Ovulation Confirmation and Timing
Based on your hormone pattern, you ovulated on cycle day 13, with the egg released sometime between the evening of CD13 and morning of CD14. The LH peak of 45 on CD13 followed by sustained elevation (45 on CD14 morning, then declining to 27.9 by CD14 evening) confirms ovulation occurred approximately 24-36 hours after the initial LH surge 1.
Evidence Supporting Ovulation Occurred
Your hormone pattern demonstrates classic ovulatory physiology:
- LH surge confirmation: Your LH peaked at 45 IU/L on CD13 and remained elevated at 45 on CD14 morning before declining to 27.9 by CD14 evening, indicating the ovulatory trigger occurred 1
- Estrogen pattern: E1G rose appropriately from 38.3 on CD11 to a peak of 288.2 on CD13, then declined to 197.8 on CD14 and 133.7 on CD15, which is the expected post-ovulatory pattern 1
- Timing correlation: Ovulation typically occurs 24-36 hours after LH surge initiation, placing your ovulation between late CD13 and early CD14 2, 1
The Concerning PDG Pattern
Your PDG (pregnanediol-3-glucuronide, the urinary metabolite of progesterone) pattern is highly concerning and suggests inadequate luteal function:
- Your PDG rose minimally from baseline 3.2 (CD5) to only 4.7 (CD14), then dropped to 2.1 on CD15 3
- This drop below baseline after ovulation is abnormal - PDG should rise significantly and continuously after ovulation, not fall 4, 1
- Mid-luteal PDG should be substantially higher than baseline; your CD15 value of 2.1 is lower than your baseline of 3.2, indicating corpus luteum dysfunction 3, 5
Oocyte Viability Window
The ovulated egg remains viable for only 12-24 hours after release 2. Given ovulation likely occurred between late CD13 and early CD14:
- Optimal intercourse timing: CD12, CD13, and CD14 would capture the fertile window 2
- Sperm can survive up to 5 days in the female reproductive tract, so intercourse before ovulation is more forgiving than after 2
- By CD15, the egg is no longer viable for fertilization 2
Progesterone Supplementation Timing
You should start progesterone supplementation immediately (now, on CD15 or as soon as confirmed ovulation occurred). Here's the rationale:
- Standard luteal support timing: Progesterone supplementation typically begins 1-3 days after confirmed ovulation 4, 6
- Your specific situation: Given your PDG dropped to 2.1 on CD15 (below baseline), you have clear evidence of luteal insufficiency requiring immediate intervention 5, 6
- Confirmation threshold: While serum progesterone ≥5 ng/mL (or PDG equivalent) confirms ovulation occurred, your levels suggest inadequate corpus luteum function despite ovulation 3, 5
- Critical window: Progesterone must be adequate during the implantation window (approximately 6-10 days post-ovulation, or CD19-23 in your cycle) 4, 6
Progesterone Dosing Considerations
- Luteal phase support requires adequate progesterone levels throughout the luteal phase, not just confirmation of ovulation 4, 6
- Your provider should prescribe progesterone supplementation to continue through at least CD28 or until pregnancy status is determined 5, 6
- Do not wait for mid-luteal testing (CD21-22) - your CD15 drop already demonstrates the need for intervention 3, 5
Critical Pitfalls to Avoid
- Don't delay progesterone: Your PDG dropping below baseline by CD15 indicates the corpus luteum is already failing; waiting will miss the implantation window 5, 6
- Don't assume ovulation equals adequate luteal function: You clearly ovulated, but your corpus luteum is not producing sufficient progesterone 5, 4
- Don't rely on "day 21" testing in your case: The standard mid-luteal progesterone check (7 days post-ovulation, approximately CD20-21 for you) would only confirm what is already evident - you need treatment now, not more testing 3, 5
Summary of Your Cycle Events
- CD11-12: Follicular maturation with rising estrogen
- CD13: LH surge peak (45 IU/L), estrogen peak (288.2), ovulation trigger initiated
- CD13 evening to CD14 morning: Ovulation occurred (follicle rupture)
- CD14-15: Post-ovulatory period, but PDG inappropriately low and declining
- CD15 onward: Egg no longer viable; luteal phase with inadequate progesterone production
Contact your provider immediately to start progesterone supplementation - the evidence clearly supports both that you ovulated and that you have luteal phase insufficiency requiring treatment 5, 6.