Does experiencing abdominal pain at 7 days post-ovulation (7dpo) with a history of fluctuating estrogen (E1G) levels, stage 3 rectocele, and premenstrual dysphoric disorder (PMDD) symptoms, while undergoing fertility treatment with letrozole (generic name) and progesterone, indicate a reduced chance of pregnancy?

Abdominal Pain at 7 Days Post-Ovulation Does NOT Rule Out Pregnancy

Experiencing abdominal pain at 7 days post-ovulation (7dpo) with PMDD does not indicate a reduced chance of pregnancy—this symptom is non-specific and can occur in both pregnant and non-pregnant cycles. 1

Understanding the Timeline

At 7 days post-ovulation, you are in the critical implantation window, which typically occurs 6-12 days after ovulation. 1 During this time:

• Implantation cramping is common and can feel similar to premenstrual discomfort
• PMDD symptoms are triggered by changes in hormone levels, not by stable levels 2
• Early pregnancy and luteal phase symptoms overlap significantly and cannot reliably distinguish between the two states

Why PMDD Symptoms Don't Predict Pregnancy Outcome

The key insight from research is that PMDD symptoms are triggered by the acute change in estradiol/progesterone levels (from low to high), not by steady-state hormone levels. 2 At 7dpo:

• You are receiving progesterone supplementation as part of your fertility treatment, which creates a hormonal environment that can trigger PMDD symptoms regardless of pregnancy status 2
• The presence of abdominal pain or PMDD-like symptoms cannot differentiate between a pregnant and non-pregnant cycle at this early stage 2
• Women with PMDD have altered sensitivity to normal hormonal fluctuations through the GABAergic system and serotonin pathways, making them more susceptible to symptoms during any luteal phase 3, 4

Your Specific Treatment Context

Given your treatment with letrozole and progesterone supplementation:

• Letrozole maintains estrogen levels near physiologic ranges during ovarian stimulation, which is beneficial for endometrial development 1
• Progesterone supplementation is standard in fertility treatment and supports the luteal phase regardless of whether conception occurred 1
• Your fluctuating E1G levels and stage 3 rectocele do not preclude pregnancy but may contribute to pelvic discomfort independent of pregnancy status 1

When Pregnancy Can Be Confirmed

A healthcare provider can be reasonably certain about pregnancy status only after specific criteria are met: 1

• A positive pregnancy test (most sensitive urine tests detect hCG at 20-25 mIU/mL, but may require an additional 11 days past expected menses to detect 100% of pregnancies) 1
• At 7dpo, it is too early for any pregnancy test to be positive, as implantation may not have occurred yet and hCG levels would not be detectable 1

Critical Pitfall to Avoid

Do not interpret early luteal phase symptoms as predictive of pregnancy outcome. 2 The only reliable method to determine pregnancy is:

1. Wait until at least the day of expected menses (approximately 14 days post-ovulation)
2. Perform a sensitive urine pregnancy test
3. Follow up with repeat testing 2-4 weeks later if initial test is negative but menses has not occurred 1

Bottom Line

Your abdominal pain at 7dpo is most likely related to normal luteal phase changes, your PMDD sensitivity to hormonal fluctuations, or your existing pelvic floor condition (rectocele). This symptom provides no information about whether conception has occurred. 2, 1 Continue your prescribed progesterone supplementation and wait for appropriate pregnancy testing at the time of expected menses.