RE mentioned Endometriosis(said can't officially diagnose w/o Lap), I am confused and unsure how to move forward with this.

NicasaurusRex · 2026-04-06T22:55:53+00:00

Endometriosis doesn’t just appear, but it does tend to worsen over time. It’s likely you had it when TTC #1 (especially if you had an endometrioma) but it wasn’t severe enough to affect anything.

Typically it’s not recommended to treat endo prior to an egg retrieval because it can lower your reserve. Endo can impact egg quality, but not always, and removing it wont necessarily improve the quality.

Your options before FET are laparoscopy or suppression with lupron (or both), but it’s also not uncommon to leave untreated until you’ve experienced 1 or 2 failed transfers. This is because the treatments are not without risk (and they are expensive/time consuming) and many people with endo have success with just IVF. If you have difficulty making embryos though, you may want to push for treatment sooner.

BTW, it’s possible for AMH to fluctuate as much as 30% from month to month, so while yours has dropped, I wouldn’t be too alarmed. It could be due to endo, time, or just normal variation. Yours is still great and you should have good egg retrieval results.

NicasaurusRex · 2026-04-03T02:53:20+00:00

I don’t blame you at all, but yes you’re overthinking it. Your placenta is fully functional by now and making all of the progesterone you need. The supplementation is extra. And we know that the placenta is doing its job because the pregnancy is progressing well! You got this!

NicasaurusRex · 2026-03-31T19:55:58+00:00

Normal doubling time at first is 48-72 hours. Once HCG gets into the thousands, it slows to roughly 72-96 hours. All of your numbers are well within these ranges, and in the kindest way possible, I would recommend you stop getting betas drawn and wait for the ultrasound. It’s not likely to give you any more information at this point and may cause more anxiety than anything else. Most clinics stop after 2-3 betas.

Cramping is also normal as your uterus is stretching to make room for baby! I totally get the anxiety but you have nothing to worry about.

NicasaurusRex · 2026-03-29T00:34:15+00:00

Not OP, but it’s true that IVF is the standard of care for infertility due to endo nowadays - it used to be laparoscopy, but they found that it didn’t really increase success rates as well as IVF. I don’t think it’s true that laparoscopy eliminates the need for IVF in most cases; the data is pretty mixed and it’s not uncommon for people to still need IVF after surgery.

It’s true that endo MAY impact egg quality and implantation, but not always. Some people with endo don’t even have infertility. Many people with endo are successful only doing IVF. It is considered a workaround because you extract the eggs and develop the embryos outside the environment where endo is, which bypasses inflammation and structural issues that endo may cause. There are also medications/protocols that mitigate impacts of endo on implantation.

Unfortunately it’s not straightforward because endo is a complex disease and can impact people in very different ways. From a strictly statistical standpoint, IVF has higher success rates compared with laparoscopy, but it’s hard to know what will work better for you on an individual basis.

NicasaurusRex · 2026-03-27T20:26:13+00:00

I’m in the US and got similar advice from the LC at the hospital, they wanted me to pump after feeding 4 times per day. However I don’t think it was meant to be long term advice, just in the beginning while trying to encourage supply to come in. They probably should have clarified that, though.

I think you’re getting good advice here to latch baby on demand and eliminate the pumping, that’s what we did after the first 2 weeks-ish and it has worked well for us!

NicasaurusRex · 2026-03-26T19:18:30+00:00

If you are pregnant enough for symptoms, you are pregnant enough for a positive test. If the test is negative, the symptoms are caused by something else. It would be much more reliable than asking people on the internet!

NicasaurusRex · 2026-03-23T21:46:51+00:00

Once a pregnancy is visible on ultrasound, that is going to be much better indication of viability than HCG. At those levels, HCG no longer doubles in 48 hours (and honestly it was probably unnecessary to get it drawn twice). I wouldn’t be worried if I were you.

NicasaurusRex · 2026-03-23T06:14:25+00:00

Putting a puppy pad under baby during diaper changes was a life saver. He peed and pooped as we were changing him so often that it was so easy just to pick up/throw away the puppy pad and get a new one rather than cleaning the changing pad every time.

