Quick update on my TSH troubles.  So I had not heard back from my RE this morning so I called my PCP.  I told her nurse about my miscarriage riddled past few months and about my slightly elevated TSH.  She agreed to talk to the doctor right away and get back to me.

In the time that it took me to wait for her call back, I got a call back from my RE's nurse.  She mentioned that my RE was out for the rest of the week, but that she emailed back that there was no harm in treating me if it would make me feel better.  They called in a prescription for 25 mg of some type of thyroid regulating medication that I am to pick up today after work and take every day.  She mentioned that I should come back in 3-4 weeks to get retested.  I thanked her for her call back and hung up the phone.  I was feeling relieved already.

Almost immediately after getting off the phone with her, my PCP's nurse called me back.  Apparently my PCP thinks that I should see an endocrinologist ASAP (under the circumstances).  She gave me 2 endocrinologist references and asked if I had any more questions.  I really couldn't think of any other than my shock that 2 doctors could have such differing opinions on one TSH level. 

Once again the medical profession has left me feeling confused and alone.  If I had not asked to have my thyroid checked on Tuesday I would not have even known about this.  If I didn't have Dr. G.oogle and good friends who have had similar issues, I would not have followed up after getting the test results back to ask for treatment.  If I had not called my PCP, I might not have even contemplated seeing an endocrinologist.  Does anyone else have issues like this or is it just me?  Am I just too anal when it comes to my health? 

On a side note, I emailed the psychologist from my support group this morning to tell her that I am pregnant and that I don't feel comfortable telling anyone but her.  I told her I was on the fence about coming to the session tonight because I feel awkward and untruthful.  I asked if she could call me to discuss.  I have not heard back from her yet.  If I don't hear back from her, I don't think I am going to go tonight.  I hope she calls me back.

So my RE's nurse called me back this afternoon with the results of my TSH results.  I was just scrambling to head to a meeting where I was presenting to the group and I was incredibly flustered.  I should have let the call go to voicemail, but instead I picked it up and with my co-worker right next to me.  She told me that my TSH level was 3.28 and that she had asked my RE if I should start treatment and my RE said no, that I was fine without treatment.  I didn't really have time to think about this and couldn't mention my pregnancy in front of my co-worker, so I thanked the nurse for calling me back and headed to my meeting.

After my meeting I first consulted Dr. G.oogle who felt it necessary to tell me that the normal levels during pregnancy are as follows (from about.com):

First Trimester: 0.24-2.99
Second Trimester: 0.46-2.95
Third Trimester: 0.43-2.78

So umm yeah, I am totally over the limit for pregnancy.  Not by a crazy tremendous margin, but I am over nonetheless.  Having an elevated TSH, or being even mildly hypothyroid can cause miscarriage or other later problems such as preeclampsia, placental abruption, and low birth weight.  Not things I'd ever like to experience, thank you very much.

I consulted with 2 friends who have have bee treated for mild thyroid issues during pregnancy.  One has been through 2 consecutive losses and was put on thyroid medication when she became pregnant with her daughter with a level of around 3.  She actually consulted with her PCP since her OB would not treat her.  My other friend who is currently pregnant and went to the same fertility clinic as me had a level of less than 3 and was put on thyroid medication.  So the same freaking RE's office put her on thyroid meds with lower levels than me!  WTF?!

For a better reference point, check out my previously tested TSH levels:

1/10/12: 2.50 (not pregnant)
8/31/11: 1.41 (was pregnant)
6/24/11: 2.87 (not pregnant)

So clearly being pregnant this time has caused a jump in my TSH.  I am not a doctor and I can see that.

I called back my RE's office and left a message asking to speak to the doctor about why she decided NOT to treat me.  I am going to express to her my concern that I don't know what caused my first 2 losses and that I'd like to be more safe than sorry.  I am more than likely certain mild hypothyroidism did not cause any of my losses, but why gamble, right?

Does anyone have experience with this?  I would LOVE to hear any and all advice.

I was pretty sure that I ovulated on Tuesday.  I had the positive opks and a decent amount of CM.  My temps were up on Wednesday so I thought that was a good sign.  Then I took my temperature this morning...

Last night I didn't sleep that great.  It was really hot and even with the central a/c our upstairs never gets as cool as the downstairs.  We had to keep our bedroom door open all night so that we could get better air circulation in there.  Good news for my cats.  They were so excited that our door was open that they both decided that it would be great to sleep with us last night.  One of my cats is rather large (she is like 16 lbs).  Her favorite thing to do it lay on my legs which is not so great ever, but especially not so great when it is so hot.  I woke up about 3 times last night to kick her out.  The last time was about an hour before I was supposed to get up.  Not a great night's rest.

When my alarm went off, like usual, I grabbed my thermometer and stuck it under the left side of my tongue.  The stupid thing beeped in only 2 minutes (it usually takes 3-4), so I knew that was a bad sign.  Lo and behold my temp dipped to 97 freaking degrees.  WTF.  Guess I didn't ovulate.   I got out of bed, so angry.  I rushed through my hair/make-up routine and then went to wake up my husband.  Not sure why I thought it was a good idea to wake him up with the words, "I think this is really bad news".  Basically our 7 days in a row of "baby-making" may have been wasted.  Uggggghhh.

Let me rewind to last night...day 7 in a row of having sex.  Both of us were so tired.  Me from being sick and then having to function like normal and him from working hard at work all day and then working out.  It was also so hot.  I thought it was "insurance" day, so for good measure we got the job done.  I don't think it was very pleasurable for either of us.  He was super hot and I was really uncomfortable.  Not a good combination.  I think we were both relieved that we had accomplished what we wanted to accomplish. 

