PCOS Messages for August, 2002: Re: Ovulating.... or not?

Re: Ovulating.... or not?

From: Chris (anonymous@obgyn.net)
Thu, 15 Aug 2002 18:51:39 -0500 (CDT)

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Reply: Lenora: "Re: Ovulating.... or not?"

>From inciid.org....A serum progesterone test will often be performed at
about seven days past ovulation. A level less than 14 ng/ml indicates that progesterone production in the luteal phase is inadequate.

Should progesterone levels prove to be low, the temptation is often to "treat the symptom" by giving the patient progesterone supplementation during the luteal phase. In the case of inadequate corpus luteum performance, progesterone support may indeed be the appropriate solution. However, inadequate follicle development may also be causing the low progesterone levels. Thus, it is important to measure midcycle follicle size (via ultrasound) and estradiol levels (via a blood test).

If follicle development is normal, then progesterone supplementation during the luteal phase is normally the correct treatment. If follicle development is inadequate, an ovulatory stimulant such as Clomid or an injectable drug may be in order; these drugs help the follicle to mature more appropriately, which has the double benefit of producing a higher quality egg and a better-functioning corpus luteum.

Hope that helps! Note that low progesterone on day 7 does not necessarily mean you did not ovulate. The ONLY way to know whether someone ovulated or not is via ultrasound. It's possible you're conceiving but low progesterone is keeping you from sustaining the pregnancy. I'd ask about progesterone supplementation (an EASY solution) and a midcycle ultrasound.

>>>>
>>>>Last Thursday was Day 7 after ovulation, and I had a blood test done to
>>>>check my progesterone level. Of course, my doctor and I both expected
>>>>the level to be relatively low, but today I found out the results, and
>>>>they indicate I did not ovulate this month (2.7). I was already
>>>>beginning to spot, fairly heavily, so I don't know if my progesterone
>>>>had already dropped or if that was the highest level it had reached
>>>>since I ovulated (or thought I had ovulated). I do think I should do
>>>>this test again -- I'm sure one month isn't enough to be conclusive.
>>>>Maybe my progesterone should be checked on Day 5 or 6, what do you
>>>>think? What I find puzzling is that I always get a surge for one day,
>>>>then I always (almost) have twinges or pain around the same time, and my
>>>>periods always start 8-9 days later -- everything is like clockwork,
>>>>which to me indicates that I ovulate. Could this mean my body is TRYING
>>>>to ovulate, but it doesn't actually happen?
>>>>
>>>>Do any of you have any insights on this? Thanks for your input!
>>>>
>>>>Anyway, like I said, another interesting piece of the puzzle, and
>>>>hopefully the tests I had done today will reveal more about the complete
>>>>picture.
>>>>
>>>>-Lenora
>>>
>>>--
>>>Joy 29
>>>History of Endo and Infertility
>>>Maybe PCOS
>>>1 child 10-25-00
>>>TTC # 2 one year and counting....
>>>

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