Trying for Two Years
Question
We’ve been trying almost two years to get pregnant; our daughter is five. My insulin level is 24 and on day 22 my progesterone level was 0.80. The MD said it was because I didn’t ovulate. What else can I do? He put me on metformin 1500 mg’s at hs. I don’t understand how to increase my progesterone level.
Carolyn
Answer
Last Updated: February 22, 2015
Dear Carolyn,
From what you have mentioned, you appear to have infertility with insulin resistance, most likely due to polycystic ovarian syndrome(PCO). The metformin your doctor put you on will improve the insulin resistance, and thus improve your fertility by allowing ovulation.
The progesterone is formed in your ovaries after ovulation. Increasing your exercise can also improve your insulin resistance. If you are not used to doing a lot of exercise, you can still benefit from short periods, like 10 minutes of brisk walking, and build up to 3 times a day. Most people can fit that into their schedule, especially if you keep in mind it will help restore your fertility.
You didn’t mention how long your cycles were, but there is also the chance that you are ovulating, but just hadn’t yet by the time you had the progesterone level drawn. Women with PCO tend to have long and irregular cycles. To help you determine when you are ovulating, I would highly recommend you take a natural family planning class so you can learn the mucus observations leading up to ovulation. This will help you know the days of greatest fertility. Even if you are not ovulating yet, the classes will help prepare you to identify the earliest signs of improving fertility as you continue the metformin and exercise.
I wish you well.
Dr. Lynn Keenan
From what you have mentioned, you appear to have infertility with insulin resistance, most likely due to polycystic ovarian syndrome(PCO). The metformin your doctor put you on will improve the insulin resistance, and thus improve your fertility by allowing ovulation.
The progesterone is formed in your ovaries after ovulation. Increasing your exercise can also improve your insulin resistance. If you are not used to doing a lot of exercise, you can still benefit from short periods, like 10 minutes of brisk walking, and build up to 3 times a day. Most people can fit that into their schedule, especially if you keep in mind it will help restore your fertility.
You didn’t mention how long your cycles were, but there is also the chance that you are ovulating, but just hadn’t yet by the time you had the progesterone level drawn. Women with PCO tend to have long and irregular cycles. To help you determine when you are ovulating, I would highly recommend you take a natural family planning class so you can learn the mucus observations leading up to ovulation. This will help you know the days of greatest fertility. Even if you are not ovulating yet, the classes will help prepare you to identify the earliest signs of improving fertility as you continue the metformin and exercise.
I wish you well.
Dr. Lynn Keenan
Answered By:
Lynn Keenan, MD
Lynn Keenan, MD, Immediate Past President of the CANFP Executive Board, is a Clinical Professor at the UCSF/Fresno Internal Medicine Residency Program (now retired), Board Certified in Sleep and Internal Medicine, and Vice President of the International Institute for Restorative Reproductive Medicine. She earned her BSN at UCLA, her MD at Temple University School of Medicine, and completed her Residency in Internal Medicine at UCSF/Fresno. Dr. Keenan served on the Executive Board of CANFP since 2004, as President of CANFP since 2010, and graciously agreed to continue her service to CANFP on the Advisory Board at the beginning of 2019, upon her retirement from the Executive Board of CANFP
