Dr., I apologize if this is long...

I have PCOS and am thin. I was diagnosed as a teenager by an endocrinologist who specialized in PCOS (Dr. Futterweit in NYC). I have elevated testosterone and questionable ovulation. Historically I had very irregular periods, but before my first pregnancy and again recently they have been fairly regular.

Recently I had a missed miscarriage. It was a spontaneous pregnancy with no ovulation inducing treatment. I was not taking any medication at the time of conception nor thereafter. The baby measured 11w4d at the time of his death. Subsequent testing revealed no genetic abnormalities. Since then my doctor did a RPL panel which ruled out APS and other things which he did not detail. At the time of my pregnancy blood test (9 September) an initial basic prenatal blood screening (which did not include progesterone levels) was conducted. I was not scheduled to see a doctor until what the nurse estimated to be 12 weeks. I have had one pregnancy before this miscarriage, which was conceived while I was being treated with a combination of clomid and metformin. It took only one cycle of this combination (after one unsuccessful cycle of clomid only) to become pregnant. It was a twin pregnancy, but unfortunately one embryo never developed a heartbeat. During the months prior to conception of my son I had regular periods, but blood work revealed that it was unlikely that I ovulated based on my very low day 21 progesterone levels (~1.7 during unmedicated cycle). During the cycle where I conceived my son on clomid and metformin, my progesterone was 46.10 at ~4 weeks.

I have done a lot of reading since my recent missed miscarriage and understand that there is a complex interaction of hormones required to begin and sustain a pregnancy. I have read that it is common for PCOS women to suffer from low progesterone, either during the luteal phase or in early pregnancy.

I am wondering if a lower than typical progesterone level post ovulation will affect progesterone levels in early pregnancy. Additionally, given that my miscarriage occurred after when the progesterone production should have shifted from the corpus luteum to the placenta, could early progesterone deficiency have contributed to improper development of the placenta causing an inability for it to sustain the pregnancy? Does "weak ovulation" cause a situation where low-levels of progesterone might be enough to sustain the pregnancy until 11.5 weeks but not enough long term?

My gut tells me my issue was hormonal. Any advice you can give is greatly appreciated. Thank you.