Miscarriage/progesterone levels/fobbed off

Well, this is my first post in this section. I have been reading over the last few days, feeling sad but now I'm starting to feel angry about how I've been treated through this whole process. I feel so fobbed off by doctors! (Apologies for the epic post).

Reading other people's stories has made me feel less alone in all this. I'm so sorry that any of us have had to go through this.

When I found out I was pregnant on 25 March my first reaction was to worry. We'd been TTC for 9 months and had gone to a FS for blood tests/ semen analysis. DH is fine and my first month's blood tests were good. FS told me to go for blood tests for lutenising hormone, progesterone and oestradiol. He wanted the tests to be done when I got a positive result on an ovulation predictor kit rather than nominating a particular cycle day. So the first month of testing I toddled off (at day 18) and was tested and when I rang FS he said everything was fine I did ovulate, just repeat the test next month.

So I have the test again (at day 17) and when I call to get the results FS says 'the results aren't as good as last month, your progesterone is quite low, it's only 2.1'. And then FS asks if my period has already started and when I replied that it hadn't he said 'to expect it very soon'. I was completely depressed after this conversation and went out for a few drinks, something I wouldn't do if there was any miniscule hope I could be pregnant.

I wait and wait for my period and finally at day 30 of my cycle I do a test. Bam, BFP.
I'm like 'how could this be, FS said to expect my period'. And what about my progesterone level, will the baby be alright? The night I found out I was pregnant I couldn't sleep as I knew that low progesterone could mean that pregnancy couldn't be sustained.

I was angry with FS as I felt like he had got it so wrong. I didn't want to speak with him so I rushed off to GP in the morning. I told GP my story and he told me that hormones were 'bullsh*t' and if my progesterone was so low that I wouldn't have got this far anyway. He told me that I had worried myself sick over nothing. I wish I had gone to another doctor after my normal GP had told me not to worry. If you want a simple blood test, I don't see why you should be refused. I really should have just gone somewhere else.

But anyway, my pregnancy continued along just fine for the next 3 weeks until Monday 16 April I was 7 weeks 2 days pregnant and started to spot.

My husband and I rushed up to Emergency at the Mater and had a scan. The scan dated me around 6 weeks and we saw a fetal heartbeat of 108 (even though I was over 7 weeks in my calcs). But the spotting kept going on the Tuesday and was getting worse.

My GP had referred me to an obstetrician when I was about 6 weeks and when I was continuing to spot and it was getting worse the GP said ' you need to talk to your obstetrician'. I couldn't get past the receptionist there who told me that bleeding in pregnancy was often very normal. Yep thanks for that advice love, but it obviously wasn't normal for me. She told me to ring back the next morning to let her know how the bleeding was as doctor likes to 'wait and see'.

I miscarried that night, the Wednesday, and had to spend the night at Emergency on morphine. The next morning the doctor in the emergency ward in the hosp said she would ring the obstetrician about whether I needed a curette. She couldn't get hold of the obstetrician, his office was shut (at 10am on a Thursday morning and even thought the receptionist had said to ring back about my bleeding) and his mobile was off. So the doctor there just rang a consulting gynaecologist there who said he thought that I didn't need one - this was over the phone mind you.

My Mum was worried about me so she called the obstetrician's office (after calling the GP's office who told her to call the obstetrician's office) and was told that if I had any pain or bleeding that I should call back on Monday. That wasn't really helpful as I was bleeding and still having cramps and the doctor in emergency told me that I would bleed for about a week.

I am continuing to bleed it seems like it's getting lighter. But I feel so fobbed off! The obstetrician I booked with has many rave reviews on so many baby forums but I just felt completely fobbed off about the bleeding and then the opinion on the curette as well.

With my GP why didn't he just give me a blood test to see if progesterone was an issue? I feel so weak that I didn't demand one or go to another doctor.

Perhaps my progesterone did rise and was ok but who knows since I was never tested again after day 17. But it was pretty low.....

And now I wonder why my FS tested me on day 17/18 when everybody else seems to be tested for progesterone on day 21. I have made an appointment with the FS in two weeks time. I suppose the only thing that will give me answers is further testing for progesterone levels. I just don't get how everything is cool one month and the next month my results are terrible and somehow that's the month I get pregnant.

