Using Progesterone Suppositories Before Ovulation: What You Need to Know - Obstetrics and Gynecology

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When considering the use of progesterone suppositories in the context of trying to conceive, especially for someone with polycystic ovary syndrome (PCOS), there are several important factors to keep in mind.

1. Understanding Ovulation Timing: The size of the follicle is indeed a significant indicator of impending ovulation. Typically, a mature follicle is around 18-24 mm in diameter when it is ready to release an egg. In your case, with a follicle measuring 1.87 cm (or 18.7 mm), it is reasonable for your doctor to estimate that ovulation could occur within the next couple of days. However, individual variations can occur, and factors such as hormonal levels and the overall health of the ovaries can influence the timing of ovulation.

2. Using Progesterone Suppositories: Progesterone is crucial for preparing the uterine lining for potential implantation of a fertilized egg. If your doctor has advised starting the progesterone suppositories on November 2nd, it is likely based on their assessment of your cycle and the expected timing of ovulation. While some sources suggest that progesterone should only be used after ovulation has been confirmed, many healthcare providers prescribe it based on follicular size and other indicators to support the luteal phase, especially in patients with conditions like PCOS.

3. Monitoring Ovulation: It is understandable to be cautious about starting the progesterone too early. If you are concerned about whether you have ovulated, you can continue to monitor your ovulation signs, such as cervical mucus changes, basal body temperature, and ovulation test strips. If you see a clear indication of ovulation (like a surge in LH on your ovulation test), it may provide additional reassurance before starting the suppositories.

4. Potential Impact of Early Use: If progesterone is used before ovulation, it may not necessarily hinder your chances of conception, but it could potentially alter the hormonal environment. The primary concern is that if ovulation does not occur, the progesterone may not be beneficial, as its main role is to support the uterine lining after ovulation. However, many practitioners believe that using progesterone in the luteal phase can help create a more favorable environment for implantation.

5. Consulting Your Doctor: Ultimately, the best course of action is to follow your doctor's advice, as they have a comprehensive understanding of your specific situation. If you have concerns about the timing of the progesterone suppositories, it is essential to communicate these with your healthcare provider. They may adjust the timing based on your observations or provide additional guidance on how to monitor your cycle effectively.

In summary, while the size of the follicle can provide a good estimate for ovulation timing, individual variations exist. Starting progesterone suppositories as directed by your doctor is generally advisable, but monitoring your ovulation signs can help you feel more confident in your approach. Always keep an open line of communication with your healthcare provider to ensure that your treatment plan aligns with your needs and concerns.