so - moving on - it looks like placenta FINALLY kicked in!

so - moving on - it looks like placenta FINALLY kicked in!

Mrs. A
Mrs. A

June 26th, 2011, 6:12 pm #1

Most of you know my whole P4 support dilemma. Recap - every time Cooper would try to wean me off, my P4 levels would take a drop to low 20s, which was unacceptable to Cooper. They wanted it to be 40 or above or AT LEAST in the 30s at a minimum. After a couple of tries of weaning with no success, Dr. Check himself instructed the nurses to keep me on 200 mg. of Prometrium per day until 36/37 weeks, which I did until 25 weeks.

Ever the RE/OB/knowledge hound, at 25 weeks I decided to see if something had changed so I stopped the Prometrium for 2 weeks (this was the same weaning method Cooper used previously for me so I was just repeating the same) and had P4 re-tested last week. FINALLY - a good result! 68.3!!! This is the BEST result I've had even WITH support.

I guess Dr. Check was right. By his own admission he was being conservative keeping me on the Prometrium until 36/37 weeks but as he stated, despite what some REs/OBs think, not all placentas are textbook (kicking in by 12 weeks) and instead take a while to fully kick in; he didn't want to take any chances. He actually wanted to be even more conservative and have me take vaginal support but opted not to Rx that given that I wasn't experiencing spotting or cramping, and given that PGs can make you more prone to vag infection, he didn't want to expose me to that and was OK with just the Prometrium.

I'm so glad that I followed his instructions; yes, I am coming off the Prometrium earlier than he instructed but at least I followed them to get over the hump! And more importantly, have tangible proof now that placenta is doing it's job.
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sarita
sarita

June 26th, 2011, 9:21 pm #2

That's great! Were you doing shots? Either way I bet you are thrilled to have to stop supplementing!
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Joined: June 20th, 2006, 2:07 am

June 26th, 2011, 11:14 pm #3

Most of you know my whole P4 support dilemma. Recap - every time Cooper would try to wean me off, my P4 levels would take a drop to low 20s, which was unacceptable to Cooper. They wanted it to be 40 or above or AT LEAST in the 30s at a minimum. After a couple of tries of weaning with no success, Dr. Check himself instructed the nurses to keep me on 200 mg. of Prometrium per day until 36/37 weeks, which I did until 25 weeks.

Ever the RE/OB/knowledge hound, at 25 weeks I decided to see if something had changed so I stopped the Prometrium for 2 weeks (this was the same weaning method Cooper used previously for me so I was just repeating the same) and had P4 re-tested last week. FINALLY - a good result! 68.3!!! This is the BEST result I've had even WITH support.

I guess Dr. Check was right. By his own admission he was being conservative keeping me on the Prometrium until 36/37 weeks but as he stated, despite what some REs/OBs think, not all placentas are textbook (kicking in by 12 weeks) and instead take a while to fully kick in; he didn't want to take any chances. He actually wanted to be even more conservative and have me take vaginal support but opted not to Rx that given that I wasn't experiencing spotting or cramping, and given that PGs can make you more prone to vag infection, he didn't want to expose me to that and was OK with just the Prometrium.

I'm so glad that I followed his instructions; yes, I am coming off the Prometrium earlier than he instructed but at least I followed them to get over the hump! And more importantly, have tangible proof now that placenta is doing it's job.
it's so lovely to see nice news very happy for you. It's a good feeling, I am sure.

hug
jm
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sch1star
sch1star

June 27th, 2011, 12:07 am #4

Most of you know my whole P4 support dilemma. Recap - every time Cooper would try to wean me off, my P4 levels would take a drop to low 20s, which was unacceptable to Cooper. They wanted it to be 40 or above or AT LEAST in the 30s at a minimum. After a couple of tries of weaning with no success, Dr. Check himself instructed the nurses to keep me on 200 mg. of Prometrium per day until 36/37 weeks, which I did until 25 weeks.

Ever the RE/OB/knowledge hound, at 25 weeks I decided to see if something had changed so I stopped the Prometrium for 2 weeks (this was the same weaning method Cooper used previously for me so I was just repeating the same) and had P4 re-tested last week. FINALLY - a good result! 68.3!!! This is the BEST result I've had even WITH support.

I guess Dr. Check was right. By his own admission he was being conservative keeping me on the Prometrium until 36/37 weeks but as he stated, despite what some REs/OBs think, not all placentas are textbook (kicking in by 12 weeks) and instead take a while to fully kick in; he didn't want to take any chances. He actually wanted to be even more conservative and have me take vaginal support but opted not to Rx that given that I wasn't experiencing spotting or cramping, and given that PGs can make you more prone to vag infection, he didn't want to expose me to that and was OK with just the Prometrium.

I'm so glad that I followed his instructions; yes, I am coming off the Prometrium earlier than he instructed but at least I followed them to get over the hump! And more importantly, have tangible proof now that placenta is doing it's job.
Did you see a difference as soon as you stopped the supplementation? For some reason, placental P4 had fewer side effects for me than the PIO delivered version. In any case I hope you are feeling good!

No more "yeast infections" Just kidding, I know you stopped the Crinone earlier...couldn't resist!
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Mrs. A
Mrs. A

June 27th, 2011, 12:38 am #5

That's great! Were you doing shots? Either way I bet you are thrilled to have to stop supplementing!
no shots on this cycle. I did Crinone and 200 mg of vag supps during 2WW. Once BFP, Crinone remained as is and vag supps increased to 400 mg. Then within a week 200 mg. of Prometrium added in. Remained on all 3 throughout all first trimester and continued into 2nd tri and eventually weaned off the Crinone and vag supps but remained on the Prometrium through week 25.