So I suppose ultimately what it comes down to is I wonder if the miscarriage could have been prevented if I'd had progesterone support. Even if I had perhaps it wouldn't have worked for me (having read mixed reports about it), but who knows. I am kicking myself for not calling the FS when I found out I was pregnant and just relying on the opinion of my silly GP...........

I will see what the FS says but if I don't feel that he can help me I think I will start over with another FS. Three doctors and I don't have any confidence in them at al......

Firstly I am so sorry for your loss and the ordeal you have been through.

After my first m/c my doc did some progesterone tests that came back with low progesterone. I started on a course of monthly progesterone cream and my cycles started to get better. I feel pregnant again in Dec and all throughout the pregnancy I spotted until ulitmately I miscarried at 9 wks (baby died at 7wks). Now I kept asking my local gp to check my progesterone levels and she told me that they varry so much that it was not point to testing. So I called the doc that put me on progesterone cream and he told me the same thing regarding the progesterone test. I know that this advice is wrong because heaps of ladies in here have their progesterone monitored throughout pregnancy.

I felt extremely fobbed off as well. As it turns out I fell pregnant straight after my d and c (which I demanded to have) and I am know 7wks. Yes I am paranoid that this baby will not survive but so far there has been no spotting. The doctor still won't test for progesterone so I guess I am just going with the flow and hoping for the best.

My cousin (who is a midwife at the Mater Private) has told me to call an ob by the name of Dr. Keeping on Wickham Tce. Apparently he specialises in unusual pregnancies and he does progesterone injections if required. I was planning on joing a private health fund and using him for my next pregnancy but because I fell pregnant so quickly I can't.

Hope this information helps and big hugs to you.

Josijo,
I am so sorry for your loss :hugs:
I am uncertain as to why your progesterone was done on cd17. Progesterone levels are routinely done for women with fertility issues/miscarriage issues or who are on fertility treatment. It is called a cd21 test which can be a little misleading as the test is done 7 days after ovulation. A level above about 20 nmol/L suggests ovulation has occured. The level you had at cd17 showed that ovulation had not yet occured. In fact if it had it would have indicated you ovulated on cd10. How long are your cycles usually?

Clearly you did ovulate that cycle and your progesterone climbed much higher than that original level or you simply would not have maintained a pregnancy that long.

Some women do require progesterone support during pregnancy - this is controversial with some obs and others not so. Progesterone levels begin to fall before bhcg levels. So, for some mindsets the progesterone falls only because the pregnancy is failing not the other way around.

I am not sure if I have helped any and I do know some women in BB who have had success with progesterone support. From my way of thinking it can't do any harm so if it is something that you have a hunch is your problem fight to be heard my love.
If you feel like sharing who your obs is I would be interested to know.

Keep coming into bB for support - you will find the loving support in here invaluable on this painful journey. Sending you lots of love... :hug:

Although I was an IVF pregnancy...I did have early bleeding with my 2 previous pregnancys that ended in MC in the 2nd tri. My third pregnancy was a progesterone supported from time of conception till 13 weeks and I had no bleeding what so ever. I rang my obst at 12 weeks saying I had no repeat he made me get last week filled. I'm not too sure with my prog results were as I never had day 21 tests.
Good luck it is best to find someone that is supportive and help you achieve your dreams
Bec

Josijo
I am so sorry for what you have just gone through. I just wanted to say that Bekz is right about Dr Keeping. I see him, he delived my first child and just helped me deal with the loss of my second. He was great! I gave me a choice for a natural miscarriage or a D&C (recommended the D&C due to stage of preg), he did all the relevent tests from the D&C and was so great with me and how I was feeling I would recommend him to anyone. I really hope you get all the answers you need and have a beautiful baby in your arms soon

Josijo,

I am so sorry to hear your story and for your loss. I havehad a lot of crap medical care during m/c treatment so I understand how that feels.

I must say that it is very odd that your FS wanted you to do progesterone on the day you got a +OPK. As you generally O 24-48 hours after the +OPK, that makes no sense. Flowerchild is right, a prog test is usually done on 7days post ovulation. I agree also that when you got the result of 2.1 on the day of the + you had not yet ovulated. You would not have got preg with that level, especially if you had good results the month before.

