Miscarriages at 41
Question
I practice NFP so I am very familiar with my cycle.
I have five children and am 41.9 years old. My husband is 49. I have been trying to conceive for 18 months. However over the course of the last 18 months I ovulate at day nine or ten. My periods are like clockwork at 28 days.
I have had three miscarriages over this same period of time. Two of the three miscarriages I was on 200mg prometrium 2x a day via suppositories. The miscarriages occur very early on –I get a positive on pregnancy tests and within a week they disappear. They have all been confirmed by beta quantitative hcg blood tests.
My labs on day three were as follows:
estriadol (sp?): 34
LH: 4.5
FSH: 11
Prolactin: 5.1
Thyroid: 1.6
I am Catholic and will not use IVF or anything else that interferes with the unitive nature of sex.
From my own research I believe I have a follicular phase problem. My OB put me on clomid this month.
Is Clomid a good option for me or am I wasting my time? Is the prometrium suppository necessary? Any other thoughts or tests that I should obtain?
Jeniffer
Answer
Last Updated: May 4, 2022
First of all, thank you for being open to life and to God’s design for marital sexuality and procreation. Indeed, you may have a follicular phase defect as well as a luteal phase defect.
Your FSH of 11 on cycle day three is an indication of low ovarian reserve, something that is not unexpected at your age. Nonetheless, since you are still cycling, pregnancy is possible.
The best option for effective, accurate and focused diagnosis and treatment is for you to chart with the Creighton Model of Fertility Care which is the most medically adapted form of NFP.
With charting as a road map, you could then have a comprehensive hormone profile performed. This profile would let you and your medical provider know which hormones need to be augmented.
A final word on progesterone: in your case, if you conceive again, you should initially, at least, receive injections of progesterone rather than suppositories. Injected progesterone yields higher blood levels than suppositories.
In health,
George Delgado, M.D.
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