Progesterone and Irregular Menstrual Cycles in Fertility

Progesterone, irregular menstrual cycle?

Hello Doctor:
1.
I naturally conceived in December last year, but in March this year, the embryo showed signs of degeneration at three months of pregnancy.
I have been following a regimen to conceive for the past few months.
My menstrual cycle was delayed by one day in June and by two days in July, with significantly reduced flow.
Given that my AMH level is 0.62, I am eager to conceive.
On the first day of my menstrual cycle on July 11, I visited a gynecologist who prescribed ovulation medication for me.
However, when I saw a doctor at a larger hospital yesterday, they mentioned that I have a dark spot and need to take birth control pills for seven days to help it resolve (due to progesterone).
What could be the reason for this? Is it related to the ovulation medication?
2.
I gave birth to a daughter at 18 years old, and my current husband, who is an only child, is placing his hopes on me to conceive again.
I really want to get pregnant quickly.
I regularly take inositol, folic acid, soy isoflavones, and chaste tree berry.
Will these supplements affect ovulation?
3.
The doctor suggested that I take DHEA.
Is this advisable?

Xiao Ping, 40~49 year old female. Ask Date: 2016/07/15

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I’m sorry that a diagnosis cannot be made based on the described black spot.
You may want to consult the physician who examined you.
Food has little impact; age is an important factor.
Wishing you good health and a successful pregnancy soon.

Reply Date: 2016/07/15

More Info

Understanding the role of progesterone and irregular menstrual cycles in fertility is crucial for women who are trying to conceive, especially after experiencing complications such as miscarriage or irregular cycles. In your case, it seems that you have been facing challenges related to hormonal balance and ovulation, which are common concerns for women with low Anti-Müllerian Hormone (AMH) levels, indicating a reduced ovarian reserve.

1. Progesterone and Its Role in Fertility: Progesterone is a hormone that plays a vital role in regulating the menstrual cycle and maintaining early pregnancy. After ovulation, the corpus luteum produces progesterone, which prepares the uterine lining for a potential pregnancy. If pregnancy does not occur, progesterone levels drop, leading to menstruation. In cases of progesterone deficiency, the uterine lining may not be adequately prepared, which can lead to issues such as irregular cycles or miscarriage. If your doctor prescribed progesterone or related medications, it is likely to help stabilize your hormonal levels and support a healthy uterine environment for implantation.

2. Irregular Menstrual Cycles: Irregular cycles can be caused by various factors, including hormonal imbalances, stress, and underlying health conditions like Polycystic Ovary Syndrome (PCOS). The fact that your menstrual cycle has shown delays and changes in flow could indicate that your body is still adjusting after your previous pregnancy loss. The use of ovulation induction medications can help stimulate ovulation, but it is essential to monitor your response to these medications closely.

3. Impact of Medications: The black spot mentioned by your doctor could be related to a cyst or a hormonal imbalance that needs to be addressed. The use of contraceptive pills for a short period is sometimes recommended to help regulate the menstrual cycle and allow any cysts to resolve. This approach is not uncommon and can help restore hormonal balance before attempting to conceive again.

4. Supplements and Their Effects: The supplements you are currently taking—myo-inositol, folic acid, soy isoflavones, and chaste tree (Vitex)—are generally considered beneficial for reproductive health. Myo-inositol has been shown to improve ovarian function, particularly in women with PCOS. Folic acid is crucial for fetal development and should be taken before and during pregnancy. Soy isoflavones may help with hormonal balance, but their effects can vary, and they should be used cautiously. Chaste tree is often used to help regulate menstrual cycles, but it is essential to consult with your healthcare provider about the appropriate use of these supplements, especially in conjunction with other fertility treatments.

5. DHEA Supplementation: Dehydroepiandrosterone (DHEA) is a hormone that can be converted into estrogen and testosterone in the body. Some studies suggest that DHEA supplementation may improve ovarian function and egg quality in women with diminished ovarian reserve. However, it is essential to discuss this option with your healthcare provider, as the appropriate dosage and potential side effects need to be carefully considered.

In summary, understanding the interplay between progesterone, irregular menstrual cycles, and fertility is essential for optimizing your chances of conception. It is crucial to work closely with your healthcare provider to monitor your hormonal levels, adjust medications as necessary, and ensure that any supplements you take support your overall reproductive health. With the right approach and support, you can enhance your chances of achieving a successful pregnancy.

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