Progesterone and Its Role in Pregnancy and Infertility

Progesterone. Pregnancy. Infertility?

Hello, I have polycystic ovary syndrome (PCOS).
My menstrual cycle has always been irregular.
Following my doctor's advice, I have been taking ovulation medication and receiving ovulation injections, which have allowed me to ovulate normally, with confirmed luteal phases lasting over 12 days.
However, my period has come, and I have not become pregnant.
I got married last year and have not used contraception since then.
I was pregnant once before college, but I was young and had an abortion; the doctor said my endometrium has recovered well.
I would like to know if I can still get pregnant.
Since I have not become pregnant so far, does this count as infertility?
In November 2018, I took ovulation medication and received injections; my period started on November 1, but I did not become pregnant.
In December 2018, I took ovulation medication and received injections; my period started on December 3, but I did not become pregnant.
In January 2019, I did not take ovulation medication or receive injections.
I consulted a doctor who said I did not ovulate.
I had unprotected intercourse on January 9, January 17, and January 23.
My period did not come in February.
I had unprotected intercourse on February 3, February 4, and February 11.
On February 6, 2019, I was prescribed progesterone for three days.
After seven days, my period still did not come, and I took a pregnancy test, which was negative.
On February 15, 2019, I received a progesterone injection and was prescribed progesterone for one day, but my period still has not arrived.
I would like to know if I could be pregnant and what my chances of pregnancy are.

BOBO, 20~29 year old female. Ask Date: 2019/02/17

Dr. Cai Yonglong reply Obstetrics and Gynecology

Mild polycystic ovary syndrome (PCOS) can be treated with ovulation medications.
If you have been married for one to one and a half years, you should consult a gynecologist for an examination.
The use of progesterone can delay your menstrual period.
If a urine test kit shows no pregnancy, you may need to undergo an ultrasound and blood tests, so please visit a gynecology outpatient clinic.

Reply Date: 2019/02/17

More Info

Understanding the role of progesterone in pregnancy and infertility is crucial, especially for individuals with conditions like polycystic ovary syndrome (PCOS). Progesterone is a hormone produced by the ovaries after ovulation, and it plays a vital role in preparing the uterine lining for a potential pregnancy. If fertilization occurs, progesterone helps maintain the pregnancy by preventing the uterus from contracting and shedding its lining.

In your case, having PCOS can complicate the menstrual cycle and ovulation process. Women with PCOS often experience irregular menstrual cycles, which can lead to difficulties in conceiving. The use of ovulation-inducing medications, such as Clomiphene citrate or gonadotropins, can help stimulate ovulation. Additionally, progesterone supplementation, like Utrogestan, is often prescribed to support the luteal phase after ovulation, ensuring that the uterine lining is adequately prepared for implantation.

From your description, it seems you have been actively trying to conceive without success for some time. The fact that you have had regular ovulation confirmed by temperature tracking and ovulation tests is a positive sign, as it indicates that your body is capable of ovulating. However, the absence of pregnancy despite having unprotected intercourse can be concerning. In general, if a couple has been trying to conceive for over a year without success, it may be classified as infertility, and further evaluation may be warranted.

Regarding your specific questions about the likelihood of pregnancy, it is essential to consider several factors. First, the timing of intercourse relative to ovulation is crucial. Engaging in sexual activity during the fertile window (the days leading up to and including ovulation) increases the chances of conception. If you have been tracking your ovulation and timing intercourse accordingly, you are optimizing your chances.

The use of progesterone after ovulation is also significant. If you have been prescribed progesterone and have not yet had your period, it could indicate that your body is responding to the hormone. However, it is essential to note that progesterone can also delay menstruation, making it challenging to determine if you are pregnant without a pregnancy test.

If you suspect you might be pregnant, taking a home pregnancy test after a missed period is advisable. These tests are designed to detect the hormone hCG, which is produced shortly after a fertilized egg implants in the uterus. If the test is negative and your period does not arrive, it may be worth consulting your healthcare provider for further evaluation.

In summary, while progesterone plays a critical role in supporting early pregnancy, the challenges you face with PCOS and irregular cycles can complicate conception. It is essential to maintain open communication with your healthcare provider, who can guide you through the process, monitor your hormone levels, and suggest appropriate interventions to enhance your chances of becoming pregnant. Additionally, lifestyle factors such as maintaining a healthy weight, managing stress, and following a balanced diet can also positively impact fertility.

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