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Last Updated:
Sep 17th, 2007 - 22:11:16
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Question
History if helpful...if not skip to questions.
I'm 35, have 2 children. My first pregnancy I delivered at 38 weeks and the second at 36 weeks. My last pregnancy was over 2 years ago. Since then I've had changes in my cycle: slight changes in length (ranging from 24 days to 33 days... normally I have a 27 to 29 day cycle)spotting 3 or 4 days before my period, lighter and more drawn out periods (8 or 9 days...normal for me is usually 5). I've been charting using Creighton model for 5 years. I went to be tested at an NFP only clinic and they confirmed I had low progesterone and my LH and FSH ratios were inverted, so apparently I'm an the mild end of Polycystic Ovarian Syndrome. Early Menopause runs in my family...my mom was completely through menopause by age 43 and my aunt by her late 30's.
We would like another child. We wanted to wait, but my fertile mucus has declined over the past couple of years, and in light of history of early menopause and the signs in my body, I suspect I'm in perimenopause, so we think it's best to try sooner than later.
QUESTION(S): How soon do I need to be on progesterone support if I conceive? I'm already on prometrium post peak +3 for 10 days. Last month was the first month I was on the prometrium (300mg before bed). I'm currently on day 7 and my husband and I would like to try to conceive this month. Should we wait? If we do become pregnant, how soon do I need progesterone injections? Is my post peak prometruim prescription enough to carry the pregnancy until I take my pregnancy test or miss a period?
Thank you for this wonderful site. So many of us don't have NFP docs readily available. I needed to travel 2.5 hours to my appointment. Also, if I give my lab results to my family practice dr. would they know enough to help me with this? Would I have more success with a local OBGYN?
Christine
Answer
Dear Christine,
Congratulations on being so informed and aware of the mysteries of your reproductive system. You are on progesterone support, so there is no need to wait to conceive.
With your history and your current situation, I would advise progesterone in oil 200 mg intramuscular injections twice a week as soon as you know you are pregnant. You may wish to do an HCG blood test when your post-peak phase is 2-5 days longer than your previous longest.
In health,
George Delgado, M.D., F.A.A.F.P.
George Delgado, M.D., F.A.A.F.P. is a Fertility Care Medical Consultant, a physician with Pregnancy and Family Care Centers of San Diego and
Escondido, and a Voluntary Associate Clinical Professor, Department of Family and Preventative Medicine, School of Medicine, University of California, San Diego.
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