Two weeks ago my P4 came back at 20 something after stopping the last of P4 support. Cooper re-started me on 200 mg of Prometrium per day for a week. Upon retest it went back up to 57.6. Cooper then said stop and re-test in a week. That re-test was today. P4 went back down to 21.

Dr. Check's recommendation is remaining on 200 mg of Prometrium through 36 weeks. No more retesting - just stay on the P4 until then.

I asked if this was just a Cooper thing or was Dr. Check specifically requesting this for me. She said it was a combo of both. Cooper thing based on experience with ladies and losses and pre-term labor and specific to me based on my history of 2 losses (although early losses), i.e. Dr. Check specifically was consulted on re: today's results and recommendation.

I told her the controversy with my OB and she recommended that I set up a callback with Dr. Check. She did also reassure me that there are no risks with continuing the support.

DH is on board with me staying on the meds. I just don't see how I could not continue. I would die and I would kill if I allowed myself to be convinced to do otherwise and something terrible happened.

The downside in all of this is that Dr Check is jam-packed until May 10. And that is the day that I see my OB again (level 2 u/s is on May 5 and done with peri). But since the callback won't happen until the evening I won't have the benefit of CHeck's call for my OB visit. Unless I change my OB visit. Maybe I'll do that.

Hi Mrs. A! Not sure what your controversy is with your OB, I just drift through this site from time to time. But after a failed IVF with Check (one of many failures overall) I demanded the highest freakin' dosage of P4 Check would prescribe. It turned out to be 2 200mg tabs, three suppositories and an injection every day. My bloodwork showed P4 above 65 at times. I don't have a history of MC and he did not prescribe P4 as long as he prescribed yours, I think I finished up around 20 weeks.

I don't believe P4 has any impact short- or long-term on your health, as Check has said. One of my high-risk OB's said that being on P4 at all after eight weeks when the placenta takes over and certainly the amount I was on was "plain stupid," but I ignored him. If your OB isn't checking bloods, he wouldn't know if you continued to take the P4.

In the end, my placenta crapped out on me and I had to deliver a few weeks early as my amniotic fluid got too low. Did the P4 help keep it going as long as possible? Perhaps.

You'll be fine no matter what. Cheers!

is not even worth repeating, it's so stupid. Suffice it to say that like most OBs, and even the high risk one you mention, he feels that taking P4 this late in the game (19 weeks this coming Thursday) is unnecessary. And no - he doesn't check P4. He's never checked except once and that was weeks and weeks ago and whatever the results, they were irrelevant from the perspective that I was souped up on tons of Cooper-prescribed P4 at the time.

He asked me just yesterday about whether I was on the Prometrium still and I said no that Cooper had me on a 1 week hiatus based on last week's results. I left it at that. If he asks me again at the next visit I will just have to point blank tell him "if I followed your orders and stopped the P4 and my baby died, your wife will have to come visit you at the morgue. Do you think she's up for that?" Harsh but enough already.

The nurse told me that if my P4 had come back in the 30s they could have lived with that. But 21 is just too low for them.

Thanks for responding!

I just wanted to say that I would probably do the same as you if in your shoes. Its too bad that the Check consults can't be sooner, but in any case, I hope he puts your mind to ease about how to proceed. I hope all continues to go well with you and your LO.

it's bad enough when you're dealing with REs with opposing views/philosophies. But now to still be dealing with this once you're actually PG is even more frustrating. But I have to have faith that Cooper is doing right by me. I know that my OB doesn't mean to intentionally harm me, but I also can't allow myself to be his experiment either. Not when the risk is so high.

What is going on with you?? How are you doing these days?? Are you preparing for a FET??

There's another Dee on this board and everyone once in a while when the name pops up I thik it's you! I hope to see the DeeinNYC here very soon!