I am really sorry for what you are going through, and I feel really positive that you have decent prog levels - but your ob/fs sucks! That one in Brisbane the other girls recommended sounds great. Unfortunately we have to be strong and speak up when we know something isn't right - or get a a second opinion, it's your body and your baby and you deserve good care.

Thank you all so much for your kind words, it makes it easier to get through something like this.

Thinking about it more and taking in all your advice, it really does make sense that I hadn't ovulated when I went for the test on day 17. I told FS about how when I'd used the opks I kept getting feint lines and was waiting for it to become a really clear line (like it had the previous month) but instead it disappeared altogether - and that was the day that I went to get the blood test thinking that I had left the test a little late. I think I went for the test on a Tuesday and the FS told me that I must have ovulated well before that, perhaps even before the weekend. But when he said it he wasn't too sure, he was like 'yes, you probably did ovulate then, yes you probably did'. I suppose an indication that I didn't ovulate when he said I did was that the baby was only measuring 6 weeks when I was supposed to have been 7weeks and 2 days.

So perhaps progesterone wasn't an issue at all and I suppose that could have been ruled out if my GP had given me a test when I first found out I was pregnant.

The obstetrician that I had booked with was actually Dr Keeping. Everybody has said such wonderful things about him and I was excited to have booked with him reading all the positive reports. I suppose that I dealt with his staff and not him, I've never even met the man. He sounds like he's helped so many people but for me it just seemed like I was being told to 'call back' by his staff (or my mum when I was unable to string a sentence together) and I felt like I had absolutely nowhere to turn.

I have decided that I'm not going to go back to the FS - he's sacked. He does suck! I think it would just be a waste of time and money to see him. I'm back to thinking 'how could he get it so wrong?'.

Josijo: I am sorry that you are going through all this worry and hope that it is as simple as your dates being a bit out of whack. I have everything crossed for you :crossfingers:

Usually I don't post in these sort of threads because I don't know much about the levels etc, but I did see that you mentioned you were seeing Dr. Keeping. I delivered my son Harrison with Dr. Keeping and as you can see from my sig I lost my precious son. Please, please know that I lost Harrison due to medical issues that he had and it was absolutely nothing to do with the care I received from Dr. Keeping.

However, I had a very complicated pregnancy with various episodes of bleeding and tests, stress, worry etc and I have to be honest, neither my DH or I were impressed with Dr. Keeping, he seemed to have a opinion that I was an over anxious first time mum and that I should just stop worrying and relax. I too had the call back on Monday attitude when I ended up in emergency with bleeding. I also was very disappointed with how he behaved at Harry's birth. He was literally there for the last 5 mins and didn't come to the hospital to check on me or DH once. I know that Harry wasn't a normal birth but I felt very abandoned. It was my first labour and regardless of the outcome, I think DH and I deserved more than that.

The only reason I say this is that now I am pregnant again and I am seeing Dr. Pesce at the Westmead (I have moved to Sydney) and he has been amazing. He has given me so much support and I have never been made to feel like I am over-reacting. He even met me at the hospital at 9.30pm on a Sunday evening because I had some pink CM and gave me a scan and didn't charge a cent. Dr. Pesce's care has shown me how supportive an ob can be. I hope that Dr. Keeping picks up his act a bit for you, but if he doesn't don't feel embarrased to go elsewhere.

On a positive note, the Midwifes at the Mater Private were the most amazing, caring and beautiful people I have ever met and after the wonderful care they gave me and my DH I now consider them as part of our family, so if you are delivering there you can rest assured that you will be taken care of.

Best of luck hon

Lv Spring

Spring Angel, I'm so sorry to hear about you son Harrison. Thanks so much for sharing your experience with Dr Keeping with me.

I was starting te feel like I was the only one who didn't think Dr Keeping was absolutely fantastic. As I said before, I haven't met him so Isuppose I can't judge him personally but was blocked at every turn by his staff. The 'call back later' attitude just left me feeling really alone and I ended up with no firm opinion as to whether I needed a D&C. So far, it seems like I don't but at a time like this I have so many questions going through my head like ' what if I do need an D&C and end up with an infection?',

Just to clarify my FS (who I'm not going to bother with anymore!) was another doctor who is currently on a break from delivering babies at the moment so it was only a wait of a couple of weeks to get in to see him.

