# Progesterone Pessaries Vs Injection



## Michelle44

Hi,

I was wondering if anyone knows if the progesterone pessaries are just as good as the progesterone in oil injection.

I am due to start Progesterone but as I know I will be unable to inject myself, I would like to just take the Pessaries.

Has anyone had a pregnancy with Donor Eggs and just used the Pessaries.

Any help would be appreciated.

Regards

Michelle


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## buster24

michelle i use another private site and have just heard that a study has been do that suggests there is no difference between the pessaries and the injections. The girls that had left the email did leave a link to it but i cant get it to work. but maybe if you just looked for it on the web you might come across it.
good luck


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## safarigirl

Michelle, i just took the pessaries (cyclogest) and have a pregnancy with DE.
Your clinic will usually prescribe this ... and i'm sure you can ask them this as well ... 
Wishing you lots of luck


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## Michelle44

Thanks Guys,

Much appreciated.

There is talk that they are not as good and am trying to find out if they are.

Any help is appreciated.

Regards

Michelle


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## Ruth

I starting treating couples in the days when there was only progesterone injections and no pessaries!!
I have seen absolutely no difference in effectiveness between to the 2. Normally just depends on consultant preference as to which a woman uses and most seem to prefer pessaries.
We use pessaries at CERAM.

Ruth


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## mini-me

Hi Michelle,

With IVF using my own eggs, I had 2 tx using progesterone pessaries and 2 tx with injections.  There was a difference in my progesterone levels between the 2 as seen in the HCG blood tests - around 50 with pessaries and 200+ with injections.  I also had spotting towards the end of the 2ww when using the pessaries and none with the injections.  
However, none of these IVFs resulted in a baby, so I'm not sure whether my levels of progesterone were high or low or if it made a difference.

I had no breakthrough bleeding with with my first DE - I was given the progesterone Utrogestan (taken vaginally), but also had to take oestrogen as well.

Based on my history, I would prefer injections, but not sure whether I'm being scientific or not!  (My next DE will probabaly be with pessaries, so I'm not that strong in my preference.) DH prefers the pessaries, as he had to do the injections into my bottom due to the length of the needle! 

Hope I've not confused you too much with my rambling - just hoped my experiences may help you. 

Good luck
mini-me xxx


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## daisyg

Hi Michelle,

This is a tricky one.  Basically, the injections are the gold standard in the US (where incidentally, ivf rates are much higher than in the UK).  Pessaries are absolutely fine in nearly all cases, but if for any reason, you are one of the few people who does not effectively absorb the pessaries then the injections will deliver progesterone more effectively.

If you have ever done an ivf for example and used pessaries, but then bled before the end of the 2ww, then you probably do not have enough progesterone from the pessaries.  You either need injections or more pessaries.

Most women manage perfectly well with the pessaries, but if you wanted to make sure you had more than enough progesterone, then the injections would guarantee this.  They are not that difficult to administer yourself.

The other thing to do is to make sure that, if you are using the pessaries, you use at least 3/4 x 400mg pessaries per day to be safe (used vaginally rather than rectally as this delivers prog. closer to the uterus where it is needed).  I would personally also have your progesterone levels checked by blood test after embryo transfer or at the latest, when you do your first beta.  This will enable you to supplement with more progesterone should your levels be too low.

Daisy
x


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## Marina

Hi Michelle

i used utrogestan pessaries for all my DE cycles, the last one which was successful I used 600mg a day on the 2ww, after I got a BFP I had to up them to 1200mg a day, but this was obviously not enough for me, as I had a heavy bleed at about 5 and half weeks PG, so I was told to up the dose to 1800mg a day which stopped the bleed and I continued this until 13 weeks, as Daisy said some need more than others as they don't absorb it well.

Hope that helps

Marina


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## millyJJ

Hi
I asked Dr Walker at IM about this, as I've bled on day 8 pt on every attempt - she said they could not prescribe the injections, so it would have to be done with the agreement of my GP or specialist over here. She did suggest having a test at 1 week pt if I was worried.

Milly


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## Empty2

Hi Michelle,

With my one of my donor embies I used suppositories and twice with the injection.  All resulted in pregnancies.
I have got suppositories to use this time and don't have any worries about using them.

hope this helps Michelle, good luck with your treatment.   

empty2


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## longbaygirl

All the research I've seen shows the absorption rate for injections is much higher than for the pesseries, but I don't think the evidence is completely overwhelming, and as DaisyG has said - it is gold standard in the US where they have a much higher success rate.

I used them on my DE cycle.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9478327&dopt=Abstract

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=10668157

/links


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## Willowwisp

Hi 

I used pessaries on my 1st ICSI, got a negative and then used Gestone injections for the other two and got a positive both times, sadly I MC on the 1st positive but I don't think that was because of the Gestone.  

They can be painful but I would go with the injections everytime!

Good Luck

Willow
xxx


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## roze

At ISIDA I was prescribed both- injection in the morning and pessaries at night.  The theory was that the injections were easily delivered to where they were needed ie in fat reserves allowing gradual dispersal throughout the day,  and the pessaries were supplementary.  However I know that protocols vary between and even within clinics so not sure whether the evidence supports one or the other.  

I am a complete needle - phobe and when younger jumped out of a window to get out of my rubella jab as I could not cope with the thought of an injection.  I had trouble during straight iVF when I had to inject myself with Puregon etc.  That was fairly ok in the end  as it was subcutaneous and a short needle.  Progesterone in oil requires intra muscular injections and a longer needle. I was shown how to do it several times in Kiev and thought I would never do it.  Trust me , if I can inject myself 84 times in all, ie one every day, then you can also do this.  The thought is worse than the actual experience.  If this method  is prescribed for you, then please don;t worry , you will learn after being shown how. 

roze


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## Michelle44

Hi all,

Thank you all so much for your help.  It has been amazing.  

Still in two minds what to do as there are so many mixed thoughts on the matter.

I need to decide before Friday.

Regards.

Michelle


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## three_stars

Just to add to your confusion..  I have never had daily injections.  Sometimes I have had injections of a larger dose right around ET and then a few days after... either 250 or 500 mg dose.. supplemented with the ovules.  Also have had ovules taken both vaginally and orally in combination.  Usually have always had about 800 mg a day total.  With my HCG levels so low this cycle my DR thought I was not absorbing the progesterone enough.  I take 3 x200 mg orally in the day and 1 vaginally at night.  Well the results showed that the levels were plenty.  You should be given a progesterone test same day as ET to ame sure your levels are good and then usually repeated later. 

Now that I was bleeding all week and read that others had upped the doses I did as well and it seems to have subsided a little.  SO thanks for that info ladies. 

A lot of times you are given injections versus pessaries as they are a lot cheaper abroad and sometimes the pessaries are not even available in all countries.  Doing the injections of PIO yourself is NOT fun.  I already do Clexane daily and HCG every other day so unless there is really great difference in results I can not see doing the injections.  I do not think the rates are higher in USA because of PIO. I think there will be a lot of factors but too long to go into here. 

bonnie


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## Tweetiepie

Just a quick one - I was on pessaries and suddenly my levels dropped  - I was then put on Gestone (plus 3 Cyclogest a day) which sorted my levels out.  Then they started to drop again - so they increased my gestone to 150mg a day plus only 2 cyclogest a day and this is the dose that kept my progesterone at a good level.  This was during my last pg which sadly ended in m/c.

But next IVF I will ask for Gestone injections as on the 2 ivf Cycles I had I did spot before testing day!

tweets xx


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