Just had an interesting chat with my GP...

[hobnob57]

I went about something else, but asked her about ttc. For those that don't know, we've been trying since May, and had a mc at 4+3 in July, a couple of chemical pregnancies and a mmc at 9wks in December.

She said that hpts are the bain of doctor's and ttc women's lives. She said that some women have second LH surges in the month and this can be detected as BFPs when testing early. She wishes the manufacturers wouldn't market them for early testing as there is an increased risk of false positives and this is a bad outcome for everyone. So no testing before 5 days overdue (man alive, how can you do that???!!)

She also said that folic acid tablets are sufficient rather than multivits because the artificial vits don't help half as much as fresh vits from a good, balanced diet. She advocated the diet being the most important factor other than relaxing about things.

And not trying.... which is the crux of it (because you need to have an idea when you're ovulating). Apparently the sure fire way to get pg is to get referred to an infertility consultant because the pressure is somehow off and it happens naturally. She wouldn't refer me - I've another 4 months of 'relaxing' to go!

I think I knew all this stuff from MN, but somehow it's good to hear it from an apparently interested health professional.

pregnancy tests only pick up HCG, not LH surges, though vice versa can be correct.

here

That's what I thought, but I wondered if there's more to it than that since she was adamant about it.... Need to find a sciency type person and ask.

nope, i literally do know 100% that opk's will pick up hcg as well, but home pg tests are just HCG, the pregnancy hormone! How odd.

I do agree about early testing though, last month i had a blighted ovum and if i wasnt so keen totest and could get such early tests i wouldnt have known, i dont think, apart from a heavy heavy period.

Lissie has a step away from the first response thread on here, if you want to join us to stop early testing!

Yes pg tests only pick up hcg.

The main problem with early testing is that they do show up chemical pregnancies that are extremely common (up to 50% of cycles) so give hope where ordinarily you'd just have a slightly late or heavier period and not assume pregnancy.

I do agree about the referal though - although not immediately - it took being on the top of the NHS IVF list and having the appointment at which to arrange dates etc for the coming month to get pregnant - and I managed this timing twice. I think that we'd both resigned ourselves to IVF and so weren't remotely considering that it would happen naturually....

imo home pregnancy tests are the work of the devil, and the manufacturers are just playing on women's desparation by selling ones that are accurate 5 days before due date etc. The reality is that that accuracy is only about 40% so not accurate at all.

Even in my most obsessed days of ttc I never tested early, not once.

I think she meant relaxing about ttc rather than being generally relaxed - trying not to allow ttc to be at the forefront of your thoughts every day and allow yourself to be immersed in other things - i.e. trying to to obsess to the point of destroying your mental health. I'm inclined to believe that in her experience as a female GP she has probably seen more women become pg after the 'pressure is off'. Obviously this won't be every one, but as a general trend I think it's an acceptable thing to say. Putting it into practice, however, is quite another matter.

I do believe that psychological status can affect ttc - the balance of hormones in your body (not just the ttc ones) is affected and could affect things such as blood supply, blood glucose, toxin levels, etc. I find if I consider it to be a purely molecular process then I find it impossible to reconcile why implantation can be successful for my dd1 so easily yet has not happened successfully since (apart from my mmc, and faulty chromosomes notwithstanding).

Interesting comments. I knew OPK's picked up HCG because I dis a test for a MN friend who wanted to know if the fact that her OPK's were showing positive a week after she should have ov'd was a good sign. Given that I was pg at the time although knew the outcome was unlikely to be good I volunteered to test for her. S

Sadly I went on to have an mc but there you go.

I do think these early testing kits cause grief. Even when ttcing I try very hard to avoid testing until I am officially late. On my bfp month I was 4 days late when I tested.

The relaxing thing is a difficult one. I do believe in a mind/body link (I have had hypnotherapy to help me relax about ttc again)but at the same time agree that conception is a biological process. Just "relaxing" won't cut it if there are other issues. I do get wound up when I hear the "oh, so and so was trying for years then they just forgot about it and bingo" type stories.

i totally agree with leningrad - if another person tells me to relax and it will happen I will punch them

An LH surge cannot cause a false positive on an hCG test. I would seriously consider changing my GP.

I'm trying very hard not to be the same. What I'm saying is that I know that ttc takes an incredible toll on your psyche and I'm wondering if there's actually something in it. But as I said, how to do it is the big challenge. As the GP said, you need to have an idea when you're ovulating, but shouldn't be counting days and thinking about things at other times in your cycle. And the longer it takes the more you feel you should be thinking about it...... vicious cycle.

[totally not relaxing about this!] I'm intrigued by the GPs assertion about cross-reactivity with LH. I've found the following:

From a 1997 study:
The fewer false-positive results with current monoclonal-based kits have been attributed to ectopic sources of HCG or elevated levels of circulating luteinizing hormone.
From:
Diagnostic Efficiency of Home Pregnancy Test Kits A Meta-analysis
Lori A. Bastian, MD, MPH; Kavita Nanda, MD, MHS; Vic Hasselblad, PhD; David L. Simel, MD, MHS
Arch Fam Med. 1998;7:465-469.

And lots of instances of cross-reaction in the blood assays done by hospital labs, e.g. HCG can cross react in the radioimmunoassay of gonadotropins, especially luteinizing hormone. Each individual laboratory should establish the degree of cross reactivity with their gonadotropin assay.

So if it cross reacts with LH in blood, why not in urine? Are hpt manufacturers banking on us all being normal and not having second, late, surges?

............Must Get On With Life And Pick Up The Hoover Or Something..........

Yip.

But why don't the manufacturers point this out? Not in their best interests I suppose.

grrr

so a lh surge can actually cause a false positive. And therefore there are women out there who believe they are having early mc's when actually they're just having a late lh surge.

Afaik there was an entire thread devoted to people who had false positives from a particular brand of pg test.

As an aside, while I hate this notion that if you just relax you will miraculously fall pregnant (given that the reason most people struggle to conceive does actually have a medical basis which relaxation alone will not cure), I think that telling someone to relax is perfectly valid. After all, stressing will not help you fall pregnant either, so it is better to relax rather than let it take over your life.

i wonder about the relaxing thing. last month was my first of ttc and i wasn't exactly chilled out. i'm equally tense this month... i suppose the only ways i can imagine this affecting my chances are purely logistical, i.e tenser vaginal muscles? less enjoyment/fewer orgasms, less sex in general because i'm a pita? other than that im sure it doesn't make a jot of difference.