# Luteal support with IM progesterone



## mummywannabe75 (Nov 12, 2011)

HI,

I am new to the site. I am currently on the 2WW, 1 day post transfer. Previous history of 3 miscarriages and I failed IVF cycle. I always suspected luteal phase defect but been told that is a theory gone out of fashion. Nevertheless I still worry about it.

I am currently on progesterone 100mg (Prontogest 100mg) daily and I have been supplied 23G needles that are 1 1/4 long and it took a lot of psychological barrier to come round having those injections. I am just wondering if those needles will do the job as I read that a lot of patients are having their im injections with 1.5 inches of needles.  ( although secretly I am hoping I don't have to use longer/bigger needles, but would be gutted if the cycle failed with inadequate luteal support). I do BBT still even though I know with all the hormones, temp are likely to be out of whack anyway but my temps are lower than the first ivf cylce even with im progesterone on board. I used cyclogest in my first ivf cycle where I started bleeding day 7 post transfer.

Also I would like to know how long does the im progesterone stay in your system and how does one determine if she needs more progesterone and when is the best time to test the blood level? I presume there is a peak and trough level.

Thanks!


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## Mistletoe (Holly) (Jan 1, 2007)

Gestone(UK product of oily progesterone injection) is recommended to be given with a 1.5inch needle so that it is injected deeply into the buttock muscles where there are ample fat cells (  ) so that the oily injection forms a depot and is slowly released into the system.
Prontogest is unlicensed in this country so I do not have specific information on its characteristics.

With the length of IM needles it is difficult to say exactly what would be the correct length for an individual patient - a slim build patient needs a shorter needle than a patient with more subcutaneous fat. What is important is that the oil is injected by deep intramuscular.

What we mean by a depot is that it releases slowly over several hours or days. Again it depends on many factors, probably including how much fat you have and how much activity you undertake. The level in your body would depend on how much you are making yourself as a background level and your rate of metabolism.
If you are worried I would get a predose level done to ensure it is not dropping too low before the next dose is due.


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## mummywannabe75 (Nov 12, 2011)

Hi Hopeful Hazel,

That is useful information, I am hoping that my petite frame and normal BMI is enough to warrant using a 1 1/4 inch needle as it was supplied by the IVF unit anyway, but I get paranoid when I don't get the characteristic muscle pain you get when you have an IM injection and that makes me think if it is in the right site sometimes. I think I will do a pre dose level just to be sure and I am currently supplementing myself with cyclogest, I suppose the good thing is my body is acting as though I am progesterone loaded so that is reassuring. 

Do you know the half life of prontogest by any chance?


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## Mistletoe (Holly) (Jan 1, 2007)

Like I said it is unlicensed in the UK so I don't have detailed information.
I have just looked up progesterone in micromedex as a general drug. It is very complex as it is heavily protein bound (96-99%) and has active metabolites.
There is half life information of anything from 9 hours to about 70 hours depending on the study. Some of the metabolites undergo enterohepatic reabsorption.
Given that it also provides a depot that is absorbed over a few days it is very difficult to say what would happen in an individual.
Best thing to do is to have your levels checked. However, if you are one of the patients where the half life is long, your levels may not be at steady state for some time.


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