# Anyone else bleed before OTD even on Gestone?



## Sarapd (Dec 4, 2012)

Hoping someone can help me please? I'm on my third fresh cycle, 12dp2dt and am bleeding bright red blood. I'm on 50mg Gestone, 2x400mg Cyclogest, 40mg Clexane and 10mg Prednisolone.  This is the third time I've used Gestone and I have yet to make it to OTD without bleeding.  I thought Gestone was meant to stop any bleeding. Does anybody have any ideas why this keeps happening please?  I have no idea what to do next, what tests to have or where to go for them.  
Really hope somebody can shed some light on this as I'm 40 and fast running out of time and money.
Thanks.
Sara. xx


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## Greyhoundgal (Oct 7, 2013)

Sorry Sara - I don't know anything about this but didn't want to read snd run. Hope you're ok   I have read a lot of IVF ladies bleed early and well into the pregnancy so could mean nothing at all. Thinking of you 

Grey xxx


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## Tincancat (Mar 19, 2012)

I would say you are not absorbing enough progesterone from the pessaries and therefore your levels are too low.  It was for this reason I had to switch to Gestone injections but I needed 100mg each injection each day.  I would think if you are having 50mg you may as well be having the 100mg dose to ensure you have enough.  I then did not need the pessaries.
I would think you need to be having a blood test to get a progesterone level so that even if this cycle does not work you will now if you need a higher dose of Gestone for your next cycle.  If this cycle is BFP you may need to up your dose of Gestone now.
Good Luck
TC x
Ps your prednisolone dose seems a little low too.  If you are a little chunky like me you will need a higher dose


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## Sarapd (Dec 4, 2012)

Thanks Tincancat
I got the impression that giving me 10mg of Prednisolone is just paying lip service to it and I may as well be taking smarties! I am on the larger side although not huge so your comment makes sense.
Only had the one episode of red blood today and nothing now so don't know if that's a good sign or not.
If this fails, I really don't know if I've got it in me to try again.
Sara. xx


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## KandK (Nov 17, 2011)

nothing you are taking will _prevent_ you from bleeding, it will only support a pregnancy should it happen. Usually only taking hcg shots will prevent a bleed. The most likely reason you are bleeding early is because you missed your implantation window. How long are your usual natural cycles (ie. in your past, without meds). If you had your embie/s transferred before the ideal window then most likely it was due to that. For example, you have a regular 28 day cycle - egg collection should have been around day 14, transfer 5 days later (as that is the ideal time that embies are arriving at the uterus in a natural cycle). I had that exact problem for my first 2 cycles - they were pushing it all too soon and I got one chemical pg (with a bleed 2 days before OTD) and one mmc. Cycle no. 3 I finally twigged and stimmed longer to match my own very long cycles of 34-36 days and then I got a BFP for cycles 3 and also #4. Were your lining scans good when you had them done?

oh and edit to add that if you are PCOS I hope you are taking Metformin and continuing it through stimms and up to 3 months after any BFP (should it happen). Do some reading if you aren't already on it - it does wonders for PCOS and also preventing miscarriage and improving egg quality.


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## Sarapd (Dec 4, 2012)

Thanks KandK
EC was actually very close to when I would have ovulated as I ovulate late and have a short luteal phase. I was on low dose of Gonal F and stimmed for quite a time.
I am also on Metformin. My lining scans were also great and we had 100% fertilisation of 3 eggs, although one wasn't as great as the others and all 3 we're put back in on day 2.
We've thrown everything we can at this cycle and really don't understand what else we can do differently. Bleeding has stopped completely now but still waiting for my clinic to call me back.  When I've had bleeding before it has taken a good few days to stop so hoping this is different.
This is just such a hard process.
Sara. xx


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## magz1 (May 9, 2011)

Hi Sarandon, sorry to hear you have had some blood, all I can say is on my successful cycle I was on 50mg gemstone and started bleeding, tested positive 10 days past a 3 day transferr. Clinic upped my gemstone to 100mg. Hope u got hold of them. Have u tried testing magz xxxxxx


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## Sarapd (Dec 4, 2012)

Thanks Magz
I tested this morning but it was a BFN - I'm still only 10dp2dt so it is early. Am now on 3 Cyclogest as well as Gestone but starting to lose hope as I've had more bleeding this afternoon. It's always at the same time of my cycle.
Sara. xx


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## magz1 (May 9, 2011)

I really hope everything settles down and you get a positive result magz xxxxxx


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## KandK (Nov 17, 2011)

Sarapd said:


> Thanks KandK
> all 3 we're put back in on day 2.


