My hypothalamus is broken
1 Replies
melger - May 10

Hello Dr. Jacobs. Here's my story. Hubby and I have been trying to conceive for 3.5 years. I am 37 and hubby is 33. We had all of our levels checked and everything came back normal except for my progesterone levels at 4 (unmedicated). Doctor said I wasn't ovulating. I also have Hashimotos thyroiditus.

Estrogen 58
LH 2
AMH 3.2

I was on Birth control for 6 weeks and then did an injectable cycle. 225 iu of gonal-f days 5-13, and then 10,000 HCG on day 14 and then b2b iui's on days 15 and 16. My estrogen level on trigger day was 600 and I had 8 follicles. 2 at 21, 1 at 17, 2 at 15 and 3 at 14. Doctor said I had 2 mature follicles.

At 4 days post iui, I had a p4 test done and an ultrsound that showed one corpus luteum measuring 3.5x3.5, my p4 came back at 4.5! MEDICATED! DEVASTATING! I was also on crinone gel starting the day post iui.

Could you give me some insight as to why this would be happening? I mean...I saw the corpus luteum with my own eyes...isn't that the thing that produces the progesterone? From what I gather, could it be my egg quality? And if it is my egg quality, are ALL my eggs bad eggs since I always have low p4 levels. Or is it that the one that ovulated was bad. Or maybe is it that my hypothalamus is broken.

Any insight would be so appreciative! Thank you in advance for you time. -Melger


B. Jacobs, M. D. - May 11

I would expect your progesterone to be higher after ovulation induction with FSH. As fara s the progesterone supplement, if it was a vaginal preparation, that really does not provide much of a serum level, but does provide an excellent tissue level in the endometrium - where you want it. I have no explanation as to why your serum level was not higher after your FSH treatment, but it was not your hypothalamus. That became somewhat irrelevant with your Gonal-f administration..
Good luck.



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