Hi ladies.. my sister has had high FSH (better known as POF and DOR) numbers for a very long time last she was told there was only a 5% of her conceiving... well now shes pregnant (no tx)! Shes had a miscarriage before so Im a bit worried about her. I figured you guys could help me out with this... she said her first HCG level was 838 no sign of baby on u/s so MD thinks it is too early... has anyone had u/s done early pregnancy and seen no sac? Is this number bad? I believe she did another level yesterday what should she expect those numbers to be? Im guessing she is probably around 4 weeks... she said she goes back to MD monday for another u/s....

Worried Sister

on an ultrasound. You might be able to see the sac and fetal pole in another week and usually the heartbeat isn't visible till the 6th to 7th week.

If she is only four weeks, then that number is great. The doctor will probably take another blood reading since it doubles about every 72 hours and they may watch that it goes up at the beginning.

Congrats to your sister. FSH isn't everything, and this board is proof that many people have success.

Thanks.. thats what I keep telling her!!! I also forgot to mention she said her progesterone was 9.1 ish...is that a good number? Ive heard of suppositories... will it really help?

level should be over 15 and possibly higher. It fluctuates all day long, so she may be fine. I would call the doctor and get his opinion because she did have a previous loss and her problem could be as simple as a low progesterone issue. It is easily remedied by supplementing with progesterone pills, supps or shots.
Dr. Check has different standards than the norm. Don't get upset by the post which mentions the number 40.
Good luck

Which one is best? Which could bring it up the fastesr???

but most docs go with the supps.
I did both during my pregnancy, just to cover but there is evidenence that the pills (prometrium) are not as effective, so go with the supps. Most docs do 200 twice a day but mine did 400 twice a day.

I remember from my experience Dr. Check likes progesterone to be around 40. 9 is a little low. Maybe your sister could ask for progesterone supplements. A lot of women need them.

Sincerely,
Anne

The HCG doubling every two days or so (at the beginning, slower later) is an indicator of a viable pg. A single read is a good start when it's high like that. 800 for 4w is outstanding (see also http://babymed.com/tools/pregnancy/hcg/Default.aspx - e.g. 800 at 16dpo and 1600 2 days later)

Studies I've read conclude that progesterone (P4) of >20 is near 100% viable pg and P4 of <4 is near 0% viability. That said, your sister's 9 is in the gray zone. For my losses, my P4 was around 8 or less. On the other hand my friend's P4 dropped(!) from 20 to 10 or so and she was told to expect a mc --- her energetic daughter is 6 yo today! All different ways.

I am of the camp that supplements after a BFP won't prevent a mc. Again, all different ways.

With a vaginal u/s, a uterine pg is visible near 100% when HCG is 1000-1500. You're sister would know within a day or two for a *singleton*; a few days for multiples.

WARNING TRAUMATIC LOSS. I know this because in May I had an ectopic (tubal) pg, my P4 was low 6(!) and there was nothing in my uterus at HCG 1500 - we waited a full week longer to ensure I didn't have multiples. Despite a bumpy but favorable response to medicinal treatment, my tube ruptured anyhow and nearly killed me (massive hemorrhage, four units replaced). Thankfully I am alive but less one tube.

That nastiness aside, I am always hopeful for a viable pg - for myself and others. I'm am hoping your sister's next u/s is good news!!

Wow that must have been tough!!! Question... would they have been able to tell via u/s it was a tubal preg? How far along were you? Does the thickening of the uterine lining really give a lot of info on how viable the pregnancy is?

I too got a 10 p4 and put on prometrium... is spotting common? I have heard the opposite of what you said... Ive heard many times that hormone supplement has made a difference in sustainiing a pregnancy.... have you heard mostly that it doesnt really matter?

As someone said, you will not see a baby and hb to closer to 7 weeks. So at 4 weeks it is WAY too early to see a baby. Seeing a baby and a hb is a much better indicator than HCG.

Her progesterone is on the low side. My doc told me the suppostories were the best for absorbtion. So I did that twice a day for the first trimester. Progesterone does fluctuate though and she should not be worried if one week it is at 40 and the next at 28. That is normal. It will even change depending time of day. It will be higher on the supplements though.

My RE doesn't even schedule an u/s until Hcg/beta level reaches 1000. So it sounds like your friend's MD did the u/s way to early. My first u/s wasn't until week 6 and even then we couldn't detect the hb. We didn't see the hb until 7 wks and 2 days. HTH. Good luck to your sister!

I had my first us with a beta over 4000 and they didn't see anything. They thought it might be ectopic but two days later it was there!

Hope things go well for your sister. Jen