Sara I think you just answered your own question.... you had a 2 day transfer? Hmmm I don't want to rock the boat and offend just wanted to kindly suggest that a 2 day transfer is sub-optimal. Embies naturally arrive in the uterus on day 5-7, putting them in on day 2 is not a natural time/place as on day 2 they would be in the fallopian tubes. Can you push your clinic to do 5 day transfers? I had 2 separate 3 day transfers and got one chemical and one mmc. I pushed (okay DEMANDED) a 5 day transfer and said that I wouldn't do a transfer unless they went to 5. With a bit of grumbling they did. 2 x BFP cycles followed, both with the 5 day embies. It is a real tetchy point with ivf drs and patients - the "they are better off inside you" at day 2 or 3 I believe is tosh. Read the studies, there are so many about the MUCH higher success rate of 5 day transfers. Don't want to sound preachy sorry  But honestly there are financial gains for the clinic to do 2-3 day transfers and they are guaranteed their money that way.

Push for a 5 day transfer and maybe ask about hcg support during the 2ww - it's big in USA. Personally I haven't tried it but there are studies yes/no for it.


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## Sarapd (Dec 4, 2012)

Time to give up on this cycle KandK then.


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## Tincancat (Mar 19, 2012)

When is your OTD Sara ?  A blood HCG should give you a more definitive result today but urine tests need an extra 48hours to be reliable .
I hope you were also able to have blood drawn for a progesterone level to ensure you are on the correct dose for this or future cycles.
TC x


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## Sarapd (Dec 4, 2012)

Just an update for completeness in case anyone else ever finds themselves in this horrible position.  It was a BFN for us.  Not sure what to do next as this has happened on every cycle regardless of it being a 2, 5 or 6 day transfer.  I'm told I shouldn't bleed when I am on this much progesterone so off on a factfinding mission to see if anyone can shed any light on this and whether there are any further tests I need.
Sara. xx


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## Bumble Bus (Apr 23, 2013)

Hi Sara, I don't know anything that could help but just wanted to send   Really sorry. xx


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## KandK (Nov 17, 2011)

hey sara, sorry for your bfn    I had a chat to DH about your situation (he's an ob/gyn) and he suggests you should have hysteroscopy if you haven't already - check for things like fibroids and myomas etc.  He said you would most likely benefit from endometrial damage before your next cycle (so a light curette or scratch).  You didn't mention any of your hormone profile results and antral follicles before this cycle; and also the cycle/protocol you were on and dosages - if you prefer to pm me feel free.


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## sasra (Apr 27, 2012)

Sorry about your bfn, I was going to say exactly what the lady has above about having a hysto to check your lining, I've had 3 bfn all bled before otd, now preparing for a 4th and having a hysto to see if there is anything. Xx


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## Sarapd (Dec 4, 2012)

Thanks both - had a hysteroscopy done - nothing abnormal there and had an endo scratch. Had 11 follicles before last cycle. Only problem with hormones is that LH and FSH are wrong way round due to PCOS but FSH is still low. I think I'm a bit of a medical mystery so far! 
Got follow up this afternoon so may get a few answers.
Sara. xx


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## KandK (Nov 17, 2011)

then you must change your protocol - I hope you are on metformin if you are/were pcos.  You would really benefit from long Lupron protocol with low-dose gonal-f. pregnyl as the trigger and continue the metformin until several months after your bfp (at least 500 mg).  If I had three neg cycles I would be demanding a more tailored protocol or getting another opinion.  Also you can ask about hcg support during the 2ww - it's big in USA but so far other countries are slower to catch on (I've never had it personally, but you can try it).  And why are they keeping you on pred after embryo transfer?  Most clinics recommend you take it to day 5 after EC (to stop/reduce inflammation response) but not normally after transfer unless you have immune issues.  Just some people that can negatively affect if not taking for immune reasons.


