a straight solution. Not getting pregnant? Maybe that slight pain you feel is endometriosis! Struggling to conceive? Could be that twelve day luteal phase! Ectopic pregnancy? Bet that was caused by low progesterone levels!
Odds are that if you “have something” – you’d figure it out by now. Of course there are the random few posts where women will say “I was having regular cycles, positive OPKs, and found out a year later that I was never ovulating!” and those are the stories we latch onto. We dig our nails into them and make them our own because having something you can fix is better than just. not. working.
So where did I come up with my newest theory? As if I need a reason! But this time I did have more to go off of than just blind fear. I had at home progesterone tests! You may have only heard about LH and hCG, but there’s also PdG (progesterone) that can affect your chances of getting pregnant (because why should it be just a couple of hormones?!). Progesterone is important because it helps to thicken the uterine lining for implantation and so your levels will be highest post ovulation. If you have low levels of progesterone you may have irregular cycles, experience early miscarriages, or (like me) find out that it’s an ectopic pregnancy (since my levels were at 1 when I was “seven weeks” along). Progesterone levels should be highest between 6-9 days after ovulation. If you’ve been in the game for a while, you may have heard about the 21 day progesterone test, but that may not be accurate for all women. 21 days is based on a “normal” 28 day cycle with ovulation occurring on cycle day 14 (14+7=21, wala!) – so for women with longer cycles, or who ovulate later, you may miss your progesterone surge if you get your blood work done too early.
I wasn’t getting blood work though. Why go to a doctor’s office when you can just test it yourself at home?! Considering you can’t find the progesterone tests absolutely everywhere like you can pregnancy and LH strips, I figured they may not be totally reliable, but since I owned them I decided they were telling me the truth and that my progesterone levels were: low low low low low. They came with my easy@home 3-in-1 pack and instructed that, like a pregnancy test, you should use them after your longest sleep, but completely unlike pregnancy tests – you don’t want to see two lines. The first time I used these tests were during my ectopic pregnancy and they helped convince me that I never ovulated that cycle because there was a second line seven days after my positive OPK. I used the strips again a month or so post the ectopic to see if I was back to ovulating, but there it was again: the second line. In November I used these for days 5-8 past ovulation to see if there was any difference and…the second line kept showing up.
So, not fully ovulating? I’m constantly annoyed with the 12-month rule and refuse to wait while I get negative after negative only to be told later that I haven’t been ovulating and that I just wasted an entire year. I wasn’t sure about how it works with requesting blood work for yourself though. Don’t you need a doctor to agree that yes, that’s something you need? I tried it out anyway and was volleyed between the receptionist and nurse while I explained yes, I get positives on LH tests, but I have what I assume are unreliable progesterone test strips and they’re always negative. They seemed confused, which goes to show that these progesterone strips are definitely not well-known, and I had to play the ectopic card, “I think that I may have low progesterone levels and that could have caused my ectopic pregnancy back in September, so I just want to check to make sure I don’t need to be put on supplements.” And I was in! I was surprised when the nurse I spoke to asked the date of my last period and then counted to say the day I was calling was cycle day 21 and I could come in. Um, no thank you, I just ovulated 3 days ago so I’d like to try to be slightly more accurate with this. I broke it down for her and scheduled an appointment for about 8/9 days past ovulation (never 100% sure since you know I can’t handle temping!)
I was unnecessarily excited about scheduling blood work – I was getting ANSWERS! Nothing can be more thrilling than adding another piece to the puzzle of trying to conceive! Low progesterone levels would’ve been fine with me, because that meant I was going to be put on supplements to help us conceive, and then this whole thing would become a walk in the park! I began to imagine that the doctor would call and say “we also threw in an hCG test since we usually do these together and, well, you’re pregnant!” and then we’d both jump up and down on the other end of the phone and scream about how exciting this was and how I never had anything to worry about after all! There was a shift in that mindset once I made it to my appointment though.
One of the nurses eagerly came over to me and began asking if I’ve been experiencing any spotting or cramping because “there’s always that increased risk of the ectopic”. Which I know, but I was suddenly confused – what did that have to do with my progesterone levels?
“No, well…yes, my right side is cramping, but it’s been more vocal ever since the ectopic.” She seemed pleased by my answer and suddenly it dawned on me…did she…did she think I was pregnant?
Automatically I changed my mind and I no longer wanted them to “accidentally” check my hCG levels. I wasn’t ready to hear that this was another lost month – I was supposed to find that out myself on New Year’s Day! How could they not understand what they were testing me for? This was very clearly an appointment to confirm ovulation, not pregnancy.
I woke up to a voicemail the next day.
“Looks like you did ovulate, your progesterone is 10.31,”…and then without missing a beat, “The pregnancy test did come back negative, it does look like you did ovulate, but will probably be getting your period in another week or so. If you have not gotten your period in another week or so, we ask that you do take ANOTHER pregnancy test, but it does look like you ovulated just unfortunately not pregnant at this time. But if you have NOT gotten your period in another week or so, please retake a home pregnancy test.”
Alright. First of all. What is this pregnancy test that you keep referring to?! I’m confused about what she’s confused about. Was I not clear about why I was getting this blood work? Second of all. How dare they test for something that I didn’t request! That would only be okay if I actually WAS pregnant! Now she just ruined something that I was supposed to figure out all on my own in a week! And did she really expect I’d just accept that? NO. Of course I had to take to Google and see if some women have gotten 0 on their beta test around 8/9 days past ovulation and still ended up being pregnant. She knows I’m not pregnant, I know I’m not pregnant, and yet…could I be pregnant? No, no…probably no. The whole reason I was going to wait to test this month is so that I could avoid crying into my glass of champagne on New Years Eve for entering another year pregnantless. Well…cheers to an empty uterus now! I was doing so well with this TWW too! Keeping myself busy, not counting days, calming myself down and repeating “good uterus vibes” whenever I got anxious…even sitting there with a polite smile on my face while my troop of aunts and cousins swapped birth stories at Christmas. A right of passage that I haven’t experienced. What about that string on my bathroom floor that was curled at the top and looked just like a sperm!? Are you telling me that meant NOTHING?!
Moral of the story is: progesterone wasn’t the culprit and I’m keeping up my not-pregnant streak for the remainder of 2017. Here’s to hoping 2018 holds either all the BFPs, or all the answers.