# progesterone pessaries - always used for ivf??



## lexx7

Ok, so I haven't even had ER yet but hopefully next week  

I'm starting to worry about everything else and don't go for another scan until Monday afternoon.

I've been given orgalutran to use on Sunday and Monday morning and already a bit worried about that but got to do it and just glad my neighbour is ok doing them for me.

I just wanted to know if progesterone pessaries are always given for Ivf?  I've not done any down regging, just low dose Gonal f of 150iu, 75 and now 37.5 and then the orgalutran and I assume a trigger.  Will I have to have the progesterone pessaries or is it dependant on tests and a need for them?  Or is it necessary no matter what?  

I'm asking as I'm really worried about using them - I have a bladder disease and go to the loo a lot so I would be concerned about them being absorbed correctly.  I'm also concerned about what I've read about them causing irritation and thrush    I used to have vulvodynia (constant vulva sorness) and I really do not want that to happen again.  I also had ureaplasma at the end of last year and although asymptomatic in most, it caused irritation and soreness there too    So I desperately don't want to have these.  That all said, I have read that they can be used anally (sorry tmi) and yet people say this is far better but causes bowel issues    and the latter is causing me huge issues at the moment already    And again, (yes I know I should quit googling   ) I also saw that they can cause uti's, severe headaches and heart issues    The uti's are a huge worry given that I have a bladder disease.

I really hope that I'm worrying about nothing, but I've gone the last 2 nights with only a couple of hours sleep from being in pain from I assume my expanding ovaries that are causing bowel cramps and therefore bladder pain and gassy issues    

Thanks for any info of experiences and advise


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## Martha Moo

Hi

Progesterone support is normally prescribed during IVF to support the luteal phase to at least test date

It is normally prescribed following Egg Collection although it varies clinic to clinic

I have endo and a lot of scarring at the front door so to speak, i used the pessaries rectally, i think you need to speak with your clinic and discuss your concerns with them to see what options are available to you or at least share your concerns (and perhaps step away from dr google it sometimes can cause more harm than good!)

Donna Marie


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## Lexi2011

Hi lexx, I am on progesterone injections as opposed to the pessaries. The are not overly pleasant as its a bigger needle that you use for stimming drugs but it's over and done with quickly each night. I am sure your clinic will provide you with the best advice so try not to worry too much xx


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## lexx7

Thanks to both of you for the replies  

Donna Marie - I have endo too (as well as Ic and myasthenia), how were you with using the pessaries rectally?  Did you have any side effects, irritation etc?  And yes, I do agree that dr google can be a bad thing - but that said, I would have continued to be told I had a salt deficiency instead of Mg if I hadn't of used it    

Lexi2011 (good name   )  Can I ask why you have been given injections instead of pessaries?  Are they done every day?  Do you do them yourself and are they easy to do?  And do you have any side effects at all?  Hope you have a magical bfp next week


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## Lexi2011

It's just the preference of my consultant not sure why, yes they are daily injections in my bottom courtesy of my husband! They are very easy to do but do hurt and you get the odd lump on your bottom! Apart from that the main side effect for me is night sweats again not pleasant but everyone's different. X


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## lexx7

Thanks Lexi2011 - I don't think injections will be an option for me    My husband works away in the week and I've been relying on my neighbour to do the gonal f when he hasn't been here and I'm now putting her out getting her to do the orgatrun (sp?), just hoping the tirgger is at a descent time or I think she may fall out with me      Don't think I can realistically ask her to do injections in my bum every night for potentially months    Do they have to be injected into the bum?  I haven't been able to do any myself despite trying, I'm just far too afraid to do it and it has been handy having a physio next door who knows what she's doing    I'm petrified of all things medical after everything I've been through the last few years  

Donna Marie & anyone else that uses the pessaries rectally - how are they?  Have you had any side effects?  How long do you have to use them for and how often?