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## Sarapd (Dec 4, 2012)

I also tried a different protocol this time......


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## ruth157 (Jul 8, 2010)

Sara, I'm not sure if this helps but I also bled early on all my negative fresh and frozen cycles despite being on cyclogest. My consultant also said it wasn't possible. Once I even bled the day before a planned replacement which led to a cancelled cycle. Every time my lining scans looked perfect. In the end I had a Lap and a couple of Polyps removed, plus some mild endo. These hadn't been visible on any previous scans or HyCoSy. I still don't know if they we're what was causing my bleeds but my positive cycle was the first after my lap. However it was also my first immune cycle so may have been that either. Or luck.

We were trying for 5 yrs and I had a scan and HyCoSy early on which suggested no physical problems so we always assumed the issue was elsewhere, but in the end I had polyps, blocked tubes and mild endo. I guess what I'm saying is if your hysteroscopy was done a while ago maybe worth considering a lap. Good luck, R x


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## missy12 (Dec 14, 2013)

I am in the same position now and after any help or answers I can get. Last cycle I bled at 7dp3dt I was on 2 pessaries a day and had one hcg shot in 2ww. This time I asked for gestone so I got 50gestone 3 times a week and 3 pessaries a day plus 1 hcg shot 2 days after transfer. On Friday I felt my progesterone drop as my boobs stopped hurting which is always a sign my progesterone is dropping off and my period is about to come. I rang my clinic n they told me to up gestone to 1 everyday. However today I have started bleeding. At a loss with where I can now go. X


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## fififi (Mar 16, 2011)

Sorry to see you're bleeding Missy   

Every clinic does things differently but in my case having bled twice prior to OTD clinic put me on 100mg of gestone daily as wondered if I just wasn't absorbing the progesterone via cyclogest pessaries. In the cycles on gestone I've not bled early.
From what I've seen when asking others about help administering gestone I get the impression most ladies are on 100mg daily. Progesterone is released into body slower via gestone than pessaries and I think this is what has helped me as perhaps my needy window is greater than every 12 hours.

I'd ask your clinic about upping to 100 gestone daily. (On this dosage this was my only form of progesterone.) I'd also see if you could get your progesterone levels tested and see if they are actually at the right place. If your clinic won't test them you should be able to find private centre that will. (Eg private hospital like Spire or Bupa)

Hope your bleeding stops quickly and it turns out to be a wierd blip in your run up to getting BFP


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## missy12 (Dec 14, 2013)

My clinic are so frustrating I rang this morning to ask them to up my gestone and they said there is no point because that won't stop the bleeding. They basically said to me I was bleeding because it's a failed cycle and gestone won't stop that. Everything I've read contradicts this tho. They also won't test my progesterone level but luckily I have a lovely gp and I have just been and had it tested. I am so frustrated that I cud stop this bleeding before it becomes a major problem by them just upping my gestone x


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## fififi (Mar 16, 2011)

Your clinic may be right in saying changing gestone dose now may not make any difference. However I disagree with assumption it's a failed cycle as have seen many ladies on here have a bleed & still get BfP.
Glad your GP tested progesterone - for your own peace of mind, and as way to move forwards with a plan should this cycle not work out, I think if you have proof that progesterone levels are ok/low then you'll be reassured.

Could you just increase your gestone dose & use 2 vials instead of the 1? (In UK it's pretty much impossible to get 100 vials so that's how I've been taking the gestone). If you've enough to get you to OTD by using 2 a day then perhaps that's something to consider.
What strength are your pessaries?
Another consideration is are you using the pessaries vaginally or rectally? Although in theory you can do either my clinic highly recommends vaginally as this improves absorption.

