Thursday, December 27, 2007

slowly finding pieces to the puzzle

Well I started Clomid today for the clomid challenge test.

I go back in for blood work on 1/2. If my FSH level is to high it will indicate diminished ovarian reserve. My FSH on day 3 was very good (6.4) Last time I was on clomid it was in 2005 and it was only 50mg. This time I'm on 100mg. The only side effect I had last time was hot flashes. At least it's not the middle of summer! :)

I also got my TSH level back. It was higher then most doctors like it to be. My level was 4.68. My doctor is going to recheck it on 1/2 when I go in for blood work. A high TSH could indicate an under-active thyroid (hypothyroid).

I've read "symptoms" of hypothyroid and I seem to have some of them. Mainly high cholesterol (yes you read that right I have high cholesterol) fatigue/exhaustion, mood swings (although that could be lots of things) and weight gain. I'm NOT over weight by any means but I have gained over 10 lbs in the past year. I was underweight for my height and now I'm on the higher end for my height (if not slightly over). I'm happy with my weight but if I keep gaining that could be another story.

I asked my doctor if I could trigger ovulation with an HCG shot this month (since my body refuses to release eggs till they are GIGANTIC and old) but he said no. he said he "wants to see" what my body does "on it's own". *sigh* I have been through this with 2 different doctors. It's like starting over. However he's the doctor so I'll do what he wants. I just figured since we are on clomid we might as well give it a shot this month. With out a trigger though I have pretty much no chance.

It's kind of frustrating to be starting from scratch with another doctor but oh well. At least he is taking the time to do these tests. I'm hoping that he will look into my thyroid further (test my T4, T3 and antithyroid antibodies) I searched online and I can't really find where it has a "normal" TSH level. One web site said it should be under 4.4. So according to that mine is not THAT bad. However woman on the FF forums say their doctors like it around a 2 for TTC. A over active (or under active)thyroid can be bad for a pregnancy. Not to mention these woman said they felt MUCH better once their thyroid was down to about a 2. I'd be curious to see if "fixing" it (getting down to a 2.0) would help me feel better. It's amazing how an over active thyroid can really mess with your entire body. I never realized how much it effects things. It even can mess up a
menstrual cycle. Who knows if that's part of the reason I have issues in that area. (delayed ovulation, low progesterone due to a weak ovulation etc)


M said...

Hi Amy. I've been away for the Christmas break. I've missed blogging with you! Thanks for your inquiry on my blog. I'm waiting for AF in a few days. I'll start Lupron mid/end January and transfer mid Feb. Can't wait!!

Well, you've sure been getting some interesting information. Your TSH is what mine was. I was at 4.45, I think. I've had 2 different top notch endocrinologists and they have both emphatically told me that a 1-2 TSH is the best level for pregnancy to occur. That's why we tried on our own for so long after it was fixed. We thought that would solve our problems. Unfortunately, it obviously wasn't the only problem, but I bet it contributed.

I had no major symptoms of being hypothyroid except fatigue and being cold. One thing interesting is after being on Synthroid my TSH stabilized at 1.25, perfect level, and then I went on Clomid 50 for a few months. My TSH went up to about 3! So word of warning, you will have to be frequently monitored when stimulating. The higher estrogens bind to the thyroid hormone and increase the TSH. I had to increase my Synthroid when I went on Follistim. Get a good endocrinologist. (Most family docs would say your level is fine. but, it's not fine for pregnancy)

Smart of you to get free T3 and free t4 AND microsomal/ TPO antibodies tested. I have increased antibodies which means I have Hashimoto's--an autoimmune disease. In addition to improving T4 and TSH levels Synthroid will also dramatically decrease antibodies. Low dose aspirin and fish oil helps with the negative effects of antibodies in the uterus too.

You're absolutely right about it messing with ovulation. I didn't have that but many women do. This could be a breakthrough for you. Did your last RE never check for this or were your levels normal back then?

So glad you are finding these pieces!!!!!

Amy said...

My past RE checked it. It was a 4.04 back in March. He did some additional testing but I'm not sure what. I checked my records and he has the box next to antibodies checked but no results written down. I have to call and find out what was done and what the numbers were. My current RE is checking my TSH level with my CD 11 us/ and blood work (CD 10 is new years day and they are closed)

In 2005 my thyroid was a 3.0. As you can see it has gone up since then. :)

do the antibodies effect implantation at all?

Jennifer said...

Hi girls...this topic is right up my alley!

I have a hyperthryoid (opposite of you both)'s near 1 right now (usually a little below - maybe 0.77 or so). My IVF cycles (all those fertility meds we take) tend to increase your thyroid level for a period of time (according to my endochrinologist). Mine went up to over 3 after IVF #1 and now went back down to around 1.

Anyway, I've been taking meds for several years to keep it regulated. I was tested for antibodies and I have those too - oh joy!

I take my thyroid meds daily, plus I add a steriod (prednisone) during my IVF/FET cycles (after ER/ovulation) to help control the antibodies to help implantation (obviously that hasn't helped yet), but I'll take it again for my FET next month. I also take fish oil supplements to help this (of my own choosing).

Amy, you should totally see a thyroid specialist. Your RE can only do so much when it comes to your thyroid - that's not his specialty. Get a good endo and get your thryoid down to 1-2...M is right, that's the level they say is best for TTC.

Amy said...

Do any of you know how the antibodies effect implantation? Any web sites you can suggest for reading on that topic?

Amy said...

Ok I just read a study that says that the antibodies can effect pregnancy (m/c) and implantation of an embryo!

M said...

A lot of debate over whether antibodies affect implantation once the thyroid levels have been stabilized. My doctor is emphatic that once TSH is in check there should be no negative effects on implantation. However, I know once you are diagnosed with any autoimmune disease, you are prone to 'other' autoimmune issues which 'could' attack an embryo. Much debate.

I believe Dr.Sher's group tends to put patients like us on IVIG (which controls the immune response and is about $2500 per treatment-never covered by insurance) to neutralize the uterine environment. I wonder if the Colorado group does this too? That would be super interesting to find out!!

Interesting that Jennifer is on Prednisone for the 1st trimester. I wonder if we should be on that too.

MamaSoon said...

Hi! I just found your blog and read the whole thing. I too have had multiple IVF failures (2 BFNs). I too have slightly high TSH. I too have high cholesterol (both high in the good and the bad). I have endometriosis. I recently had a phone consult with CCRM too. I really hope you nail this cycle. I've added you to my blogroll. I am rooting for you!!!!

Tamara said...

I have had hypothyroidism for years and have never found a supplement that really worked for me. My search is over thanks to thyroid iodine supplements . This supplement worked within seven days!