Hi,

You are so sweet to think of me!! Maybe the other Dee will bring me luck and back on this board AFM, my beta numbers went down to below 2 so I am now just waiting for my first AF. I am to begin a natural FET as soon as AF comes...seems very simple...I don't even go in until CD 9!! No shots, drugs, etc except Folgard and prenatals before transfer (possible HCG trigger)...so...I'm looking forward to an easy cycle. Honestly however, I don't feel all that confident in the embies I am transfering...one (5) cell and two (10) cells, but hey...you never know.

Anyway...I am a believer in going with your first mind so to speak so I think you are doing the right thing by continuing the P4. I'm sure everything will work out just fine.

for the next big move. I know you've just come off a hurtful loss, but stay bright and positive to receive those little frosties. They need you and your belly to be nice and warm to cuddle them up right away!

Asking ur OB to talk to dr check directly ? Given that ur OB will be taking care of u for the rest of the pg it would be good if he can be kept in loop for p4. May be a direct discussion between them would convince ur ob for the need of p4support. I know dr check will be open for this discussion.

"I'm going to call down there." But to my knowledge never has. If he feels that strongly about it I think he should be calling down there. He's "threatened" to "call down there" since my very first visit with him at 5W6D. Cooper already has him on file as my OB so he can call down there whenever he wants without needing further permission from me.

stay on the progesterone and not discuss the matter with my OB. But that's me.

Dr. Check hasn't steered you wrong. If he wants you to stay on the P4, do it.

and I feel even more strongly about following the recommendation after confirming that Dr. Check himself has made this recommendation after personally reviewing my file. (Subsequent to my post above I had another conversation with Cooper which further re-confirmed this.)

I don't think they're playing games with me here. (not that anyone here is suggesting that!). But I say that because they were confident in my E2 levels and monitored my levels through the crossover to placenta and everything looked great there in their eyes. I was never placed on any estrogen support like some ladies receive. It's just been this P4 that's been the pesky one.

I'm staying on the support! Case closed lawyer!

confers authority to grant your request to stay on P4. Screw the OB. I've learned the hard way not to listen to their words as gospel.

he sounds weird and arrogant.

I know a woman who had to stay on P4 through both her pgs otherwise she'd lose misscarry, she took P4 all the way through. It does no harm staying on it so stick with it and mentally stick your tongue out at the OB. ha!

I know you are joking but I have to say this so I feel better. Don't threaten your OB. If he asks you about the P4, admit to him you are back on as per Check orders and that your P4 tests have proven that it falls too low and that you feel better keeping on it. If he objects, what can he do?? come over to your house daily and stop you from taking it?? Drop you as a patient??

Don't let him get to you. You hired HIM to help you through this pg, you don't need to keep seeing him, find another that will be more open to listening to you. Heck, you can have your GP follow you up to a certain point, even. I can't remember what week you'd have to go with an OB but it's later on.

Unless he's fun to be annoyed at, don't stay with him.

jm

he's totally arrogant! when we went for the hopsital tour the staff talked about him as if he's this nice and humorous and great guy. If he's funny his delivery is sorely lacking.

When I went for my vag culture on Tuesday I mentioned to him that I wasn't sure how I could get this yeast infection because DH and I haven't had ANY sex. In a totally straight face he says "well obviously you have had sex." Not even with a chuckle or a wink. Now, that's not a terrible statement by any means. It's just the aggregate of stupid comments like that that makes each one annoying and arrogant. I cocked my head and responded "OBVIOUSLY, my husband and I have had sex otherwise we wouldn't have heard the little heartbeat you just picked up on the doppler! You know what I meant."

At my first visit with him I forgot to ask him for the heart rate while he was actually doing the u/s. Before the visiti was over I remembered and asked him and he said it was normal. I said can I have the BPM. He huffed and said "140". I asked isn't that too fast? He rolled his eyes and asserted "it's normal." I f&%$ing knew it was not 140 BPM at 5W6d but I left it at that.

On a subsequent visit I asked the heart rate and he asked if I really needed to know. Can you believe him?! I said "YES I do!"

So yes, he's arrogant in my opinion. And it's more so annoying because I was very upfront with him at my first visit with DH present. I explained to him all that I'd been through and for him to bear with me. I explained to him how as an IF patient you get so involved in every aspect of your care and that I'd probably be the same with the PG.

