Hormone Levels and Early Pregnancy Assessment
Your current hormone levels at 11-13 days post-LH surge, while on progesterone supplementation, cannot definitively confirm or exclude early pregnancy without knowing the actual numerical values of E1G and PdG, but the clinical context suggests you should obtain a serum beta-hCG test for definitive pregnancy confirmation.
Understanding the Timeline
At 11-13 days past your LH surge, you are in the expected implantation window and early post-implantation period:
- Progesterone naturally rises 24-36 hours after ovulation in a typical cycle 1
- Implantation typically occurs 6-12 days after ovulation, meaning you are now in the timeframe where pregnancy could be biochemically detectable 2
- hCG becomes detectable in urine approximately 11 days after the day of expected menses for 100% detection with standard qualitative tests, though earlier detection is possible with more sensitive assays 2
Critical Limitation: Progesterone Supplementation Confounds Interpretation
The progesterone supplementation you are taking makes it impossible to interpret your PdG levels as a marker of pregnancy status because:
- Exogenous progesterone (whether vaginal, oral, or intramuscular) will elevate your urinary PdG measurements regardless of pregnancy status 3, 4
- Studies evaluating luteal phase hormones show that progesterone levels on day 11 post-ovulation do not differ between pregnant and non-pregnant patients when supplementation is used 5
- Your supplementation is artificially maintaining progesterone levels that would otherwise reflect corpus luteum function
Estrogen Patterns May Provide Some Insight
While your E1G levels might offer limited information:
- Rising estradiol levels from day 11 to day 13 post-ovulation are associated with 71-72% pregnancy rates in assisted reproduction cycles 5
- Estradiol levels on days 11 and 13 are significantly higher in women who achieve pregnancy, though there is substantial overlap between pregnant and non-pregnant patients 5
- However, these data come from IVF cycles with controlled luteal support, and individual variation is substantial
Definitive Testing Recommendation
You should obtain a serum beta-hCG test now (at 11-13 days post-LH surge) for definitive pregnancy confirmation because:
- Most qualitative urine pregnancy tests have sensitivity of 20-25 mIU/mL and may not detect 100% of pregnancies until 11 days past expected menses 2
- Serum beta-hCG testing provides earlier and more reliable detection than urine-based hormone metabolite measurements
- At 11-13 days post-ovulation, a viable pregnancy should produce detectable serum hCG levels (typically >25 mIU/mL)
Common Pitfall to Avoid
Do not rely on urinary progesterone metabolite (PdG) levels while taking progesterone supplementation to assess pregnancy status - this is a fundamental error in interpretation. The supplementation you are receiving (regardless of route) will maintain elevated PdG levels whether or not conception has occurred 3, 4, 5.