Why HCG injections??

This cycle I've been doing 2000iu injections of HCG on P+3, P+5, P+7, and P+9.  This is not how the average MD uses this.  When I was seeing my RE, I did Ovidrel (brandname HCG) 10,000iu to induce ovulation.  Nobody has really asked me why I'm doing the injections this way, but I thought I would clarify here anyways!

Progesterone and HCG (Human Chorionic Gonadotropin) are naturally occuring hormones with positive effects on the luteal phase of the cycle. The luteal phase is the day after ovulation to the day before the menstrual flow. It is also known as the secretory phase because the progesterone will cause some more thickening of the endometrium as well as vascularization of the endometrium in case of a pregnancy.


Progesterone does not require the presence of a corpus luteum, the residual of the follicle which produces progesterone. Vaginal progesterone gives higher endometrum levels of progesterone and has a moderate effect on the length of the luteal phase. However, sometimes this approach doesn't work because there are different types of luteal phase defects. For instance, sometimes someone needs more estrogen in the luteal phase as well. This is where HCG comes in handy.


HCG increases post-peak or luteal phase progesterone AND estradiol and prolongs the post-peak or luteal phase. HCG is very similar to LH (lutenizing hormone) and one of its main functions is to stimulate the corpus luteum to continue producing progesterone and estrogen. Thus, HCG sustains the functional life of the corpus luteum.
 
I had my P+7 blood drawn and spun on Wednesday, and I shipped it down to the National Hormone Lab at PPVI (saved me 10 bucks to ship myself, woohoo!).  I called today to see if they got it and they did.  Unfortunately I didn't receive a call with the results and don't think I will during the weekend.  So, I have to wait to see if my progesterone and E2 are better than last cycle.  Oh well!

The Plan

So AF decided to show up early last week.  I had my P+7 bloodwork drawn (it was actually P+8 since I forgot the order form on P+7!) and AF came late the same evening! 
I called in for my CD1 chart review, but since they were waiting on the bloodwork to arrive, they only thing they told me to start was the T3 (triiodothyronine).  I have to take that every 12 hours to the minute.  That also includes taking my temperature when I wake up and then again at 11am, 2pm and 5pm. 
My b/w arrived on Friday.  I didn't think it would get there so quick, so that was nice! My progesterone was very low at 2.2 (normal is 13) and my estradiol was 4 (normal is 12).


My new plan from Dr. H is:
-start Vitamin B6 500mg sustained release once daily
-start taking FertileCM as directed on day 8 thru P+2
-do P+7 blood draw for progesterone and estradiol every cycle and ship to PPVI lab
-begin HCG injections 2000 units this cycle at P+3, +5, +7, +9

I'm super excited to be doing more than taking a prenatal and recovering from surgery!!  It is a lot to remember, but I'm sure I figure it real quick!