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Progesterone deficiency possible with regular cycles?
ttc_81 posted:
Hi, I have been trying to conceive for about two years now. I went to a gynecologist who gave me Clomid 50mg for 3 months, which didn't help so he raised the dose to 100mg. I have taken 100mg last month but it still didn't work.. I am wondering if it could be progesterone deficiency or hormonal imbalance rather than an ovulation problem. I have very regular cycles (28-29 days) but I also have very painful menstruation for the first 2-3 days and my period usually lasts for 5 days. I always have some brown discharge for 1 or 2 days before the actual "bleeding" starts. I read somewhere that this brown discharge before the bleeding could be linked to progesterone deficiency. However, my gynecologist says it's unlikely because I have regular cycles.. I would like to have a second opinion on this and would really appreciate your feedback. Thanks in advance!
Joel Bernstien, MD responded:
The "progesterone deficiency" phenomenon gets a lot more hype than is truly shown through evidenced based medical studies. A lot of women trying to conceive get on extra progesterone, etc. It has never been proven (outside the realm of say, IVF) to be of importance. The low progesterone phenomenon also gets a lot of blame for miscarriage, when in reality it may not be the reason.

I hope that you have had an entire infertility evaluation.... including HSG (an x-ray to look at your uterus and tubes), a semen analysis, and labs to look at your ovarian reserve. If not, you need to get these. If so and still not pregnancy after 4 months of clomid.... it is time to see a reproductive endocrinologist (REI) doctor for more aggressive management of your infertility.

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