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progesterone and fsh levels normal but no ovulation?

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Hi, I have been trying to conceive 18 months +. I have been tested at dr for progesterone and fsh levels at day 21 which have come back normal.I have been using ovulation test predictor kits but they seem to come back neagtive and have been using them daily. I have periods which come between day 28 and 45. They have been of lately a dark brownish spotting rather than a normal period lasting around 3 days. Previously my period has been dark red bleeding for 6 days which has just changed these past few months. I am 32 years old. An ultrasound to rule out polysyctic ovarian syndrome has been done and came back fine. I am not in private health insurance. What other tests can be preformed to work out my cause of infertility at a General Practise Surgery? Can I have normal Progesterone results but stil not ovulate? Could this be early menopause??

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replied June 4th, 2012
Infertility Answer A35699

Welcome to the ehealthforum and I am glad to help you out. Regarding your primary infertility, various causes responsible for it are stress, age, taking up alcohol or certain drugs that causes infertility, food, coffee, medical causes may be due to problems in ovulation,tubes,uterus,cervix,endometriosi s,pituitary,hypothalamus, hormonal imbalance or problems in male genitourinary tract. Infertility starts to kick in slowly from age 30 and more rapidly from age 35 onwards in women.

Exact cause for difficulty in conceiving can only be diagnosed by investigations to weed out the various possibilities and then confirming a diagnosis. I would suggest you to consult a fertility expert as both you and your partner need to be investigated thoroughly.

Apart from these tests you need to get Day 3 FSH (measuring follicle stimulating hormone), Day 3 Estradiol (measuring estrogen), ultrasound (to confirm ovulation occurred) and blood tests to determine the levels of inhibin B, thorough hormone tests (prolactin, free T3, testosterone, DHEA), a post coital test (PCT) which determines if the sperm is able to penetrate and survive in the cervical mucus, hysterosalpingography, hysteroscopy, MRI head or endometrial biopsy done. Your partner may also need to get his semen analysis done.

For anovulatory cycles, apart from progesterone levels, other hormones need to be ascertained. These include LH (on days 13 and 15 of menstrual cycle, to detect midcycle peak), FSH, prolactin, DHEA, Testosterone and SHBG and specific antibody tests.

It does not look like early menopause but diagnosis can be confirmed by getting the estradiol levels and FSH levels done. When your FSH levels rise above 30 or 40 mIU/mL, it usually indicates that you are in menopause. Your FSH levels are normal. So it does not look like early menopause.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care.

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