I Told You So

For the uninitiated, hcg is a hormone created in early pregnancy. While the starting number isn’t too important (although there’s some solid research suggesting that the value at 14 DPO is predictive of outcomes), the speed with which the number goes up is critical. A viable pregnancy will see hcg double roughly every 24-60 hours, with a 48 hour doubling time being expected. My 12 DPO beta was 14. My 14 DPO hcg was 14. Saying ‘I told you so’ is rarely as rewarding as you hope. This time is no exception.

So, we’re on to miscarriage #3.  During the call with the office, I did a few things: asked to find out which doctor would be a better fit for me (answer: Dr. J), paid the bill from my d&c (high deductible health plan deductible met for the year now), and booked my saline sonohysterogram for May 6. I should know at that time if there’s anything structural causing these losses. I had a hysteroscopy years ago to remove a traveling IUD, so I know there’s no septum or other permanent structural issues. I could have a polyp or other adhesion that’s grown since Jan ’13, though, which might explain the issues. The sonohysterogram will determine if that’s the case.

To give a  quick summary of how a saline sonohysterogram works, the goal is to get a good picture of the inside of the uterus. Despite all the medical diagrams that you see in school growing up, the uterus doesn’t actually have an open space in the middle during normal life. While there is space there, the tissue presses up against itself. Thus, to be able to see clearly, a small catheter is threaded through the cervix and the uterus is filled with sterile saline. Following that, an ultrasound is conducted. At my clinic I’ve been told that the sonographer will do about 30 minutes of prep work, then the doctor will come in to perform the ultrasound and remove anything she sees. I’m to take 800 mg of ibuprofen before the procedure and arrive with a full bladder. Sounds like fun, right?

The other thing I plan to cover during that appointment is a question about my luteal phase. Research indicates that most blastocysts implant between 7 and 9 DPO. Once implantation happens, hcg begins to be produced in detectible qualities, and that hcg helps to prevent your period from starting. Thus, it’s important that your period not start early (14 DPO is the norm). In my case, the few periods I’ve had recently have started on 10 DPO. My progesterone this cycle was 14 at 12 DPO, so perhaps it isn’t a problem, but I want to delve into it further after 3 losses, so I understand better what’s happening.