Are There Any Options for Me Besides IVF?

Question

My husband and I have been trying to conceive since August. We have run into some “roadblocks”, and obviously at this point I’m getting kind of despondent.
To start, my history: I am 37 years old with two children, neither of which gave me any problems in terms of conception (to be honest, they were both unexpected). For the past three or so years my cycles have been erratic, and were only 23 or so days in length. In January my cycle suddenly went to 45 days and then I started to spot. I thought I might be miscarrying, but after an ultrasound they found an 8cm cystadenofibroma that they thought was on my left ovary. Surgery was scheduled, and it turned out that it was actually on my left fallopian tube. I lost that tube but kept the ovary.

About two months later my OB/GYN re-evaluated me since she knew we were ttc. I was put on Femara for days 5-9. First month was 5mg, but since my progesterone levels were still low they bumped me to 10mg for the 2nd month (they wanted me over 10, and the 10mg had me at 12.3). My cycles then went to 28 days like clockwork. After four months total, I missed a period, and on about day 40 I started to spot. Again, they found a cyst, this time a 2cm simple, and took me off the Femara (she said a cyst should not have developed if the Femara was working).

My OB/GYN had suggested getting a test done on my husband as well, but since there were so many problems that were on my end, we never did those tests. However, two months ago my husband and I found out that he was taking a medication that caused low sperm count, so he went off of it and we decided to try again. I still had two refills of the Femara left and I chose to risk the cyst and start the regimen again. I informed my GYN of this on the second month and had my 23-day tests done this past Tuesday. This time even after two months my progesterone was only at 2.9.

I know this is a little run-on, but I wanted to give all the background first before I asked my questions…

My questions are as follows:

1. What would cause the Femara to work fine on the progesterone levels the first round, but not at all on the second?
2. I know I don’t have PCOS, so what could be causing these low progesterone levels? (I never had any problems getting pregnant with my two children).
3. Are there any options available to me other than resorting to something like IVF?

I meet with my GYN again on the 30th, but was hoping someone here could give me a little hope in advance…

Ayara

Answer

Last Updated: May 2, 2022
Dear Ayara,

The Femara will primarily raise your follicular phase (pre-peak) estradiol levels. If your luteal phase (post-peak) progesterone levels are low then HCG injections on post-peak days 3, 5, 7 and 9 would be a better treatment.

The low progesterone levels could be a result of an age-related luteal phase defect. The cysts are not necessarily a good indicator that the Femara was or was not working.

I suggest that you get a comprehensive NaProTechnology evaluation. Go to www.naprotechnology.com for more information. Go to http://www.fertilitycare.org/mclocations/usa.htm to find a NaProTechnology physician.

NaProTechnology seeks to identify defects in the reproductive system and then treat those defects. Its approach respects the integrity of the design of the natural reproductive system, never impeding, destroying or circumventing it.

In health,

George Delgado, M.D., F.A.A.F.P.

Answered By:

George Delgado, M.D., F.A.A.F.P.
President and Founder of Steno Institute and Medical Director of Culture of Life Family Services (COLFS), San Diego, is a Professional Member / Supporter of CANFP. Board certified in both family medicine and hospice and palliative medicine, Dr. Delgado received his medical degree from the University of California, Davis, and completed his residency at Santa Monica Hospital/UCLA. Dr. Delgado is a Natural Family Planning Medical Consultant, trained in NaProTechnology.

Read more related questions

Panic About Fertility

I’m having a complete panic about my fertility. I’m 30 years old and stopped taking the pill a few months ago after being on it…

Trying to Conceive for First Time

I am a 38 year old woman, trying to conceive for the first time. I am using the Clearblue Fertility Monitor and it showed high…

Could Polyp Be Causing Miscarriage?

Could you please help me as I don’t know who I can ask? I am 43 years old (have had no children before) and within…

Breastfeeding and Miscarriage

I am a 38 year old woman with three children who has also had five miscarriages. I am currently four weeks pregnant (six weeks after…

Conflicting Advice on Progesterone and Infertility

I am 27 years old and my husband and I have been trying for our first child for five months. I have been charting since…

Low Estradiol on Day Three of Cycle

I am 26. I have had four miscarriages. Recently I had cycle day three labs done. The results are as follows: FSH 5.5 TSH 1.33…

Is My Premenstrual Spotting Related to My Miscarriages

I am 40 years old, with an almost-three-year-old daughter. My husband and I have been married for eight and a half years. We went through…

New Normal After Stillbirth?

My first child (a beautiful baby girl) was stillborn in February of this year (40 weeks gestation with no known cause). My husband and I…

Poor Cervical Mucus and Now Miscarried

I am 37 years old, with two children ages six and three and a half. I have been trying to conceive for one year using…

Still Think Something is Just Not Right

I am 26 years old and my husband and I have been practicing NFP since we married two years ago. Right after getting married, I…

What is Normal TSH?

I was having a difficult time becoming pregnant. I finally got pregnant, but then miscarried. This was unusual for me because I quickly became pregnant…

How Long Should I Wait to Conceive After Weaning

I had a miscarriage a few weeks ago, and I believe that it is very possible it was due to low hormone levels. I had…

Create An Account

This is not a membership, this is an account for our CANFP website. If you decide you would like to sign up for one of our memberships later, you can do so with or without this account.

First Name *
Last Name *
E-mail *
Username *
Password *
Confirm Password *
Edit Profile
Information
Subscriptions
Payments
Order History
Downloads
Shipping and Billing
Donations
Settings
Login Information
Notification Settings
Notification Subscriptions
Profile

CANFP conducts varied outreach programs to the community at large, in addition to serving our members (NFP users, teachers, and advocates).

CANFP provides education programs tailored to the audience, not only on Natural Family Planning, but on the wide variety of topics related to it.

Programs can be continuing education for NFP Professionals, introductory information for a lay audience of youth or adults new to the topic, or specifically tailored to the interests of a professional audience, such as educators, physicians, or clergy. Content is faith based or secular, whichever is suitable for situation.

CANFP offers a variety of resources for those just discovering Natural Family Planning, as well as to meet the varied needs of our CANFP Members. Most resources are available to any visitors to our site. Some resources do ask you to register as a site user in order to access them, others are available only to CANFP Members.

CANFP statewide conferences, regional events offered in collaboration with local partners, events featuring CANFP speakers, or exhbit, as well as other events throughout the state of interest to our NFP community.  Come meet one of our experts at one of these events or book a speaker for your own upcoming event.

CANFP depends on the gifts, talents, and generosity of our members and supporters. The success of our mission depends on the collaboration of our members. Please consider contributing your time treasure and talent through CANFP to share the good news of NFP with the world! Both volunteer and contracted positions available.

Stay informed by joining our email list

* indicates required
Which role(s) best describes you?