And no - he's not a high risk OB. I am considering moving on but don't want to make any hasty moves either. He's not a bad doctor; just sorely lacking in bedside manneras an OB. And FWIW, he was my GYN long before he was my OB and I never saw this side of him. But then again, as a GYN I saw him once a year, maybe once every 6 months, for a pap. Not a whole lot of care involved.

Thanks for listening!

having heard the level of care was better and nicer with a midwife, where she'll listen and answer all and every question.

Then I had a c-sec so had to see an OB for #2 but I chose another, a woman. By the time I saw her (she'd been on mat leave and kept putting off coming back) I was disappointed with her bedside manner too.

All they need to do is measure the fundal, chart the heatbeat and your weight and blood pressure. If they feel it's below them, then empower a nurse practitioner who might actually give a hoot about the patient (sorry for the rant)

btw, my first OB was supposed to be this wonder guy, so funny, so competent. Well he totally missed my friend's dissent into pre-eclampsia because she wasn't presenting with typical signs yet I could see there was something wrong--I mean her skin colour was all off, her nausea level was profound. She delivered at 35wks--get this, they tried to have her go vag. Her boy is fine, a healthy 7yo, spunky active bright boy and it took her a few months to recover but her body is tiny and tends to be sick anyways. Still had me fuming at this Dr who the nurses fall over saying how wonderful he is. grrrrrr Even my RE was excited that I chose him.


I hate that Drs only look and recognize textbook stuff. Where are the Dr Houses?? lol

anyways, you have lots of time to find a more suited to you OB. I'd have to look it up but I think it's in the last tri that a GP would transfer care.

I don't know about where you live but for us, with our provincial health care, when labour starts, we present at hospital and have whatever Dr is on call. Even for a planned c-sec, which my #2 was, I was scheduled with whatever Dr was on call the Monday before her estimated due date--yet she decided to have me go through labour and came 2 days before her appointment. Girls (roll eyes) they do as they please and you'd better get out of the way!!

keep us posted on the OB front.


me:42, DH 43
FSH 26
DS: born by c-sec Apr15'03, 9lbs5oz 41wks gest. (after 4 years of ttc, starting in 1998)
DD born by c-sec Oct 13 2007, 8lbs13oz 39wk gest. (after just under 3 years of ttc)
~~DS was conceived naturally the cycle following a cancelled DE IVF, using my good friend's eggs. She was on the verge of hyperstimming.
~~DD's nat conception I attribute to using OPKs like a crazy nut, eating grapefruit daily and using preseed. also 5 cycles of TCM ending 2 cycles before that lucky cycle.
~~~~~~~~~~~~~~~~~~~~~~

Wow, I'm floored by all this. It makes me reaaallly want my p4 tested throughout my pg. My RE seemed really quick to say "p4 is excellent. Stop it in 2 weeks." I wonder if I should have my OB test me...or maybe she'd be like your doc and not believe in it.

Sigh. I'm sorry you have conflicted opinions. I think I would try to put off the OB visit by a couple of days so you can talk to Check and get firm quotes from him to give to your OB. Goes w/out saying, I would stay on the p4.

Hugs,
Meg

with your OB. Tell them what your OB has done up until to this point as far as P4 and what their latest instruction is and see what the OB says and come up with a plan. The fact is that plenty of ladies here go off the support without any issues and some without ever knowing their P4 levels at all. Quite frankly, for me it's become an issue only because my OB has made it an issue and made some outlandish claims. If he never acted the way he did and Cooper said do XYZ and I did, there'd be no quandary. It's only surfaced because OB wants to be big man on campus.

When I see the peri next Thursday for the Level 2 I'm going to ask about the P4 support.

There are some women who need to be on progesterone the whole pregnancy, in different forms. Kacee is a check patient, not sure though if it was check or her OB who insisted on the P4 or what prompted it. Kenny also stayed on progesterone in high amounts.