Progesterone Testing Tied to Knowing Ovulation Timing
Question
I have been trying to conceive for 13 months. I went to a fertility specialist and he did a progestrone test at mid-cycle or cd 19; it came back 1.0 so he put me on Provera, and then Clomid after I had a flow. Is this the right treatment or should I worry that if I conceive I will miscarry? And what does the 1.0 mean?
Thanks.
Brittiney
Answer
Last Updated: January 31, 2022
Dear Brittiney,
It is common for a physician to order a progesterone level testing for adequacy in the luteal phase of the cycle.(which is after ovulation has occurred). The physician assumes that your cycle is 28 days long and ovulation has occurred on day 14. As you may have already noticed all cycles are not 28 days long! A progesterone test result will not be useful if ovulation has not occurred; progesterone levels will be very low then. As in your case, it gives the impression that your progesterone is inadequate or that ovulation is not occurring. In order to get more useful information a woman should chart the changes in her cervical mucus and identify the Peak Day (observation which corresponds with ovulation). When timed appropriately the assessment of progesterone can then be accurate. At a level of 3.1 ng/ml ovulation is certain. The level continues to rise in preparation for pregnancy. If conception does not occur levels fall and menstruation begins. By prescribing Provera the physician is treating you with a progestin (synthetic) in order to cause these changes at the end of the cycle. In high doses Provera also prevents ovulation. This is why it is commonly used as a contraceptive!
After menstruation begins Clomid is used to induce ovulation by blocking the estrogen binding sites and the hypothalamus responds by producing more GnRH, which stimulates the pituitary to produce FSH. In a normal healthy cycle developing follicles produce increasing amounts of estrogen and this signals to reduce FSH. Clomid can cause side effects such as ovarian hyperstimulation, multiple births, nausea, and diminished “quality” of cervical mucus.
Once ovulation occurs the sperm cells depend on the cervical mucus to reach the ovum. This ovulation induction therapy is commonly used but patients should undergo a fertility workup prior to beginning any therapy. Ovulatory disorders are not the only cause of infertility. The other causes of infertility may include endometrosis, tubal disease, polycystic ovarian syndrome, cervical factors, and sperm count.
By inducing all of this the underlying problem has not been identified and “yes” you may have an increased risk of miscarriage. So the physician should monitor you closely.
On the other hand you can learn to chart your natural cycles to help pinpoint the inadequacies in your cycle and once they have been treated, achieve pregnancy. Your health as a new mom should be of primary concern. This site can direct you to a Natural Family Planning teacher that can help you get started charting your biomarkers of fertility.
Wishing you a healthy pregnancy,
Angie
It is common for a physician to order a progesterone level testing for adequacy in the luteal phase of the cycle.(which is after ovulation has occurred). The physician assumes that your cycle is 28 days long and ovulation has occurred on day 14. As you may have already noticed all cycles are not 28 days long! A progesterone test result will not be useful if ovulation has not occurred; progesterone levels will be very low then. As in your case, it gives the impression that your progesterone is inadequate or that ovulation is not occurring. In order to get more useful information a woman should chart the changes in her cervical mucus and identify the Peak Day (observation which corresponds with ovulation). When timed appropriately the assessment of progesterone can then be accurate. At a level of 3.1 ng/ml ovulation is certain. The level continues to rise in preparation for pregnancy. If conception does not occur levels fall and menstruation begins. By prescribing Provera the physician is treating you with a progestin (synthetic) in order to cause these changes at the end of the cycle. In high doses Provera also prevents ovulation. This is why it is commonly used as a contraceptive!
After menstruation begins Clomid is used to induce ovulation by blocking the estrogen binding sites and the hypothalamus responds by producing more GnRH, which stimulates the pituitary to produce FSH. In a normal healthy cycle developing follicles produce increasing amounts of estrogen and this signals to reduce FSH. Clomid can cause side effects such as ovarian hyperstimulation, multiple births, nausea, and diminished “quality” of cervical mucus.
Once ovulation occurs the sperm cells depend on the cervical mucus to reach the ovum. This ovulation induction therapy is commonly used but patients should undergo a fertility workup prior to beginning any therapy. Ovulatory disorders are not the only cause of infertility. The other causes of infertility may include endometrosis, tubal disease, polycystic ovarian syndrome, cervical factors, and sperm count.
By inducing all of this the underlying problem has not been identified and “yes” you may have an increased risk of miscarriage. So the physician should monitor you closely.
On the other hand you can learn to chart your natural cycles to help pinpoint the inadequacies in your cycle and once they have been treated, achieve pregnancy. Your health as a new mom should be of primary concern. This site can direct you to a Natural Family Planning teacher that can help you get started charting your biomarkers of fertility.
Wishing you a healthy pregnancy,
Angie
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