# Progesterone and Implantation



## Claudia H (Oct 2, 2015)

Hi Ladies,

i have a question about progesteron and implantation when doing an FET. I know that the day you start the progesterone is key - but is the amount also key?? 

a bit of background. I had an ERA in December where I only took cyclogest beforehand and it came back 'receptive'. I then did an FET in January and followed the same HRT protocol with only cyclogest. I then tested my progesterone on the day of transfer but it was only 6. I started Lubion immediately, but that round was a BFN, despite it being a PGS tested embryo and I am wondering if my progesterone levels being so low meant that my uterine lining wasn't receptive when we transferred? 

fast forward 10 months and we are doing a DE cycle - which is essentially an FET for me. New clinic, and doctor thinking of adding prontogest on alternate days before transfer because my progesterone was so low last time. But shouldn't we be following exactly the same regimen as the ERA? Perhaps the weird low progesterone for my last FET was just a fluke and normally its fine?

so, does anybody know, if you start the progesterone on the correct day, does it matter if you take a little more than you do with your ERA? will you still be receptive? are are the amount and the timing both equally key? 

thanks for any thoughts or experience!! 

x


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## kittykat76 (Jan 17, 2016)

I think its better to have more than less if that makes sense? I used cyclogest on 1st fet,progesterone wasn't tested until my BFP and it was only 10,they started me on prontogest but I miscarried the day after,I do have immune issues though(one of which being CD19 which affects progesterone absorption) After that I insisted on prontogest each cycle as even if its tested on day of transfer,if its and found to be low I always think that my lining wont be as receptive and I would rather have a high amount to start with


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## June2015 (Jun 20, 2015)

I don't know the answer regarding ERA etc, but  I always had low progesterone so was on cyclogest and progesterone in oil injections. I prefer to have more than less. My consultant said more progesterone is ok, won't harm you.  I didn't have my progesterone levels tested so don't actually know if it made a difference, but I figured it must have done as the embryo stuck x
Good luck x


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## Carrie88 (Aug 2, 2015)

I did the era in the summer and although it came back receptive my progesterone came back at 20 and needs to be at least 80. Surprising as I was on Lubion.

Dr called me and asked me if I even wanted to bother sending it off as my protocol would now have to change. 
I said yes and it came back receptive.

I did more testing and found out I was insulin resistant - which can affect the absorption of progesterone so now on metformin.

Dr Gorgy doesn't like the era as you do need to follow it 100% and protocols get tweaked all the time - but we're doing the next transfer with Lubion and pessaries xx


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## MadameG (Jan 13, 2012)

Claudia did you include a hcg trigger? Hcg acts like lh does, telling the egg to release and then to trigger the corpus luteum to produce progesterone. Repeat boosters can encourage the body to raise progesterone production too. I feel that this was a key part of my cycle last time, even though things didn't work out, but I suspect this was more a chromosome issue xxx


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## Claudia H (Oct 2, 2015)

Thank you ladies - all v interesting! 

Carrie, sounds like you are in the exact same position as me. What I don't get is how can an ERA come back as receptive if progesterone levels are too low?? 

I am also with Dr Gorgy and yes he was telling me he doesn't like ERA for this reason. I'm now trapped in a situation of having to add PIO shots (prontogest) due to low progesterone which is not at all what I did with my era. 

So hard to know what to do.... 


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## Claudia H (Oct 2, 2015)

Madame G - no no HCG as it was /is an HRT cycle so body not producing any progesterone. X


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## MadameG (Jan 13, 2012)

Claudia so did you just use estrogen pills/patches? This is the medicated fet cycle at my clinic and then the hcg shot is added when the lining is thick enough for transfer, followed by the luteal progesterone support. Might be worth asking xxx


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## Claudia H (Oct 2, 2015)

Thanks that interesting - I'll ask. At the moment yes just pulls and then add the progesterone. 


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## WatermelonBelly (May 18, 2017)

Just for reference - they want to see progesterone levels at 50+ on transfer day.

Like PP mentioned, some hCG can be added - just read some studies about that literally yesterday. I think they added 500-600 units.


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## Claudia H (Oct 2, 2015)

Thanks ladies. I think my point is more, if I had a receptive era with only cyclogest, isn't it now dangerous to add prontogest - or any other progesterone too? Even if my progesterone was low when tested on transfer day, if my era was receptive it was receptive - why mess with that?? 


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## June2015 (Jun 20, 2015)

Hello Claudia,

It might be receptive, but does your body continue to produce progesterone afterwards to ensure it continues a d maintains the pregnancy? That's probably why they are looking to add prontogest. 

Xx


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## ZC (Mar 14, 2016)

Following. Will ask clinic these questions. Some excellent feedback here. 

Have a history of low progesterone. I guess the question is if you increase progesterone too much can it inhibit implantation? For sure lower progesterone is linked to miscarriage and lack of implantation.  
And second question is does supportive HCG shots help with implantation?


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## Claudia H (Oct 2, 2015)

Thanks June, I get that you might need to add more progesterone after transfer if you have low progesterone on ET day, but if you add before, won't it risk messing with implantation? 

ZC hello!!! You ask your doc and I'll try asking mine and we'll figure it out xx 


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## ZC (Mar 14, 2016)

Here is work using ingognito mode in google chrome to research "uterine receptivity progesterone levels"
The things we do ...


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## ZC (Mar 14, 2016)

I asked the question here. He is pretty good with responses and advice.

http://drgeoffreysherivf.com/ask-dr-sher-open-forum/comment-page-91/#comment-27110


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## Claudia H (Oct 2, 2015)

Great idea! Let me know if you get an answer x 


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## ZC (Mar 14, 2016)

A short reply to my question 

It is my preference to use PIO rather than vaginal progesterone. Second choice is Crinone 8%, introduced twice daily


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