Thanks so much for any help


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## charlie61

Hi Lexx 
just wanted to let you know my experience with the progesteone injections, I asked for these instead of the pessaries for our second tx as i had heard they were more effective.  Firstly it is possible to do the injections in your   yourself, you just have  to be a bit bendy    i did try this but was a bit too squemish  for my liking (my DH is registered blind so  unable to do the injections) so i ended up going to my doctors daily and getting the nurse to do the injection, it was a bit of a juggling act geting an appointment every day but my GP's were brilliant, at the weekends i had to go to the local hospital to get the out of hours nurse to do it and again they were fab, not sure if any of this is something you can do but just wanted to let you know that there are other options out there


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## lexx7

Charlie61 - awww, thanks for your reply    I did think of the Gp doing it but my surgery is a 10 min drive away so not so easy but if it's what I have to do then I will.  The hospital is half an hour away so maybe my husband could attempt them at the weekend - depends if they are big needles, he is ok with the little gonal f pen ones but the others he isn't so sure of so had my neighbour do them.  Maybe my neighbour would do them, but I feel bad putting her out so much when she has 2 little ones and I've only known her for 9 months and so I'm unsure about flashing my bum infront of her    How often did you have to do them?  And for how long?  Did you have any side effects at all?  Thanks again for your help


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## charlie61

Oh Lexx yep they are biiiiigg needles!   they are intramuscular injections so  have to actually go into your bum muscle (and if you are anything like me there is quite a bit of flesh to get through before it gets into the muscle    ) I cant remember exactly when i  started the injectionns but had FET so would have had them after ET and continued them daily until i was 12 weeks gone so a lot of injections and quite a sore bum lol 
The only side effect i got was a nasty rash on my bum where the injections were being done which was really itchy aand did last for quite a while even after stopping the injections but was all wort it!!


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## lexx7

Oh pants, no chance of my husband doing them - think I may have to go to the docs every day then   and brave the embarrassment of flashing my bum to my new neighbour at the weekend if she is willing    Was it just once a day and did it matter what time of day it was done?

Did you not have the option of pessaries?  

Was there anything you could do about the rash?  Cream or anything to stop it itching and being sore?  How did you sit down for 3 months?    

Sorry for so many questions - just trying to fathom out what to ask for and what will work out for the best given my circumstance and medical history.  Really appreciate your help    The picture of your little girl makes me realise it's worth it, she is beautiful


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## Martha Moo

lexx

i did the cyclogest rectally, it was ok really just need to make sure you dont put them in when needing a poo! they absorb withing about half hour

I took them from ec night through to 8 wks pregnant

Donna Marie


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## lexx7

Thanks Donna Marie  

I'm just winding myself up about the injections at the min and wondering if I will be better with the pessaries rectally - did you have any side effects at all?  I've read that they can cause wind, bloating, constipation/dirrahea.....  but having looked more so into the injections, I'm unsure if I could realistically do this as it is a 20 min round trip to my Gp and I really don't know if my neighbour will do them on a weekend and I don't like the idea of the sore bum    

I'm still really tired at the minute from 3 nights of little sleep, I probably shouldn't be stressing myself out with this lol but it's gonna be Wednesday before I know it and I need to decide quickly  

Are the pessaries absorbed just as well recatally as they are the other way?  I keep reading so many conflicting things that say the injections are best for absorbtion and success.  The pessaries used vaginally are a definite no no as I think I mentioned in my original post - so any info you can give me about using them recatally would be much appreciated.  All I can find is that using them vaginally can cause irriataion, soreness and infection, but I can't find anything to say if any issues when used rectally.....  And do they leak and cause a mess like they are said to vaginally? Is it twice a day?  Sorry I'm asking so many questions but please know that I really appreciate your help


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## charlie61

Aww thank you, she really is a sweetie, cant believe she is 2 already!!  
I did have the option of pessaries aand used them for our first attempt but bled before OTD and read that the gestone could help with this.  I think the rash from the gestone is a pretty rare thing and most people dont get that reaction to them, i was just one of the unlucky ones but was told there was nothing that could be done just put up with it or stop the  injections and move onto the pessaries but after getting the BFP with the injections i wasnt going to do anything to put the pg at risk so just moaned a lot during the first 3 months    and they were just once a day.
I used the pessaries both front andback doors    aparently they are absorbed better rectally but they do make a bit of a messs however you do them, unfortunatly there is nothing attractive, painless and you do loose all dignity during  any fertility tx    xxx