However, if my P4 had come back low this last test my OB (not my RE) was going to switch me to the weekly Makena shot. As it turns out, with a result of 68.3 after 2 weeks of no supplementation, both my RE and OB are happy, and me too. I was ok with continuing on with the Prometrium until the 36/37 week but felt strongly to at least do a re-test. It was at my own direction that I did this re-test.
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Mrs. A
Mrs. A

June 27th, 2011, 12:39 am #6

it's so lovely to see nice news very happy for you. It's a good feeling, I am sure.

hug
jm
I'm glad I got to see for my very own eyes just what Dr. Check was referring to about lazy placentas.
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Mrs. A
Mrs. A

June 27th, 2011, 12:45 am #7

Did you see a difference as soon as you stopped the supplementation? For some reason, placental P4 had fewer side effects for me than the PIO delivered version. In any case I hope you are feeling good!

No more "yeast infections" Just kidding, I know you stopped the Crinone earlier...couldn't resist!
remember how I had all that residual weeks after stopping the Crinone? And even though I cleaned myself out with a Q-tip I guess it still wasn't enough and even weeks after that there still was a smidge of it leftover (the so-called yeast infection!). That stuff is like Elmer's glue I guess!

I have not seen any difference but I've been so lucky to have such a great PG symptom-wise.

Glad I never had to do the PIO because PIO constipates me pretty badly!
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DeeinNYC
DeeinNYC

June 27th, 2011, 1:54 am #8

Most of you know my whole P4 support dilemma. Recap - every time Cooper would try to wean me off, my P4 levels would take a drop to low 20s, which was unacceptable to Cooper. They wanted it to be 40 or above or AT LEAST in the 30s at a minimum. After a couple of tries of weaning with no success, Dr. Check himself instructed the nurses to keep me on 200 mg. of Prometrium per day until 36/37 weeks, which I did until 25 weeks.

Ever the RE/OB/knowledge hound, at 25 weeks I decided to see if something had changed so I stopped the Prometrium for 2 weeks (this was the same weaning method Cooper used previously for me so I was just repeating the same) and had P4 re-tested last week. FINALLY - a good result! 68.3!!! This is the BEST result I've had even WITH support.

I guess Dr. Check was right. By his own admission he was being conservative keeping me on the Prometrium until 36/37 weeks but as he stated, despite what some REs/OBs think, not all placentas are textbook (kicking in by 12 weeks) and instead take a while to fully kick in; he didn't want to take any chances. He actually wanted to be even more conservative and have me take vaginal support but opted not to Rx that given that I wasn't experiencing spotting or cramping, and given that PGs can make you more prone to vag infection, he didn't want to expose me to that and was OK with just the Prometrium.

I'm so glad that I followed his instructions; yes, I am coming off the Prometrium earlier than he instructed but at least I followed them to get over the hump! And more importantly, have tangible proof now that placenta is doing it's job.
That's great...and good info too. Most places say the placenta kicks in weeks 10-12....good to know that this may not be true. It's all so scary. Glad that your numbers are good.
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Mrs. A
Mrs. A

June 27th, 2011, 2:52 am #9

that is what the rule of thumb is and by and large that holds true I'm sure.

When I discussed with Dr. Check about the ranges that are given in the lab reports and how first trimester P4 ranges can go as low as 5 he went ballistic on me (not in a mean way) but told me that you can't go by those ranges because those lab ranges are not based on the P4 levels of live birth PGs - they are based on ALL PGs, including those that end in m/c, are ectoptic, pre-term, etc. They are just ranges based on reported values across all pregnancies vs. values representative of ONLY PGs that resulted in full term live births.

Obviously I don't know if that's true or not but I can see now with my own experience what it means when the placenta kicks in fully and how that is reflected in P4 b/w.

Btw, you were so right about the yeast infection not being yeast but leftover Crinone!
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KerriA
KerriA

June 27th, 2011, 12:43 pm #10

Most of you know my whole P4 support dilemma. Recap - every time Cooper would try to wean me off, my P4 levels would take a drop to low 20s, which was unacceptable to Cooper. They wanted it to be 40 or above or AT LEAST in the 30s at a minimum. After a couple of tries of weaning with no success, Dr. Check himself instructed the nurses to keep me on 200 mg. of Prometrium per day until 36/37 weeks, which I did until 25 weeks.

Ever the RE/OB/knowledge hound, at 25 weeks I decided to see if something had changed so I stopped the Prometrium for 2 weeks (this was the same weaning method Cooper used previously for me so I was just repeating the same) and had P4 re-tested last week. FINALLY - a good result! 68.3!!! This is the BEST result I've had even WITH support.

I guess Dr. Check was right. By his own admission he was being conservative keeping me on the Prometrium until 36/37 weeks but as he stated, despite what some REs/OBs think, not all placentas are textbook (kicking in by 12 weeks) and instead take a while to fully kick in; he didn't want to take any chances. He actually wanted to be even more conservative and have me take vaginal support but opted not to Rx that given that I wasn't experiencing spotting or cramping, and given that PGs can make you more prone to vag infection, he didn't want to expose me to that and was OK with just the Prometrium.

I'm so glad that I followed his instructions; yes, I am coming off the Prometrium earlier than he instructed but at least I followed them to get over the hump! And more importantly, have tangible proof now that placenta is doing it's job.
I know it was difficult to decide whether to keep your faith in Check throughout pregnancy treatment, and it looks like your decisions paid off. I'm VERY happy for you!
Thank you for sharing this - if ever in this position it will give me the guts to do as the NJ Guru would suggest.
best,
kerri
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