At six weeks, seeing only a gestational sac is actually very common, as it may simply be a bit too early to see more, or your conception date might be slightly later than calculated. Additionally, every pregnancy is unique; having milder symptoms like less nausea than your last pregnancy is entirely normal and not a sign of trouble. Your doctor prescribed progesterone to help support your pregnancy during this early stage. A follow-up ultrasound in a week or two is the best way to monitor your progress.

For progesterone support at 9 weeks with a history of miscarriage, standard protocol typically involves using either oral dydrogesterone (Duphaston) or vaginal micronized progesterone (Susten), but rarely both together. Combining them is generally redundant and not standard practice. Either medication alone is effective, so a single, consistent method is usually preferred to keep your routine simple and stress-free. I highly recommend discussing this with your OB-GYN.

While Duphaston (dydrogesterone) is indeed a medication used to help induce a period, it is a prescription hormone. Even though your pregnancy test was negative, you should not start taking it without a doctor's guidance. Sometimes stress, lifestyle changes, or minor hormonal shifts can delay your cycle. I gently recommend consulting your healthcare provider. They can safely evaluate your situation, confirm the negative test, and prescribe the correct dosage of Duphaston if it is the right step for you.

After finishing Duphaston (dydrogesterone), it can take 7 to 14 days for bleeding to begin. If it doesn't occur, the most common reasons include an early pregnancy, low estrogen levels (meaning the uterine lining was too thin to shed), or hormonal fluctuations from stress or thyroid issues. As a first step, I gently recommend taking a home pregnancy test. If that is negative, please consult your doctor. They can run simple blood tests to check your hormone levels and may recommend an ultrasound or a tailored hormone therapy to help restore your body's natural rhythm.

On day 22 of a 28-day cycle, ovulation has typically passed. Stopping Duphaston (dydrogesterone) can cause temporary hormonal shifts that alter your vaginal discharge. While it is less likely to be late ovulation, there is no harm in continuing to try if you feel up to it. However, if the discharge has an unusual odor, color (like green or yellow), or is accompanied by itching, it could suggest a mild infection. I highly recommend discussing this with your doctor to ease your mind and support your fertility journey.

Since you had unprotected sex, the most important first step is to take a pregnancy test, as four missed periods could indicate pregnancy. If you are not pregnant, Duphaston (dydrogesterone) can indeed be effective in inducing a period by mimicking the hormone progesterone. However, because you have missed your periods for four months, it is crucial to consult your doctor before taking it. They will need to identify the underlying cause of the delay and prescribe the correct dose and schedule safely for you.