Progesterone Levels Question


#1

Hi Ladies-

I need some advice… For the past 5 months now I have been on 50mg of Clomid and then bumped up to 100mg just to make sure I ovulated for my IUI.

Over the last 4 months my results on day 21 were:
-40.4
-50.2
-79.3
-80.1

This month I had a surge on 3/27, got my iui done on 3/28 and had my progesterone checked on day 23.

This whole time I have had cramps, sore bb’s, and fatigue so I thought this could really be it.

Well… I just called my Dr office to see what my day 23 results were and it was only 6.1!!!

Anyone know of why this would happen? Why would I get a surge but not ovulate, why would all my other months be so high and this one so low, and why would I have sore bb’s but not ovulate? I am not on progesterone shots or anything because my numbers have been so high normally.

Any advice would help!

Thanks


#2

Were your levels checked first thing in the morning? Or at least the same time as your previous draws? 6.1 does not mean you did not ovulate, I believe it’s anything over 2 - 5 (depending on doctor/lab) so I think you did ovulate.


#3

My levels were checked in the afternoon. I usually try to go around the same time each month, this one included. I really hope I did! I am going to have another test done hopefully once I get a response from my Dr. Just to be sure either way.


#4

They like to see CD 21 progesterone over 15 on a medicated cycle. The thing that stands out to me is that you say you have done 5 clomid cycles so far and it is clear that you have been ovulating by your progesterone levels so…my question would be are you seeing an Reproductive Endocrinologist or an OB/Gyn for your treatment?

The reason I ask is because studies show that if one does not get pregnant within 6 cycles of clomid the odds that they will on the clomid are very ulnikely. Also, for some multiple cycles can backfire in that the side effects of the clomid can counteract fertile CM, decrease favorable endometrial lining, and even stop working to induce ovulation. It appears that in your most recent cycle you may have ovulated, but it doesn’t appear to be a good ovulation and thus after 5 clomid cycles it may be time to do some more testing to find out what else could be wrong (i.e. blocked tubes, polyps, fibroids, abnormalities, hormonal imbalances, or even male factor infertility).

Looks like your DH’s SA is good so that is promising. Have you had a Saline sono or HSG to rule out blocked tubes or abnormalities?

Also, it appears you were ovulating on the 50mg so why bump up to the 100mg? The recommendation is to use the lowest working dose due to the side effects and them possibly backfiring with an increased dose so I am curious if you were getting ovulatory results with the lower dose what benefit there would be in increasing the dose? It may be that you need to try another cycle at the 50mg dose.


#5

[quote=ahhny]They like to see CD 21 progesterone over 15 on a medicated cycle. The thing that stands out to me is that you say you have done 5 clomid cycles so far and it is clear that you have been ovulating by your progesterone levels so…my question would be are you seeing an Reproductive Endocrinologist or an OB/Gyn for your treatment?

The reason I ask is because studies show that if one does not get pregnant within 6 cycles of clomid the odds that they will on the clomid are very ulnikely. Also, for some multiple cycles can backfire in that the side effects of the clomid can counteract fertile CM, decrease favorable endometrial lining, and even stop working to induce ovulation. It appears that in your most recent cycle you may have ovulated, but it doesn’t appear to be a good ovulation and thus after 5 clomid cycles it may be time to do some more testing to find out what else could be wrong (i.e. blocked tubes, polyps, fibroids, abnormalities, hormonal imbalances, or even male factor infertility).

Looks like your DH’s SA is good so that is promising. Have you had a Saline sono or HSG to rule out blocked tubes or abnormalities?

Also, it appears you were ovulating on the 50mg so why bump up to the 100mg? The recommendation is to use the lowest working dose due to the side effects and them possibly backfiring with an increased dose so I am curious if you were getting ovulatory results with the lower dose what benefit there would be in increasing the dose? It may be that you need to try another cycle at the 50mg dose.[/quote]

Wow! You gave me a lot to think about :slight_smile: I have had an HSG test done and all was open but that was 2 years ago at the beginning of this journey. I just started seeing an RE this month (cycle 5) so we could do an IUI. I was told that my clomid was bumped up to 100 just to make sure I ovulated for my IUI, go figure, I may not have now. I am hoping to hear from my RE soon as they haven’t responded to my email yet. I am going to have to see about more testing etc. Just so confused. I am hoping that this was just an error and hopefully I did ovulate and they recorded the level wrong but that is me trying to stay positive. I will keep this page updated until I find out. Going to get another progesterone test done this afternoon to rule out any error.

Thank you so much for the thoughtful response and congrats on your baby girl :slight_smile: I am the only girl with 3 older brothers as well :slight_smile:


#6

Hopeful, keep us updated. I really want to hear what your RE says. I’ve never had a day 21 progesterone check, though I now use crinone to supplement my progesterone in my luteal phase.

I would love to hear what your doc suggests… whether your numbers are fine, need a booster, why they’re lower, etc. I agree with the question about the 100mg of clomid. My doc never even tried 50. This is my second clomid cycle, but the first wasn’t monitored (and I never got an LH surge - I’m thinking now, based on more recent data, that my LH surge is too low for OPKs to indicate. Regardless, no surge, no IUI on my first clomid cycle). I ended up with 3 mature follicles, one more measurable, and still a number of smaller… guess I respond really well. I wonder what 50 would’ve done for me.

Please, though, let us know how it goes - and good luck!


#7

[quote=Poenym]Hopeful, keep us updated. I really want to hear what your RE says. I’ve never had a day 21 progesterone check, though I now use crinone to supplement my progesterone in my luteal phase.

I would love to hear what your doc suggests… whether your numbers are fine, need a booster, why they’re lower, etc. I agree with the question about the 100mg of clomid. My doc never even tried 50. This is my second clomid cycle, but the first wasn’t monitored (and I never got an LH surge - I’m thinking now, based on more recent data, that my LH surge is too low for OPKs to indicate. Regardless, no surge, no IUI on my first clomid cycle). I ended up with 3 mature follicles, one more measurable, and still a number of smaller… guess I respond really well. I wonder what 50 would’ve done for me.

Please, though, let us know how it goes - and good luck![/quote]

Poenym - I am definitely going to ask about the Clomid and why they upped my dose… Hope it isn’t doing the opposite of what it is supposed to. Maybe if it turns out negative this month I can bump back to 50mg since I know that worked for me.

I tested again this morning (12dpiui) and got another negative :frowning: I know I am possibly still in the game but my heart is pretty crushed after finding out about my progesterone level yesterday. Still haven’t heard anything from my RE or Dr so I am hoping to get some answers today, maybe re-test or just wait until Friday to see if AF arrives. My bbs still hurt and I am cramping lightly like I have been for a week and a half now so I am HOPING the results were wrong.

How are you doing? That is great that you produced so many follies! I have never been monitored like that.


#8

Hopeful, I recommend the monitoring. It definitely helps time things better, and you know more about what your body is doing (and what might be going wrong) - but it’s not cheap.

The first cycle we monitored was a diagnostic cycle, so my insurance paid for it, though we still did an IUI (they didn’t pay for that). It was the last of my really off cycles… and the diagnosis at the end wasn’t great.

But it was the LAST of my really off cycles. My RE at that point said she didn’t think I would ovulate on my own and therefore we had to do monitoring from now on. So… okay. We paid for another cycle of it.

This cycle my monitoring was covered by the clinical study I was in.

The next two we’ll pay for… but then insurance starts covering things, because 6 failed tries is enough to get them to admit I’m infertile. Then, on to IVF.

But the monitoring… it really helps me understand, and certainly gives my doc way more information!