Back to this morning.  As soon as I got to work I called my doctor and left a frantic message.  Then I called my friend and she let me bitch to her about my body being so messed up (if you are reading this B, thank you).  As soon as I got off the phone with my friend, the nurse from my RE's office called. 

Paraphrased for brevity's sake
Nurse: I just listened to your message.  So you got a positive ovulation test on Tuesday but don't think you ovulated?
Me: Yes.  I got a positive ovulation test and I know that you don't believe in temping, but my temperature is really low today and it always goes up after I ovulate.  Since I was really sick on Tuesday, I think that may have caused me to not ovulate.  Should I come in for a blood test?
Nurse: If you got a positive ovulation test then you ovulated or are ovulating now.  Your temperatures are not going to be reliable if you were so sick because chances are you are still slightly dehydrated.  That might cause your temperature to be low.
Me: So it isn't possible that I got the positive ovulation test/LH surge and didn't actually ovulate?
Nurse: No, it isn't possible.
Me: Can I come in for a blood test to confirm? 
Nurse:  (Goes into a spiel about coming in every day for LH tests and says it is too late for this cycle)  You can come in on cd 21 for a progesterone test and we can confirm ovulation then.  When is your cd 21?
Me: Next Tuesday.
Nurse: Ok then, come in then and we will test you and then you will know for sure.
Me: Should I continue the opks to be sure I haven't ovulated yet?
Nurse: No.  You already got a positive test so you already ovulated or are ovulating now.
Me: What if my blood work on Tuesday shows that I haven't ovulated?
Nurse: (In a tone of complete contempt and annoyance of my apparent lack of ovulatory knowledge)  Well we will talk to Dr. X to see if we need to evaluate/change your treatment.

Fabulous.  Now I feel sooooo much better.  NOT.  I am so incredibly angry and annoyed this morning.  I totally feel like just leaving work and going home to go to sleep.  Oh and I forgot to mention, my husband uttered the words, "I don't think it is ever going to happen" right before I left for work.  Awesome, that's the spirit.  I can be pissed, but he shouldn't be pissed with me.  This day can go to hell.  :(

Back in December, after my second miscarriage in a row, I decided to seek out the help of Reproductive Endocrinologist.  I had a nagging feeling that something was wrong even though my Ob/Gyn assured me that that I was just having a string of bad luck and that "these things just happen".  I did a lot of research and took recommendations from friends.  I ended up choosing a place that had a recurrent loss program and is also ranked in the top 5 programs in the country.  I ended up choosing a doctor that US News rates as being in the top 1% of doctors in the specialty field of reproductive medicine.

Don't get me wrong, I am overall impressed with the place.  I see many happy pregnant women coming and going.  Normally, seeing pregnant women upsets me, but seeing pregnant women at the RE's office makes me happy and hopeful.  I think my doctor did an excellent job at handling my d&c.  I had a much shorter recovery time that I did after my first d&c and an overall better experience.  Here are a few things that have bothered me, though.  I need to get them out.  Apologies in advance for this rant.

1.  I was nearly scheduled for the wrong procedure during all of my testing.  I was inadvertently scheduled for an HSG when I should have been scheduled for a hysteroscopy.  They also tried to schedule me for the procedure outside of the regular window, which I read that you were supposed to have it done (between cd 5-10).  Luckily I thought something was wrong and called and got everything straightened out. 

2.  I had lots of blood tests taken for various genetic disorders.  It turns out that they forgot to run one of the tests so I had to go back and get more blood taken.  Huge pain in the arse.

3.  After my 3rd miscarriage, they basically told me there was nothing they could do other than IVF w/ PGD and that we should just try again and hopefully at some point the stars will align and we'll have a sticky baby.  I asked about the ovulation induction meds and the RE agreed to try them out on me since my cycles are so long.  They have not looked in to my FSH/AMH to see if it is abnormal since I am not of "advanced maternal age", but I have heard stories of people my age having issues with this causing unhealthy eggs.  They have not suggested testing my husband's sperm to see if there is an issue there.  They basically told me I was having bad luck.  I feel like at a place that is so highly ranked, that they should be able to do a little more.  Right??

4.  I feel like most fertility clinics try to push you towards ART rather than trying other methods.  Since I am not doing IUI/IVF I feel that they do not monitor me closely enough.  I am given this breast cancer drug to hopefully move up my ovulation date and I am left to Google to find out the possible side effects and generally what to expect.  Seems like I am only expected to call if I get pregnant.  I called the office yesterday to ask when they thought I should start taking opks and the nurse told me she wasn't very familiar with the drug I was taking.  I asked her if she thought it would move my ovulation up and she told me she didn't know.  I asked her if I could get blood taken at the end of the 2ww and she said that was probably a good idea.  WTF.  I have to ask for that?  They don't tell me to do it?  What about checking to see if I actually ovulate on this drug?  Ultrasounds/blood work?  I get nothing.  I have been completely abandoned by my doctor's office.  Left to my own devices...my own research. 

I have been feeling rather hopeless the past few days.  I feel like no one can help someone like me.  They can make a woman who does not ovulate, ovulate.  They can make a women with no tubes get pregnant.  They can genetically engineer a baby in a test tube and put it into another women.  But, they can't help someone who has regular, but long cyles/late ovulation and gets pregnant fairly easily only to habitually miscarry right away.  They can't find anything wrong with me so they just give up.  I feel like I should just wear a name tag when I go into the office that says lost cause.  Can you tell I am not having a great week?  Maybe it is the Femara.  I guess I'll Google it to find out.