I suppose what I need now is an ob who also deals with fertility. I don't think Dr Keeping will be the doctor for me if I get pregnant again, how his satff treated me just felt wrong. So I suppose I need to keep looking around and perhaps be patient if it takes a couple of months to get in to see my chosen FS/obs.

Dear Josijo

Sorry, I got a bit confused about your story, I am so very sorry for your loss.

When I was looking for a ob I too felt like every was raving about Dr. Keeping but perhaps he is fantastic when everything goes to plan and it is a different story when complications arise. The reason I wanted to share my experience with you is that I didn't want you to feel like you were the only one.

My experience with him as I said wasn't good enough in my eyes and I wouldn't go back to him again if I still lived in Brissy.

Even just thinking about it over the last hour or so, he left me waiting in his waiting room for 1.5hours when I went for my post-birth checkup with pregnant ladies and new born babies everywhere. I completly understand that he got called out at the last moment, but his staff did nothing to comfort DH and I. I basically sobbed the whole time. It wasn't until DH said it wasn't good enough and that we were leaving and to stuff the check up that they offerred us a private room to wait in. At the time for me it was a complete blur, but when I look back now I realise how horrible it was to put grieving parents in that situation.

Shop around honey, you will find the perfect Ob for you and deliver a healthy earth baby.

Lv Spring

Hi Spring Angel, sorry I confused you. I've just been madly bashing away at my keyboard getting my whole story out (and eating leftover chocolate easter bunnies) without stopping to think about whether I was making much sense. It's bl**dy complicated - what with a gp, an fs and an obs! Throw in the progeterone issue and it's even more complex!

Your post birth checkup sounds none too pleasant. I wish that his staff could have been more thoughtful at such a tough time. Sometimes little things mean so much.

I'm so pleased that you have found a great ob for your pregnancy. Again, thanks so much for sharing your story with me. If DH and I are lucky enough to get pregnant again I think that I'm going to be extra anxious since I've had an m/c and will need an obs who is cool with that.

I am sorry to hear of your loss. A m/c is a difficult thing to go through, particularly when you've been trying a while. My first one was after 3 years of trying & my second after 9 months of trying with a new partner so I understand what it's like.

Before you beat yourself up about this please remember that the stats show that 1 in 3 pregnancies end in miscarriage... usually before 12 weeks (most well before that) and that most doctors will tell you that there is nothing that can be done to avoid it. If you have a history of miscarriage (usually 3 or more) then they will start looking into causes, but before that they will pretty much just say it's inevitable. What I'm trying to say is the result would most likely to have been the same regardless of which doctor you saw, they pretty much all would take the wait & see stance that is so popular with the docs & early bleeding.

Make sure you get the test done next time 7 days after ovulation which will show more clearly if your progesterone level is low or not and that way you will be able to discuss what measures need to be taken to support any future pg.

Josijo,
I am truly sorry for the care your received. :hugs: It was certainly not good enough and it pains me to hear stories like yours and Springs...

Think of yourself as a consumer. You are a health care consumer and you deserve the care you are paying top dollar to receive. It is my personal opinion that you should be able to speak to your doctor within a reasonable time frame.
Maybe you could take this time to seek out a new obs. Interview them - they are applying for your job! Make a list of questions that you may have. such as: Can I speak to you on the phone if I have bleeding, an urgent question etc. Or are you able to answer questions such as this via email. There are many obs out there who will be available such as the new obs Spring has. I too have a wonderful obstettrician that is always available. They are out there.

Thinking of you as you go through this time. :hug:

Flowerchild, I took your advice and I have put together a doctor 'shopping list'. I have fired off a few emails already.

It makes me feel better being proactive and choosing who I want to care for me and any future babies.

Thanks so much!

You go girl!!!

You deserve only the best care.

Lv Spring

Good on you Josijo! It does help us to be proactive and realise we don't have to choose a personality or care that we dont' feel sits well with us. I wish you luck on your journey.:hug: