Brief Answer:
Can get pregnant with proper hormone balance and induction.

Detailed Answer:
Hi,

Thanks for posting your query.

Firstly, let me tell you that you have every chance of being a mother, so please do not worry.

It is true that with advancing age, the number of follicles declines until the number is about 1000 at menopause. This is because no fresh development is possible after birth unlike the sperms.

Low Progesterone level on day 21 could mean anovulation or failure to ovulate within two weeks prior to the test. The day 3 FSH should be clubbed with measurement of Estradiol and this should preferably be done on day 2. Analysis of isolated FSH value is erratic.

Considering your age, your ovarian reserve also should be calculated to see what should be done next. Antral follicular count and AMH levels help in doing so. If the ovarian reserve is good, natural pregnancy can be tried with ovulation induction and regular monitoring. If the ovarian reserve is poor, there is not much time to waste on simple procedures and you should go straight away for IVF.

The fact that you are attaining periods on your own without external hormone supplements shows that your hormone levels are essentially normal, though there may be erratic ovulation. This can be corrected easily through simple treatment using either priming with Dexamethasone and later using Clomiphene, or though use of Metformin if insulin resistance is detected. Either way, ovulation can be achieved. I believe you will ovulate normally with induction.

If you ovulate and conceive, even if the Progesterone levels are low, there is nothing to worry; supplements can be given safely until the placenta takes over.

Hope your query has been answered. Please feel free to contact for further clarifications. I will be happy to help.

regards,
Shanti.V.

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Brief Answer:
Delayed ovulation can give spurious values.

Detailed Answer:
Hi,

Thanks for writing back.

Since you are planning to conceive, though your ovulation status needs to be established, your husband also should get tested as part of the protocol. This is to avoid any missing links.

Also, when you do not ovulate regularly and/or fail to ovulate early, the day 21 test can become spurious and hence, not dependable. A better alternative would be to go for basal body temperature measurements and follicular studies.

Since it was six months ago that your ovarian reserve had been tested, you may be asked to go for it again when you see the fertility specialist.

Hope your query has been clarified. Please get back if you need more help. I will be glad to do so.

regards,
Shanti.V.

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Brief Answer:
Either deficiency or anovulation may be the cause.

Detailed Answer:
Hello,

Thanks for writing again.

This sudden fall in Progesterone, as you say, could be due either to anovulation or luteal phase defect, where inspite of ovulation, the corpus luteum fails to produce normal amounts of Progesterone.

In my opinion, you would do better with assisted reproductive techniques. Natural means should be tried when you have plenty of fertile periods yet to come. At your age, this is not so and you need to act fast.

Progesterone supplements can be given if you have luteal phase defect.

Hope this helps. Please do contact if you need any more information.

regards,
Shanti.V.

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