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Achieving Pregnancy : Evaluation and Treatment Last Updated: Sep 10th, 2007 - 18:59:21


Trying Two Years to Achieve a Pregnancy
Answered by: Dr. Kerr
Mar 19, 2007, 14:06

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Question

We've been trying almost two years to get pregnant; our daughter is 5. My insulin level is 24 and on day 22 my progesterone level was 0.80. The MD said it was because I didn't ovulate. What else can I do? He put me on metformin 1500 mg's at hs. I don't understand how to increase my progesterone level.

Carolyn

Answer

Dear Carolyn,

From what you have mentioned, you appear to have infertility with insulin resistance, most likely due to polycystic ovarian syndrome(PCO). The metformin your doctor put you on will improve the insulin resistance, and thus improve your fertility by allowing ovulation.

The progesterone is formed in your ovaries after ovulation. Increasing your exercise can also improve your insulin resistance. If you are not used to doing a lot of exercise, you can still benefit from short periods, like 10 minutes of brisk walking, and build up to 3 times a day. Most people can fit that into their schedule, especially if you keep in mind it will help restore your fertility.

You didn't mention how long your cycles were, but there is also the chance that you are ovulating, but just hadn't yet by the time you had the progesterone level drawn. Women with PCO tend to have long and irregular cycles. To help you determine when you are ovulating, I would highly recommend you take a natural family planning class so you can learn the mucus observations leading up to ovulation. This will help you know the days of greatest fertility. Even if you are not ovulating yet, the classes will help prepare you to identify the earliest signs of improving fertility as you continue the metformin and exercise.

I wish you well.

Dr. Lynn Kerr


Lynn Kerr, MD

Lynn Kerr, MD, is an NFP Medical Consultant and member of the Executive Board of the California Association of Natural Family Planning. Dr. Kerr is an Assistant Clinical Professor at UCSF/Fresno Internal Medicine Residency Program, and Medical Director of Sierra Adult Health Center.


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