IVF and Insemination Unsuccessful


I have gone through an IVF cycle and now through artificial insemination to no avail. I have been spotting before my period for 5-7 days before it actually starts.  This has been going on for years. I have had an ultrasound done of my uterus and ovaries and a hyscopenia (?) (where they insert fluid up through the ovaries to check them and look at them on the ultrasound screen). I have had my Progesterone checked many times and it was normal. I even am taking Progesterone supplements during IVF and the last procedure to make sure it was not a Progesterone deficiency. Could you tell me why I am spotting? I don’t have pain and my periods normally last 5-6 days after the spotting with only really one heavy day, but they are not as heavy as they were when I was a teenager. I am 32. I would like to solve my spotting problem so I am not bleeding half the month and so I can get pregnant. Thanks so much!


I am sorry to hear of your difficult situation. Yes, premenstrual spotting and bleeding by 3-4 days usually signals low progesterone levels. I would wonder a couple of things about this. First, laboratories have wide ranging “normals” which are not standardized. There is only one lab that I know of that has standardized progesterone levels and that is in Omaha. The progesterone levels that I would check in your situation would be over many days and correlated with the time that you ovulated, not with the date of the last menstrual period.

Secondly, I would wonder if you have developed progesterone receptor malfunction. The progesterone level could be near normal, but the receptors at the target organs (ie the uterus) were not responding. This is the fairly new area of reproductive immunology, an area of science which investigates the immune system effect on reproduction.

IVF has about a 20% success rate per cycle and involves a lot of drugs and money. Additionally, there are on average 5-6 embryo deaths per successful embryo transfer and pregnancy. I would strongly recommend locating a Creighton model natural fertility care teacher. The teacher would then refer you onto a medical consultant trained in NaPro Technology. This is a physician (usally Ob/Gyn or Family Doctor) who has gotten additional training in fertility using the Creighton model. The other models of NFP have not been as heavily studied for infertility problems as the Creighton model.

There is a concern that with prolonged bleeding you can develop anemia. Additionally, women who have chronically lower progesterone levels increase their risk of estrogen types of cancer such as endometrial and breast cancer. Please don’t delay. By correcting the reason for your spotting and bleeding, you will probably find the reason for your decrease in fertility and enhance your overall health.

I hope that this information helps!

Dr. Gretchen Marsh

Answered By:

Gretchen Marsh, D.O.
Dr. Marsh graduated from Western University of Health Sciences in 1987 in Pomona, CA and is board certified in Family Medicine by the American Osteopathic Board of Family Physicians. She has been certified as a NaProTechnology® Medical Consultant (NaPro) and Creighton model Fertility Care System (CrMS) teacher since 2001. She and her husband, Jon, have 5 sons and live in the Reno region, where she sees patients in person, in addition to her telehealth services offered via MyCatholicDoctor.com

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