From CANFP
When Should Progesterone Be Checked?
By Dr. Davenport
Oct 1, 2007, 15:39
Question
On Sept. 12, 2007 I took a progesterone test that was 21 days after my period which was on August 23rd. The level was 3 and my doctor said that it is considered low and that with a low progesterone I may not sustain a pregnancy. I had my period today September 26. Now I would like to try for conception this cycle but I am afraid that my progesterone is at a low level. Also I hear that if my luteal phase is shorter than 10 days I might not be able to sustain a pregnancy.
Based on those dates that I have given you are you able to assume the length of my luteal phase? And if I do have a luteal phase that is too short what can I do about it? I know that I am asking more than one question but I want to know if I should refrain from trying to conceive this month, because I just had a miscarriage two months ago and I don't want to go through another one if I can help it.
I appreciate your help and understand if you are unable to answer.
Sincerely,
Carima
Answer
Dear Carima,
A progesterone level of 3 ng/ml (presuming these are the correct units) is low for a mid-luteal phase progesterone. If a progesterone is drawn 21 days after the beginning of the menstrual period, it will evaluate the middle of the luteal phase in a 28 day cycle if ovulation was on day 14. However, your cycle was 34 days and we do not know when you ovulated. Also, we cannot tell if your luteal phase is short without knowing the time of ovulation. So it is not clear if your hormone test was drawn at the best time.
Ovulation can best be detected by noting the last fertile mucus day in a natural family planing method, or with an ovulation kit or monitor that detects the hormone LH. Ideally, the luteal phase is checked by obtaining three progesterone levels 5,7, and 9 days after ovulation. The values should be, respectively, above 12, 15 and 12 ng/ml. If only one value is obtained 7 days after ovulation, you cannot tell if the progesterone level is sustained throughout the entire luteal phase. Even if the progesterone is adequate in the early part of the luteal phase, a pregnancy can be lost if the level drops off rapidly. Progesterone supplementation can be done in the luteal phase with very little risk, and might benefit you with your next pregnancy. The progesterone supplementation should be started before you attempt pregnancy. In addition, estrogen and thyroid levels should be checked.
Mary L.Davenport, M.D.
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