Luteal Phase Defect - Progesterone Supplementation

[fantesia28]

Hello,

I have had an issue with losing 3 pregnancies... while we are not 100% sure that progesterone is my only issue as I have been found to have DOR, it may very well be a contributor. I have been tested for everything possible from clotting issues, genetic issues, to NK Cells and Intacellular Cytokines... everything has tested normal outside of my DOR issues. I am 34 years old.

My progesterone has been on the low side with my last two pregnancies. First loss my P4 was 16 at 5weeks, but dropped to 8 at 6 weeks, we lost that pregnancy. In May I had a chemical pregnancy in which my progesterone level at 7dpo was only 9.1. I was put on prometrium, but it didn't help the issue.

Fast forward to my current cycle. I was monitored throughout the entire cycle and triggered when my follicle was mature and estrogen at an appropriate level. I had my P4 test done today at 5dpo and my level was only "4"! I knew this would be the case as my temps were pretty low, but wasn't prepared for such a low reading. We know that I did in fact ovulate because the U/S after the trigger confirmed a collapsed follicle.

So here are my questions that I would like your opinion on...

I was given prometrium "orally" 200mg 3x per day. I know in some cases this is prescribed orally and sometime vaginally. Is one way or the other more effective? If taken vaginally will the blood levels be affected at all or will my level stay low despite the supplementation?

Is starting progesterone 5dpo too late in ones cycle to really help? I tend to conceive easily when I ovulate and am just wondering if starting it at this point verse at 2 or 3dpo would make a significant difference on the outcome providing that the fertilized egg is healthy to begin with.

Does a low progesterone level indicate bad egg quality or is it just an issue with the CL cyst? I guess I just wonder if the levels are low due to poor egg quality.

I realize that progesterone will NOT prevent a miscarriage that is doomed from the start due to chromosonal problems, etc. However, I am all for it if it can truely help support a pregnancy that is destined to suceed but perhaps needs a little help. I know that many doctors differ on their opinion as to if it does or doesn't help a pregnancy.

Thanks in advance for reading and your response!