WOMENS-HEALTH Messages for July, 1997: Re: When EXACTLY to begin progesterone supplements ??

Re: When EXACTLY to begin progesterone supplements ??

From: Marcia (anonymous@obgyn.net)
Mon, 21 Jul 1997 08:46:09 -0500 (CDT)

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I'm interested in speaking to ANYONE about this topic. I'm about to begin my 3rd cycle of progesterone supplements. I'm in the care of an OB/GYN (no RE available). My instructions are to begin taking the supplements (vaginal suppositories) 3 days after ovulation. I've been using BBT charts. My understanding is that I count the day of the rise as day one. I really think that any difference of a day or two in the beginning is negligible. I've also been corresponding with someone who has instructions of beginning the 4th day after the LH surge. She uses OPT kits. Anyway, there is very little information out there about progesterone, so I'd be happy to talk to anyone about this and share my limited sources. You can contact me at anonymous@obgyn.net At Tue, 27 May 1997, Laurie wrote: >
>At Tue, 27 May 1997, Mary wrote:
>
>>>What I would want to know is, what is your diagnosis of luteal phase defect based on?
>>
>>It was based on 9-10 day luteal phase lengths and a progesterone level
>>of 6.8 on day 23.
>
>Serum progesterone levels correlate poorly with endometrial histology,
>but a luteal phase length of 9-10 days is clearly short. Did the prior
>clomiphene treatment lengthen your luteal phase?
>
> Hopefully intercourse on days 9,10,12,13 and 14 was adequate.
>
>We'll keep our fingers crossed!
>
>Since my periods (in the
>>past, before my previous pregnancy last year) were once or twice a year,
>>I would have had no idea when to use an LH kit. Now that my cycles
>>appear a bit more normal and are being monitored, I will definitely try
>>a kit next cycle *if needed* :-)
>
>Here's hoping for the best...
>
>>My doc likes to take things in steps beginning with the least invasive.
>
>I like this approach.
>
>>I don't disagree with this but at the age of 33 1/2 and with only one
>>successful pregnancy in 12 years - I hear my clock ticking loud and
>>clear!
>
>It sounds like you are taking an active approach, though, not just
>sitting around waiting for something to happen.
>
> Since I have been pregnant 4 times (P1111), a
>>semen analysis has not been done (my doc scored major points with my
>>husband for that one!).
>
>Oh, those husbands always object. I would think it beats mowing the
>grass or cleaning out the garage! :-)
>
>Do you think an endometrial biopsy should have
>>been done?
>
>While endometrial biopsy is the "gold standard" for diagnosis of luteal
>phase defect, it is painful and requires confirmation with a second
>biopsy in another cycle. For these reasons, many M.D.'s prefer NOT to
>do a biopsy if it can be avoided. In your case, you definitely had a
>short luteal phase, and you are getting treatment for LPD anyway
>(clomiphene and progesterone), so a biopsy diagnosis wouldn't make a
>difference. The time a biopsy becomes useful, in my opinion, is when
>pregnancy doesn't result despite treatment; then, a repeat biopsy can
>show whether a luteal phase defect still exists. The major drawback to
>progesterone therapy in my practice is that it postpones a subsequent
>period in those who haven't become pregnant. That waiting period can
>generate false hope and be heartbreaking in infertile couples.
>>
>>Thank you again for you input!
>
>Best wishes to you and your family, Mary. If I could make it work out
>perfectly from here, I would love to do so.
>
>--
>Laurie Lovely, MD
>RE fellow, UNC-Chapel Hill
>

Next message: Marcia: "Re: Progesterone Supplements/Pregnancy Symptoms"
Previous message: Loriann: "normal AFP result"

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