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Question
Posted by: Tray | 2007/07/23

Normal Progesterone on D21

Hi there
DH and I have been ttc for 6 months. I have a history of PCOS and am on Metformin. I have been having regular cycles, but still nothing. I went to gynae on D14 - she did a scan and could not see any signs of ovulation - no corpus luteum? She sent me for a progesterone test on D21. This was completely normal! Why could nothing be seen on the scan? Is it possible to have a completely normal D21 progesterone, and not actually be ovulating?
This month I also did a home OPK test - it definitely showed a positive result - so I do produce LH.
I am 34 yrs and getting quite worried that I'm running out of time. The gynae said I must come back to her in another 10 months if nothing has happened yet. Does this sound right?
I am so worried that there is something wrong, and I am just wasting time.
Any advice would be most appreciated!
I

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Our expert says:
Expert ImageFertility expert

Dear Tray

The positive ovulation test as well as confirmatory day 21 progesterone would most likely indicate ovulation having occurred. However in severe cases of PCOS it is possible to have false positive LH detection, simply due to the fact that PCOS sufferers have raised baseline LH levels continuously. Furthermore PCOS patients may also have an increased tendency towards lutenised unruptured follicle syndrome (lufs) which implies no ovulation despite the formation of a corpus luteum and hence elevated progesterone levels as well, in the second half of the cycle. Therefore one would have to trace significant reliance on the ultrasound scan and trusting that this scan was done accurately, I would be inclined to believe that PCOS is quite advanced and needs to be dealt with as a matter of urgency. Aggressive but careful ovulation induction should be considered.

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Our users say:
Posted by: Dee | 2007/07/23

What was your prog count on D21?

Its possible that you had already ovulated when the scan was done on D14 thus no follicle was seen.

I would suggest ur partner does a sperm analysis, if that comes back normal then you can try for another 6 months or so. I wouldnt wait for as long as 10 months!

Reply to Dee

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