Desire Sibling for our Four Year Old
Question
Good morning,
My husband and I are parents of a four year old girl and have been trying to conceive again unsuccessfully for two years. My periods have been erratic and I started charting my temperatures. I discovered that my luteal phase lasts only ten days max. I start spotting on day eight and nine and than full bleeding starts on day ten. We are currently living overseas and there are no fertility doctors at this place, only one U.S. health practitioner. We tested my progesterone level on day three after ovulation and the level was 15, than again on day ten when it dropped to 1.5 which was according to HP extremely low. He prescribed Cyclogest 200 mg that I have to supply from the neighboring South Africa.
Before I order it, would that be a good medication for this condition or is there something better? Also, what are some other tests that you would suggest?
Thank you in advance.
Natalie
Answer
Last Updated: November 15, 2021
A 200 mg. Cyclogest pessary used for ten days in the luteal phase is adequate therapy for luteal phase defect due to low or rapidly dropping progesterone. However, one can not be certain that that is your problem, as your luteal phase was not tested for progesterone at the optimal times. It is best to test for progesterone deficiency at least three times; ideally five, seven and nine days after ovulation (or peak day, according to some natural planning methods). Ideally estrogen (estradiol) levels should be obtained at these times also, as low estrogen can cause a thin and inadequate uterine lining. Low thyroid and mycoplasma/ureaplasma bacteria are also treatable causes of miscarriage. Ultrasound can sometimes delineate cervical polyps or fibroids, which can cause intermenstrual spotting.
That being said, your spotting and low temperature could be due to low progesterone, and a trial of Cyclogest therapy would be reasonable in your situation.
Mary L. Davenport, M.D
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