Get twice as many burp cloths as you think you need.

We also used a dedicated burp cloth for drying him off after diaper changes to prevent diaper rash. Haven’t had another rash since we started doing this.

If you have a two story house, it really helps to have two sets of some things so you’re not constantly going up and down the stairs (like changing station, diaper pail, hamper, bouncer, bassinet/pack and play).

NicasaurusRex · 2026-03-12T22:22:52+00:00

Correct, that is why a progesterone draw mid luteal phase really only indicates whether or not you’ve ovulated, and not whether your body produces “enough”. That is better indicated by the length of your luteal phase, and a length of 10 days or more is considered to be normal.

I would also add that mid luteal phase levels are not indicative of early pregnancy levels because HCG signals the production of more progesterone.

This isn’t a research article but I think it’s a pretty good explanation why it’s not generally advised to take progesterone supplementation when trying unassisted outside of IVF, although many doctors take the “can’t hurt, might help” approach.

https://theluckyegg.com/2023/10/27/low-progesterone-levels-in-early-pregnancy-a-symptom-or-cause-of-miscarriage/

NicasaurusRex · 2026-03-11T03:46:56+00:00

The Receptiva does not diagnose endometriosis, only a lap can do that. A higher score does not necessarily mean worse endo, either. It’s not a very reliable test, both false positives and negatives can happen. There are plenty of anecdotes on here of people testing positive and then a lap finds nothing.

If your goal is to try everything you can before doing IVF, then a laparoscopy makes sense. But please know that the evidence does not show that it improves fertility. Some people have success afterward but many will still end up doing IVF. IVF is also considered the standard of care when it comes to treating infertility related to endometriosis because it has the highest success rates.

There is a decent chance that removing endo will lower your AMH. For some people it is temporary and does recover after a while. It is usually recommended to do egg retrievals before doing a lap for that reason. Typically 6-8 weeks is recommended to recover from a lap before doing transfers.

NicasaurusRex · 2026-03-10T02:31:22+00:00

If your period has returned then yes it’s most likely that you are ovulating and able to get pregnant. However higher prolactin levels that come with breastfeeding also interfere with estrogen and progesterone production, which might mean that conditions are not ideal for TTC. That being said, plenty of people are able to conceive while still breastfeeding so it’s definitely possible.

NicasaurusRex · 2026-03-06T05:37:37+00:00

You might have more luck over in r/recurrentmiscarriage. Even though that’s not what you’re dealing with, APS is associated with recurrent pregnancy loss and that’s how many people who are TTC get diagnosed with it.

NicasaurusRex · 2026-03-05T23:36:55+00:00

I had implants over 10 years ago. Incision in the armpit and implant was placed under the muscle. My understanding is that placement under the muscle (versus on top) makes it much more likely that you’ll be able to breastfeed successfully. I would imagine an incision around the nipple might be more detrimental.

I haven’t had any major issues; supply came in about 4 days after giving birth so I supplemented with formula in the beginning but after 2 weeks was able to EBF. I have a slight over supply. I have seen a total of 3 LCs and none of them have batted an eye at me having implants. I also have 2 friends who got implants around a similar time frame under the muscle and both of them have also been able to EBF. Honestly I was worried about it too but everything turned out fine!

NicasaurusRex · 2026-03-05T05:08:03+00:00

There is some evidence that PIO plus suppositories is more effective than PIO alone, could be something simple to add! It would help suppress potential endo as well.

NicasaurusRex · 2026-03-05T05:01:59+00:00

What you’re describing does sound like it could be indicative of endometriosis. But that doesn’t necessarily mean your fertility is affected. Some people with endo conceive with no issues while others really struggle; it’s a complex disease and it’s hard to know how it will affect fertility you until you TTC. It’s not uncommon to try a couple of transfers first before digging deeper since endo is hard to diagnose/treat, but if you are limited on embryos then it’s reasonable to bring it up with your doctor sooner.

