QuestionHi there,
I just have a question about progesterone levels.
We've been TTC for over three years now. I've been on Clomid for four months now. This cycle I took 100mg Clomid CD 4 - 8. CD 13 an U/S showed one 20mm follicle on my right ovary, womb lining 7mm thick. The doc gave me an Ovidrel trigger shot on the same day.
CD 21 my progesterone tested at 34. The nurse said that I had ovulated but that it wasn't the best quality ovulation.
I just want to know what the expected progesterone level for a sustainable pregnancy should be. I've had two very early miscarriages before, one with a CD 21 progesterone level of 76.
Thank you so much in advance!
Venessa
AnswerHello Vanessa,
I have absolutely no idea what the heck the nurse meant by "best quality ovulation." In fact, I didn't even know you could tell if it were a "good quality or bad quality." It's supposed to be either ovulation or no ovulation. Or maybe she was referring to the fact that you only ovulated one follicle, whereas with Clomid or any other fertility drug, the goal is to increase the number of eggs that you ovulate up to three (superovulation).
In any case, in terms of progesterone, you want a level over 10. Anything over that indicates that ovulation occurred. The purpose of progesterone is to convert the endometrial lining for implantation mainly. As a secondary event, it is also required for the pregnancy to develop until the placenta forms (6-8 wks gestational age). There is no "ideal" or "expected" level of progesterone to sustain a pregnancy. In IVF we do test progesterone levels to make sure that there is sufficient progesterone in the system, and we like the levels to be over 20. But that is not necessarily the level required to sustain a pregnancy. There is much more involved in sustaining/prolonging a pregnancy. In addition, when vaginal progesterone is used, the blood levels don't reflect the amount of progesterone that is actually in the endometrial, which is where it needs to be.
You should probably ask your doctor, at your next visit, what the nurse meant by "quality ovulation".
I hope that clarifies it for you.
Good luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf