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## Raymondo

I've been using them rectally for 1.5 weeks and it's fine.
Last thing at night (having emptied bowels earlier post dinner) and in morning after warm drink (to make sure bowels cleared) and after morning shower. Use my index finger & scrub with nailbrush and soap before & after to be hygienic. Clench bum for few mins after!
Did use them vaginally but much messier & I was advised to use rectally on morning of Et.
Don't think I had any issues, pretty sure all my symptoms are directly from the progesterone (tender boobs, slightly dodgy digestion, bit windy etc) so would get them either way. dab of Vaseline soothes if you feel sore?
Good luck!


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## lexx7

Charlie61 - thanks for letting me know   at the moment, I don't think injections are an option as it would be very restrictive having to go to the surgery daily to have them done, but will see what fs says as I have a scan today      Just want to do what's best and hoping all goes well today 

Raymondo - Thanks for letting me know of your experience    and I really hope you get your magically bfp in a couple of days    I was trawling ff yesterday looking for experiences of ladies using them recatally and quite a few say it's fine and they just get a bit windy, which I think I could deal with, but then I started to worry as others were saying they were very constipated or loose and had lots of stomach pain    and then I read about one lady (having to remember it was only one   ) that got thrush and terrible pain, acne etc even from using it rectally    she seemed to think it was from the progesterone taking it's toll on her body   I have issues with my bladder and bowel and going once a day (sorry tmi) is great and twice is just a miricle    do you need to have emptied twice a day to use them rectally?  The front way is a definate no no for me.  How long have you got to use them for?  Some say they only used them for 2ww, others right up until 12 wks    Have you had any soreness, irritation and pains at all?  You mention dodgy digestion, have they given you constipation or lose bowels at all?  Do you have any leakage after using them or is that just when using them the other way?  Sorry to ask so much - I suppose everyone is different and I will just have to think postively that it will all be fine  

I don't even know if I need them yet, got a scan this afternoon to see how things have progressed and if all ok then to decide on which day to have Er - eeeekkkk but   with all my heart that I get to go ahead and this is all worth it


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## Raymondo

Hi Lexx

I really think you would be fine with using the pessaries rectally.  I haven't had any problems.  Initially I was constipated a bit, and now my movements are a bit more looser than normal - but of course this could easily be caused by stress, lack of sleep or all the fruit, veg and fibre I chomping on.  

The actual "poo" tends to be paler looking - which I guess must be from the pessary (which is white in colour).

My movements occur at the same regularity as normal - which is about 2-3 tiimes a day but it varies so much anyway with me - I always get upset tummy with menstruation and certain foods can just go straight through me, or hot drinks can trigger this.

Yes, the pessaries do make me feel a bit more "windy" but its nothing significant or that worries me.  Quite like competing with DH on the farting front sometimes!

I have had some stomach cramps but nothing that causes me pain (just bit of discomfort) and it is impossible to say if using the pessaries rectally causes this as quite frankly it could be anything (it could even be in my mind!) or hopefully implantation of embies!

I think the scarey thread you read about would be most unusual.  The Cyclogest 200mg and 400mg (I'm on 400mg twice day) leaflet says:
use in vagina if you have:- colitis, problems controlling your bowel movements (faecal incontinence)
use in rectum if you have:- vaginal infection or often have cystitis 
possible side effects are listed as: diarrhoea, soreness in your rectum, flatulence and it says to tell your doctor if you have these or any other side effects - well I don't think my wind is that bad to report. 

I haven't had any mess at all, and as far as I know I must use them for first 12 weeks pregnancy (I guess if I'm not pregnant then the clinic will tell me to stop).  Occasionally I am a bit sore but that is from wiping my **** too much! so bit of vaseline helps sooth it.

Sorry to go into TMI!

Hope all went well today.  Sounds to me like the worrying is getting you down and in a panic - which is the last thing you need right now.

Even if you do try them and you don't get on, I'm sure if you spoke to your doctors/nurses they would come up with an alternative to switch to.

Good luck sweets!
XXX


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## lexx7

Raymondo - your reply has made my day    

I did   and   some more when I read about your fart contests  

I'm going to think postively and be sure that it will be fine and yes, I do need to stop worrying    I just get a bit panicky due to my med history    

Things are going ok from what I can tell, unsure how many eggs I have to play with - nurse just said "yes" when I asked if they had all grown    but they were only 15 so I've got to make my legs resemble pin cushions for a few more days    For what is supposed to be "mild" ivf, I have now done 10 injections and have 3 more to go    I thought I'd got away with the cetrotide but have now got it for tomorrow morning and weds morning too    Thankfully my neighbour will do them for me but she has to rush off to work straight after and told me she won't be able to stay and hold my hand and rub my leg better    Hoping it will be ok  

Thank you so very much for your reply, it really does mean a lot and the reassurance is just great.  I also always get loseness just before or during my period and there are a few things that make me more windy    But I also get bunged up too but there are things I can use for that and perhaps if I ask for something on script just in case   

I   with all my heart that we both get our bfp's - I will be looking out to see and sending you   baby vibes.  Lots of luck and thanks again


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## Raymondo

Thanks hun, lots of luck and positivity to us all!

Re getting the follicles bigger - I was only told to expect max 8 follicles and that maybe not all would have eggs in (due to poor hormone test results). In the end they got 11 with 9 eggs mature enough. I don't know what made the difference - they had me on 450 menopur for last week of stinks which I think is maximum, but I also had some accupuncture, drank tonnes of water & cut out caffeine, tried to do meditation, relaxation & hypnosis (CD's) everyday, did some daily cycling and had a protein drink everyday. I think the protein is good for egg growth & my accupuncturist recommended it. I got a protein powder called Whey to go off amazon and had it in the morning with some defrosted frozen berries and yoghurt or rice milk drink, blended up with some almonds and honey. It had the effect of loosening my bowels though!
Of course i don't know what helped but it might be worth upping your protein intake?
Xx


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## lexx7

Thanks Raymondo    I have tried to eat chicken or fish every day for the protein and also eggs.  I'm going shopping later so will look for some protein powder - just need this darn cetrotide jab to stop stinging so much, blimey it was painful - I thought I was used to jabs by now but that one had me on the verge of a faint    

There is a protein powder that is made by sunwarrior whom make the greens powder I have been using, I will see if i can get some for tomorrow as it will be via tinternet    Kinda wish I'd got some earlier, but the lovely eggs are growing well, it's just I thought they would be about 3mm more than they were yesterday.  Do you still take it or was it just until ec?  I know protein is needed in pregnancy so wonder if it would be good to keep on with it?

Everything crossable crossed for your otd tomorrow


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## Raymondo

Thanks. I've had a bit of bleeding today (first time) so am bit nervous. So I did a test and it is a v faint positive so bit unclear what is going on. I've left message with IVf nurses but they not got back yet. I expect they will say to go in for blood test.  Really hope it's all ok.

I had a couple of protein drinks after EC and ET but used less powder as thought it can't do nay harm and I quite liked them.


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## lexx7

I've had a quick look at the protein shakes but I remembered why I don't think I can have them... so I looked up foods high in protein and I've done quite well with the chicken and fish and got some other bits in too    That cetrotide jab was awful, left me limping for hours and now I feel bluurrr  - can't wait to have it again tomorrow    Off to the clinic again tomorrow for a scan and hopefully have trigger shot tomorrow evening  

Oh Raymondo, that sounds really good - bleeding in early pregnancy is very very common, in-fact my neighbour was telling me only yesterday that it happened to her with both her daughters    Pregnancy tests are rarely false positives    Keep up the   thinking and I   you have your bfp tomorrow at the clinic.  Take super good care of yourself


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