High LH levels 6 Days post surgical management of MMC

[Cailin2912]

Hi All,

Apologies if this message isn’t written correctly - first time posting here and am still unsure of all the abbreviations! I’m posting here as am looking for a bit of advice/guidance.

A bit of background - my husband and I decided to try for a baby before Christmas and I was fortunate to fall pregnant the first month of trying. We unfortunately found out at 11 weeks that I had had a missed miscarriage, they think very close to 9 weeks given the size and we had a scan when I was 8+6 weeks pregnant and all looked well. We were heartbroken as we thought we might have been out of the risk zone when we saw a strong heartbeat at the previous scan. But I guess, no certainties with anything.

I had a surgical management last Wednesday - I lost more blood than they would have liked so I was kept in for the whole day but was fine to be discharged that eve.

Since then I have had very little bleeding (spotting perhaps?) but some cramping. I still had some testing strips from when we were trying at the beginning and so took a pregnancy test on Sat as I wanted to see how strong my Hcg levels were and there was a very strong positive line so I’m guessing they are still high. I could be showing my complete ignorance in that assessment so please do correct me!!

Out of curiosity, I took an ovulation test this morning and the line said I had very high levels of LH, which had me quite confused?

My question is - could I really be beginning to ovulate so soon already!? Or is it because I’m still testing positive for pregnancy and so that test is linked? I’m just quite confused as before looking at the test result I was expecting to see a barely visible line.

If anyone has any experience/advice on this - I would hugely appreciate it. We are keen to start trying as soon as we can but I want to make sure it is the right time. I also want to know if it would be safe to try and conceive now if I’m still showing as pregnant. Sometimes I wish my body could talk so it could tell me exactly what’s going on!!

Thank you!

Firstly, I'm sorry for your experience and your loss.

It is likely because your HCG is still high @Cailin2912. Your body will not be able to ovulate if HCG is over 10 (which is v low overall). Personally, I ovulated when I had a super super faint line on a FRER test (the most sensitive on the market - can measure an HCG of 6), which was 8 weeks after surgery. It is usual to take 6 weeks after surgery to get a period (so about 4 weeks after surgery to ovulate).

Professionals usually say to test for pregnancy 3 weeks after surgery and if positive call the EPU/EPAS back as this can mean retained products or infection (or like me it could just mean your body is taking ages to drop HCG!).

It is safe to try again as soon as you stop bleeding (sex whilst bleeding from surgery is an infection risk). However it is best to wait until your pregnancy tests are negative. This is because if they werent, its really hard to tell if a positive test means a new pregnancy or retained products or infection or nothing or... You'd end up waiting 6 weeks to find out, which can cause a lot of stress.

Some medics will tell you to wait until after a period but this is to make it easier to date a new pregnancy (and keep anxiety low), not a safety thing.

Personally, I waited until my pregnancy tests were negative on a FRER (the most sensitive test, identifies HCG at 6 or more) and then tried again.

Hi @TheDaydreamBelievers,

Thank you so much for your reply and your insight. I am sorry you have had to go through it also 😔

Can I ask, did you take ovulation tests as well as the FRERs when trying to figure out where your body was at? In my head I thought that if you had a positive HCG test, you would have a low LH test (as your body doesn’t need to ovulate anymore) but maybe that is wrong when your body is processing a miscarriage?

And sorry, one other question - did you request from your doctor a blood test to check your HCG
levels or was that what they did post 3 weeks and still testing positive? I don’t know too many people personally who have had a miscarriage so hard to find answers to the silly questions I have!

So, I only started ovulation tests after negative pregnancy tests went negative. LH and HCG are molecularly similar, in a way that strong HCG can show on LH tests (I'm not a chemist so not 100% sure how, but this is my understanding). I started using OPKs when my tests were low, and got a peak literally just after preg test went blank. I also temp. Its really frustrating that to be honest in the storm of MC chemicals neither are particularly trustworthy (temps or OPKs)!

bloods vs urine tests - My EPU (early pregnancy unit) told me to test using a normal over the counter urine pregnancy test 3 weeks after surgery, and call them back if its still positive. The current set of over the counter tests are as sensitive as a doctor's test would be. Watch out as they have different sensitivities so only compare the same tests if you are looking for them getting weaker etc. I used a cheap One Step test each week then FRERs at the end as they are the most sensitive so would pick up any HCG left over.

For me the whole journey went:
MMC discovered at 12 weeks (fetus passed away at 11 weeks)
Surgery 2 weeks later
Bled for 2 weeks
Tested at 3 weeks post surgery (One Step) - still super positive, called EPU, they told me to wait a few more.
Week 4 and 5 after surgery - tested weekly (One Step), still positives. This was over xmas so I didn't want to go, so didn't get in touch with EPU.
Tested at 6 weeks after (One Step) - still positive, but less so
Tested at 7 weeks after (One Step and FRER) - still lightly positive, but less so, EPU told me to come in for a scan (to check for anything retained)
8 weeks after surgery - EPU scanned me, nothing retained, all clear, pregnancy tests went negative (on FRER), positive ovulation test and temps rose this week (busy week!)
9 weeks after surgery - period came.

Wanted to add - Im an unusual case. It usually doesnt take as long as 9 weeks for period to return. This was partially just my bad luck and partially cause the fetus had grown until 11 weeks so HCG was v high.

Like you, we had a scan at 10 weeks that looked amazing. And so to get that news at the 12 week scan broke my heart.

Thank you! Reading your message, it makes sense why I would be reading high LH levels at this stage if it is HCG levels are somehow linked.

Think I’ll hold off on any testing for a couple of weeks as I think it’s just adding to all the confusion.