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Infertility

Pregnancy

10/20/2008

Question:

My husband and I have been trying to conceive since 2001 we had a tubal pregnancy in 2001, after the surgery we got pregnant again six months later but had a miscarriage within the first two months. We just recently in May had my fallopian tubes repaired due to the massive destruction of an STD that was present when I was 15 years old. The doctor successfully repaired the tubes and removed two cysts that were found on my ovaries. Now I’m on Prometrium 200mg due to my Progesterone level being at 7.4. I began taking them in July 08 intervaginally, I missed a month of Prometrium in August 08 and am now taking another dosage for September 08 by mouth. Realistically how long should I expect to wait for my progesterone level to increase, or better yet how long should I expect before getting pregnant?

Answer:

I would suggest that you have an HSG or hysterosalpingogram (a dye test to see if both of your tubes are still open), as your surgery was performed in May.  It is important to remember that if your tubes are really "severely  damaged", that your chances of natural conception would be expected to be lower.  If your tubes were not open, you would need to consider IVF or in vitro fertilization (stimulation of your ovaries to make extra eggs, removal of those eggs from you ovary followed by mixing with your husband's sperm, allowing fertilization of the eggs and growth into embryos; approximately 2 embryos would then be injected into your uterus).

Progesterone levels go up with ovulation.  If levels are < 10 ng/ml, we either treat patient with supplemental progesterone as you are taking, or stimulate the ovaries with either fertility pills or fertility shots. 

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Response by:

Daniel B Williams, MD Daniel B Williams, MD
Formerly:
College of Medicine
University of Cincinnati