I'm finding a lot of conflicting information on the web regarding what level of progesterone is needed to sustain a pregnancy. I tested at 11.4 (I think it was tested at day 6 past ovulation). The nurse said I had ovulated, and that anything over 10 is okay. But I'm reading on the web that you need a level of 14 to sustain a pregnancy, or you might have an "inadequate ovulation." Is this the case? I'm not being prescribed progesterone, but I'm wondering if it would help to use a progesterone cream. Is there a consensus in the medical community whether natural progesterone cream derived from wild yams or USP progesterone is more effective? I've heard that wild yam creams might not do anything for your progesterone level, and that USP creams can actually mess up your cycle.

Deann

Progesterone levels can vary from laboratory to laboratory. The level can also vary from morning to afternoon and even drop 50 percent after a meal. Unfortunately, most physicians are not aware of this fact and do not advise their patients to check levels early in the morning and while fasting. Any level over about 2 or 3ng/ml likely indicates ovulation. A fasting a.m. blood progesterone level over 10ng/ml in our lab indicates normal follicular development and ovulation. There is no specific value necessary to "maintain" a pregnancy. In fact, I have had patients with enzyme defects who had levels of 2ng/ml who have carried without a problem.

This brings us to your next question. Rarely is progesterone supplementation of any value. A low progesterone level seen during pregnancy is a sign of a failing pregnancy, not its cause. Progesterone replacement for "luteal phase defect" does not correct the problems with the developing follicle. Ovulation treatment is necessary to fix this problem. There are no studies that show that adding more progesterone can save a pregnancy. This is a myth that has been foisted on many women by well-meaning physicians who are not aware of the latest research in this area.

Progesterone treatment should be reserved for women who have undergone ovulation treatment with injectable medications, those who underwent IVF or egg donation, or those who are suspected of having an immune basis for recurrent pregnancy loss. For these cases, several forms of supplementation are available. Progesterone creams can vary in strength and absorption from brand to brand. The use of progesterone troches or suppositories is a very cost-effective alternative to injections or Crinone vaginal cream (which is very expensive).

Wild yam cream contains precursors to the synthetic progestins commonly used in birth-control pills. However, this precursor cannot be used by humans to create any active hormones. So, the use of wild yam cream is a complete and -- in my opinion -- criminal fraud on a misled public.