Is progesterone indicated?

Question

I am a 42 year old with one son. My partner and I have been trying to conceive for about two years. I have been with my IVF/ob-gynae since then. I have had my E1, E2 and thyroid levels checked and are ok. My partner has also had semen analysis and his results came back as normal.  My ob-gynae has me on 150 iu of puregon a day (blood test on day 5) followed by a ultrasound and HCG injection on day 12-13. Seven days after ovulation, I am blood tested for ovulation and progesterone levels. He says my progesterone levels are good, 58, but 2 days later (on day 9) I begin to bleed and have a normal period. Do I have a luteal phase defect? And would a progesterone supplement be useful in lengthening my luteal phase to 14 days?

Answer

Last Updated: July 24, 2013
Sorry, there is not enough information provided to determine if you have a luteal phase defect. To determine this, one needs a hormone profile of at least three luteal blood samples of progesterone and estrogen before and after treatment (preferably 5, 7 and 9 days after ovulation), the timing of your previous cycles, results of ultrasound, charting or hormone testing to determine timing of ovulation, as well as all medications you have been on for the last few cycles. If it is determined you have a luteal phase defect, progesterone or a different regiment of HCG could be used. Other causes of bleeding could be fibroids or a polyp.

M. Davenport, MD

Answered By:

Mary Davenport, MD, MS
Mary Davenport, MD, FACOG, an obstetrician/gynecologist from the Oakland Region of California, offers telehealth services over MyCatholicDoctor.com She graduated from Tufts University School of Medicine and completed her residency at UC San Diego. Dr. Davenport is a Fellow of the American College of Obstetrics and Gynecology, and serves on the Advisory Board of the California Association of Natural Family Planning.

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