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Suggest Treatment For Infertility While Having PCOS
Question: Hi! My wife has had PCOS for many years now. In the past, she was put on birth control pills on and off to control her symptoms. We are now planning to extend our family. She stopped taking bcp in the month of April this year. After some cycle irregularities initially, she now has a regular 40 days cycle. She had been using ovulation predictor kit and charting temperatures to identify ovulation days accurately. Although her charting shows she ovulated but we never got a positive on opk. She is also taking acupuncture therapy to help her with PCOS and ovulation. We recently got her blood work done for Progesterone levels. The levels came out as 8.9. This was taken 7 days before her menstrual cycle while she was in her luteal phase. Does this mean she is ovulating? If the levels are not good enough for conceiving, what would you suggest as a treatment? Thanks!
Brief Answer:
Ovulation
Detailed Answer:
Mid-luteal progesterone is best interpreted in women with regular cycles every 25 to 35 days. We generally recommend 7 days prior to the next cycle as the ideal date for blood sample collection for Serum Progesterone.
With your wife's 40 day intervals between menstrual cycles, there is inadequate reliability of this test.
Secondly, regarding the level of 8.9 it is in the grey zone. In other words it cannot be stated with confidence whether ovulation occurred or not. The reason is that published literature and practice shows that values below 5 are suggestive of lack of ovulation while results more than 10 are indicative of the occurrence of ovulation. However, values between 5 and 10 are challenging to interpret as they can indicate either possibility.
If the diagnosis of PCOS is accurate in her case, then she will be best served by consulting a Reproductive Endocrinologist in-person for management of fertility related matters
Ovulation
Detailed Answer:
Mid-luteal progesterone is best interpreted in women with regular cycles every 25 to 35 days. We generally recommend 7 days prior to the next cycle as the ideal date for blood sample collection for Serum Progesterone.
With your wife's 40 day intervals between menstrual cycles, there is inadequate reliability of this test.
Secondly, regarding the level of 8.9 it is in the grey zone. In other words it cannot be stated with confidence whether ovulation occurred or not. The reason is that published literature and practice shows that values below 5 are suggestive of lack of ovulation while results more than 10 are indicative of the occurrence of ovulation. However, values between 5 and 10 are challenging to interpret as they can indicate either possibility.
If the diagnosis of PCOS is accurate in her case, then she will be best served by consulting a Reproductive Endocrinologist in-person for management of fertility related matters
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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