Sorry can't be of more help. I really feel for you as early bleeding makes what's already a difficult 2ww even harder


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## missy12 (Dec 14, 2013)

Yeah I have got enough to get me there cos they messed up my prescription so ended up with more than they think I have so have decided to up my own dosage (great minds) I was go a do 50gestone on a morn n 50 in a night do u think that's I'll be ok?
My pessaries are 400 and I've been taking 3 a day of them. I had my gestone this morn n have since had 3 pessaries (just going for all the progesterone I can get so might have another later) so far the bleeding has progressed from brown spotting n I am thinkin it's cos of all of the progesterone I've used?
I hVe been taking them rectally. 
Thank for your help x


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## fififi (Mar 16, 2011)

With gestone you just do the one injection daily as it's released much slower into body. Draw up the two vials into the one syringe - you'd need a 2ml syringe ideally.
Although amount seems less on 100mg of gestone you shouldn't need any additional cyclogest. From what I've read too much progesterone won't cause medical problem but not advisable. Being as you've already had 3 pessaries I'd not have any more today. 
At 400mg they're already high dosage - 800mg daily should provide average lady with more than adequate levels & that's without anything else involved.
Tomorrow have 100mg of gestone in morning & perhaps 1 pessary in evening to reassure.

Glad spotting now browner. Try & keep positive and allow yourself to relax more than worry.


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## Tincancat (Mar 19, 2012)

Fififi's advice sounds sensible as indeed Gestone is normally given once a day.  The slow release depot effect from the oily base means no more than once a day is needed.  It does seem you are not absorbing enough progesterone from the Cyclogest.  Many ladies have this problem with Cyclogest.  The blood test result will also help you discover exactly what your body is doing with the Cyclogest.

Be mindful of the fact a FF moderator with come along soon here and say you should be following your Clinic's advice.
TCCx


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## missy12 (Dec 14, 2013)

Meant to say in previous message it hasn't progressed from brown spotting. Still same bleeding as I was gettin this morn light brown. Thanks for ur help. Hoping this will help x


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## missy12 (Dec 14, 2013)

Thanks tincan x


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## fififi (Mar 16, 2011)

Forget how far you are from ET but brown discharge/spotting after IVf cycle pretty normal as the process of EC & ET will cause slight "damage" / disturbance to your insides and anything brown in colour is old blood being released.
Also need to take into account implantation bleeding - which may occur 7-12 days after EC (assuming transfer was made!). This implantation bleed may be pinkish, brown or even red blood.

PS. I should have qualified my suggestion of increasing your gestone that this is what I'd would probably have done in your shoes, however like Tincat said it is not necessary the "right" thing to do given that your best advice is generally to follow your clinic's protocol for you.
I'm guessing that because of the high dosage of cyclogest you're on they don't see need to increase progesterone intake further. If you are making choice to increase that method of progesterone you really should be decreasing other forms.


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## missy12 (Dec 14, 2013)

I am 7 days on from a 3day transfers today. I will hope but who knows what it is. I am still gettin it now. X


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## missy12 (Dec 14, 2013)

An update. I am still getting brown spotting. My theory that I wasn't absorbing the progesterone support was wrong as got my results back from ydays progesterone test and it was well within the normal limit. So really don't k ow what to think now? Didn't think u wud bleed if ur progesterone was high as thought that was what stopped af from coming?


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## Tincancat (Mar 19, 2012)

Hi Missy 
Brown spotting is old blood not like fresh red of full blown AF.  I have known people bleed and still have BFP particularly if more than 1 embryo transferred.  When is your OTD? 
TCCx


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## missy12 (Dec 14, 2013)

It was next Tuesday but they are going to do a blood test on Friday now x


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## missy12 (Dec 14, 2013)

Just to update anyone that may come across SAMs problem in the future. After being certain it was all over with brown n a bit of pink spotting followed by strong period pains I got a bfp which was confirmed by a blood test yday x


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## Tincancat (Mar 19, 2012)

Great news Missy.  If you had more than one transferred then this can often happen.
Have a happy 9 months 
TCCx


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## missy12 (Dec 14, 2013)

As is the spotting is one of the embryos not implanting? X


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## Tincancat (Mar 19, 2012)

Nobody is really sure but it can be one has tried to implant and failed also twin pregnancy often has bleeding.
TCCx


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## fififi (Mar 16, 2011)

Missy          

Really pleased for you xxx


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