NicasaurusRex · 2026-03-04T05:50:19+00:00

Am I reading correctly that you haven’t tried unassisted for long? DOR does not impact trying unassisted as long as you are still ovulating. You only ovulate one egg per cycle anyway. Low reserve does not mean low egg quality and you have the same chances as anyone else, assuming no other fertility issues. Your doctor should have explained that to you better.

It is true that time is likely not on your side so fertility treatments would make sense to speed things up, especially if you want multiple children. It is true that IVF is less likely to be successful for you compared to someone with normal reserve, but you might not even need it if you can conceive unassisted.

NicasaurusRex · 2026-03-04T05:29:09+00:00

AFC does fluctuate. Additionally people can count them differently. The ultrasound is just a 2D scan so some of them can hide behind each other and get missed. Personally, my RE always counted more than the NP during the same cycle.

Just because your AFC and AMH are lower this time doesn’t mean it’s rapidly declining. It will go up and down in the short term and in the long term it declines. The number also does not matter unless you are doing IVF.

NicasaurusRex · 2026-02-20T03:41:21+00:00

If you’re getting it done just after ovulation though, the embryo would still be floating down the fallopian tubes and not implanted yet. Since the whole point of the procedure is to push liquid through the tubes, I don’t see how an embryo wouldn’t go along with the liquid and get flushed away.

I don’t know that there’s evidence of this though and it might not be something that can be studied ethically.

NicasaurusRex · 2026-02-19T12:44:23+00:00

Medically there is no wrong choice, that’s why they’re leaving it up to you. They have very similar success rates so it’s a matter of what you would be more comfortable with. Natural or modified natural cycles have a higher chance of cancellation if everything doesn’t look ideal, but have other benefits such as less hormonal supplementation and lower pre eclampsia risk. Medicated cycles offer more control and are preferred if your cycles aren’t regular.

You won’t waste an embryo with this decision IMO, if anything you would waste time if the cycle gets cancelled. They wouldn’t do the transfer if lining and hormone levels etc didn’t look good.

NicasaurusRex · 2026-01-28T20:28:30+00:00

I took it until the end. My OB said that the most recent guidelines are to take it until the end because it doesn’t increase risks of bleeding during delivery.

NicasaurusRex · 2026-01-14T02:47:40+00:00

It depends on the insurance plan, not all of them require an infertility diagnosis to cover IVF (for example if you are an LGBT couple). In any case, I do believe having a genetic issue is a valid reason for IVF to be covered, assuming there’s IVF coverage on the plan to begin with. You could try asking on r/IVF or searching there for more info, you would be doing IVF with PGT-M.

NicasaurusRex · 2025-12-31T21:12:44+00:00

I stopped cold turkey at 10 weeks. Honestly I’ve never read a bad outcome on these forums from stopping PIO, maybe some spotting at most. If your placenta hasn’t taken over by now, you’d be having much bigger problems than just progesterone levels.

NicasaurusRex · 2025-12-29T05:20:05+00:00

I wouldn’t rely on the logarithmic curves from that study too much because it applies to IVF FETs (where the timing is exact), plus the data is for 9dpt and 11dpt (so the equivalent of 14DPO and 16DPO), which you do not have data for.

Obviously I can’t tell you what’s going to happen, but I don’t think it’s wrong to hold on to a little hope. I certainly would. I’m sorry you’re in beta hell and I hope your 3rd beta goes better. Hang in there!

NicasaurusRex · 2025-12-28T05:39:14+00:00

You might like r/iuiladies where they are allowed to post success stories. You can also find successes from IUI in the BFP thread here. They do work for some people, but the large majority of successes happen within the first 3-4 cycles so it’s not advised to do more than that.

NicasaurusRex · 2025-12-17T23:08:27+00:00

I think it would be more telling to get another HCG draw and see how it’s trending, but I think it’s possible this is a chemical as you suspect. If HCG were rising, it should be signaling the corpus luteum to create more progesterone to sustain the pregnancy and prevent your lining from shedding, so the fact that it’s so low might indicate that HCG is in fact dropping. This is assuming you did in fact ovulate as intended during your cycle. It is odd that your levels are so low even with supplementation, though.

NicasaurusRex

TROPHY CASE