# Progesterone - advice for follow up



## Sunshine122 (Mar 20, 2017)

Hello

I recently had my 2nd failed IVF cycle, bleeding at about 6dp3dt, which was the same as my 1st cycle. On the 1st go I was on 3 x 400mg cycligest pessaries a day, on this 2nd try I was on 1 lubion injection a day. When I first started bleeding I had a blood test which showed my levels were very low so increased to 2 lubion injections a day but think it was already too late to help. Even in a normal cycle I have a short luteal phase of about 9/10 days despite trying everything, nothing seems to have helped.

Anyway, I have my review appointment next week before our 3rd cycle and was wondering what to ask for? My clinic don't seem to be very proactive so I want to go with my own ideas about what we could try as I'm worried about being fobbed off. I wonder if I could have a problem with abnormal progesterone absorption and if I should ask for this to be tested? I've seen some people take steroids after transfer, do you think this is something that could help?

I've also read that hidden C can cause low progesterone, has anyone found being treated for this has helped their luteal phase? I think I will send off a sample this month.

Any other advice would be greatly appreciated, I really am feeling desparate esp as I have a low AMH and don't respond very well anyway, I do worry that even if I did have a perfect egg it wouldn't have any chance of sticking.


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## June2015 (Jun 20, 2015)

Hi Sunshine122

Sorry to hear about your recent failed cycle  

With regards to progesterone, I had 200mg cyclogest (AM & PM) and Gestone progesterone injections every day for 12/13 weeks.  This was due to having had blood tests on the NHS at my initial investigations which showed I had practically no progesterone each month. (I too have extremely low AMH) 

So, when I went to the private clinics (didn't qualify for NHS) I was very concerned about progesterone.  My first clinic only gave me cyclogest (can't remember how much now) and I had a failed cycle. This may have been down to egg quality or progesterone or both, who knows.....  drives you mad.

Anyway, when I moved clinics (moved to DE too) the consultant looked at my history and said he would also prescribe intramuscular progesterone injections and he was surprised I hadn't been given this before.  My point is, yes, I think you should ask for an increased amount of intramuscular progesterone injections, plus cyclogest.  The injections are not pleasant, can be painful afterwards (not usually during the injection) and must be done daily, but it might prove worth it, giving you the little extra progesterone boost you need. PS I also put cyclogest up my back bottom, not front (something the clinic said to do, but actually it's a lot less messy).

I've not heard of abnormal progesterone absorption, sorry, but you should still ask if that is possible and if so what they can do about it.  I think people generally take steroids after transfer if they have immune issues. 

Certainly at the review meeting ask what they think went right with the cycle (eg, good lining etc) what do they think went wrong, what options they think you have moving forward (eg, further tests, if so what eg ERA, immunes) and which protocol to try and any other 'add ins' which might be worth a go, eg endo scratch, embryo glue etc. Then you can take all that away with you research and devise a plan.  

I hope others reply too who have experience with progesterone to help you along the way

xxx  xxx

PS forgot to say, also ask them about your  estrogen levels and meds for that  xx


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## Sunshine122 (Mar 20, 2017)

Thank you for your reply June, thats really helpful. I am definitely going to ask for gestone. Did you take estrogen during the luteal phase too then? 

It's all so frustrating especially as I checked so many times with my consultant that 1 lubion injection a day would be enough as I'd seen so many ladies take it in addition to cyclogest etc. To be honest I wish I could change clinic now as I have lost faith in them but we have paid for a 3 cycle package. 

Thanks again for your help   and congrats on getting your BFP


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## kittykat76 (Jan 17, 2016)

CD19 affects progesterone absorption, it's part of the immunes testing. I tested out of range for this too struggle to maintain progesterone levels and use prontogest IM injections, they keep my levels decent.As June says they aren't the nicest things to do but they work, those plus the pessaries will cover all bases. Ask them to test levels on day of transfer so if isn't high enough then it can be sorted but the injections usually work. I asked my clinic about lubion and they said it isn't anywhere near as good as prontogest and as my level after 1st BFP was only 10 they wouldn't recommend them.


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## Sunshine122 (Mar 20, 2017)

Thanks KittyKat, I wonder if they will recommend I have the test for CD19 or if they would rather just increase the progesterone anyway. Even when I was using 1 lubion injection a day my progesterone was only 19 so it definitely was no where near enough.


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## June2015 (Jun 20, 2015)

Hi ya,

Oh yes, I took oestrogen from just before embryo transfer until 12 weeks. I had patches, plus progynova. Basically I was drugged up to the eyeballs  

As well as gestone, I've used pronotgest (I think pronotgest was the one used in my successful cycle??) I can look into it if you want me to, no problem.

Ah, thank you, I've been very lucky and can't believe it really. 

It's also interesting about CD19. Defo go for that if you can. Best to get all basis covered xxx


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## Sunshine122 (Mar 20, 2017)

I'm willing to try any drugs they'll give me if it'll help, the more the merrier   so will ask about the estrogen too. Will mention about the pronotgest then, will be another one for DH to have to inject me, even after all the other jabs I'm still a massive needle wimp!!  

Thanks both for your help, had a huge meltdown earlier that it'll never work but feeling a bit better now I know what I'm asking for. xxx


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## Loonytoon (Oct 30, 2014)

I'm also a poor absorber of progesterone! You're very similar to me as I'm  a terrible responder too and Lowish amh. I have tested positive for hidden c but just can't take the antibiotics for so long. I tried but have v sensitive tummy and was feeling dreadful! Dh was same but his sperm count went way up! Still same result wrt embryo quality. But I was bleeding 7 dpt (had tested trigger out but then got bfp while bleeding). Bit of history- First cycle never got to test as mother of all periods arrived  and with mc and cps levels always  been low and always spotting. I've tried all forms from tablets, pessaries, gestone, protulex (Czech injection inti belly. This time I'm on 400 cyclogest twice a day, gestone and adding 4mg estrogen the night I trigger for ec. Supposedly 2 x 2mg oestrogen added to luteal phase in testing has been recommended dosage wrt reducing mc and I seem to remember reading about low progesterone and oestrogen being linked but just can't remember. I have also been told that poor quality embryos will not produce high levels of progesterone, and nature is taking care of things but that was by a particularly crude consultant  

Stay positive you will get this sorted   you just need to find the right combo x


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## kittykat76 (Jan 17, 2016)

If you did immunes testing then it would cover all of them,not sure worth testing just for that alone but just ask them for the prontogest,it doesn't harm you and you can't really have too much progesterone after transfer. It really does work for us ladies who struggle with it,my consultant asked if I wanted to switch back to cyclogest this cycle as they test levels on transfer day but I said no because if they haven't worked then I would have been panicking that lining wouldn't be ready for the embie. There is always something different to try so stay strong,its just finding what works for you


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## Sunshine122 (Mar 20, 2017)

I am definitely going to ask for the prontogest, does the dosage vary or is it just 1 standard injection a day?

Loonytoon, when you used the gestone previously did it delay your period starting? Is protulex similar to lubion? Hope this time it works out for you.


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## Loonytoon (Oct 30, 2014)

I think dosage is 50mg per day. 

First time I was given gestone I think it was too late. I was only 5 weeks and bleeding but scans were positive looking. I lost it few days later. That cycle my Progesterone was around 13 I think 14dpt with hcg. Last time I was about 4.5weeks pregnant but had no scans so started bleeding then too but they never checked my progesterone for me. 

I don't know if lubion is the same as protulex but protulex is def not intramuscular. 

Thanks for the good wishes xxx


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