Weaning off p4

Weaning off p4

smrc
smrc

April 26th, 2012, 3:21 pm #1

I am currently 7w3d, taking crinone morning and night after an otherwise unmedicated FET.

C.ornell wants to wean me off of the crinone next week (stop completely next Tues and go in for b/w 3 days later) before releasing me to an OB.

I am absolutely terrified about going off the p4 cold turkey and just wondering if I should be pushing C.ornell to take a different/more gradual approach or running to C.ooper for help.

I ovulated the cycle of my FET so would have a corpus lutuem making p4 but the total stopping of crinone is making me so nervous.

Any thoughts would be appreciated!!
SMRC
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Sara H
Sara H

April 26th, 2012, 3:35 pm #2

Go slowly.

Here is why:

It can't hurt if you are on it longer.
If you do it cold turkey and anything at all goes wrong (which it won't!) you will always wonder since you are already wondering now.

Personally, I was on past week 12 and was taken off slowly and STILL stressed about my last day!

What are your levels and think about how you are feeling but I say since it is on your mind and you asked the question so it is stressing you, go slowly. You'll feel better!

Either way I am sure it will be fine!
HUGS and hang in there,
Sara H
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smrc
smrc

April 26th, 2012, 5:25 pm #3

and the approach you took sits MUCH better with me. I wrote to C.ornell to ask if I could do this.

Will hope for the best. Thanks again!
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Mrs. A
Mrs. A

April 26th, 2012, 5:56 pm #4

I am currently 7w3d, taking crinone morning and night after an otherwise unmedicated FET.

C.ornell wants to wean me off of the crinone next week (stop completely next Tues and go in for b/w 3 days later) before releasing me to an OB.

I am absolutely terrified about going off the p4 cold turkey and just wondering if I should be pushing C.ornell to take a different/more gradual approach or running to C.ooper for help.

I ovulated the cycle of my FET so would have a corpus lutuem making p4 but the total stopping of crinone is making me so nervous.

Any thoughts would be appreciated!!
SMRC
I'm terrified with you! Not because there's any concrete reason to be scared (you haven't posted your p4 levels) but because I know what you've been through to get to this point. I would hate to see something like lack of p4 support be a factor should something go wrong.

Do you remember sch1star?? She was corn.nell patient and she convinced them to let her stay on P4 support for longer than they were recommending. Precisely because she didn't want such a "simple" thing be a factor.

This is YOUR pregnancy. Make no apologies for your concerns.

(p.s. - sent you an email last week I think)
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smrc
smrc

April 26th, 2012, 6:10 pm #5

on Tuesday p4 was 58.1 (e2 949 and beta level of 39,366) and my p4 levels have been in the mid-to high 50s so far, with one reading of 44.

Thanks for confirming my instincts! It makes me feel a lot better. I'm also traveling for a good part of the 2 weeks after they want me to stop p4, so this makes me feel even more apprehensive (since I won't be able to get in for b/w very frequently). Another reason to postpone and/or wean off slowly.

And it sounds like I owe you an email - I will write back - I have been in a bit of a scared haze these past few weeks!!
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Joined: January 23rd, 2009, 5:02 pm

April 26th, 2012, 6:33 pm #6

He has much more progressive views on p4 and while your levels seems good now...I would want to be safe then sorry. With progesterone, you level should, theoretically increase through the whole pregnancy. I had to stay on p4 until 30 weeks b/c my levels were running dangerously low. Then all of the sudden, my body figured out what the heck it was supposed to be doing and it sky rocketed on it's own. ...so I'm off P4 support now. I didn't even wean and it kept making big jumps every week.

This is JMO, but I don't mess around any more with P4.

I have the PPVI Institute's chart on what they like to see P4 at during the whole pregnancy. If you'd like me to email it to you, drop me a line at amy daws at hotmail dot com (no spaces). I believe it coincides closely with Coopers methods.



TTC: Since Nov. 2006
Diagnosis: Ovarian Dysfunction & PCOS
28 Years Old
cd3 FSH 16.8
cd10 FSH 13.6
7 Unmonitored Cycles of Clomid
3 Unmonitored Cycles of Letrozole
Positive CCCT
TAB for cysts
1st Cycle of 150iu of Menopur with Timed BDing - 5 mature follies - BFN
TAB for cysts
2nd Cycle of 150iu of Menopur with Timed Intercourse - 4 mature follies in play - BFN
3rd Cycle of 150 iu of Menopur with Timed Intercourse - 2 follies - BFN
1st Cycle of Gonal F - 1 follie & cyst on right - BFN
TAB for a cycle
2nd Cycle of Gonal F = BFP!!!!!
11dpo Beta=27.9
14dpo Beta=120
16dpo Beta=210
18dpo Beta=429
21dpo Beta=1064
5w6d - baby measuring 3mm, h/b 101
6w6d - baby measuring 6mm, h/b 126
7w6d - baby 18mm, h/b 171, measuring ahead at 8w2d! RE noticed enlarged yolk sac so keeping a close eye on that
8w6d - baby 2.52cm with h/b of 174
9w5d - baby 3.22cm with h/b of 180 measuring 10w1d
10w6d - baby 4.34cmcm with h/b of 174 measuring 11w1d
12w u/s showed baby at 11.2cm with h/b of 162 - unfortunately, that evening I suffered a horrible m/c of a chromosomally NORMAL girl.... RIP my angel girl...you were loved....

Gonal F with Timed Intercourse-2WW
First cycle of Gonal F with Timed Intercourse since m/c - BFN
2nd Cycle of Gonal F with Timed Intercourse - BFN
TAB for a month on bcp's
3rd Cycle of Gonal F - BFP
-11dpo beta=14.9
-14dpo beta=45.7
-16dpo beta=140
-18dpo beta=366
u/s at 6w1d showed heart-rate of 114!!!!
u/s at 7w1d showed heart-rate of 141!!!!
u/s at 8w showed heart-rate of 179
u/s at 9w showed 2 SCH's, h/r of 197
u/s at 10w showed h/r of 175
u/s at 11w showed h/r of 180
u/s at 12 w showed h/r of 188
12w2d...m/c'd baby at home, lost too much blood, had to have emergency D&C...severely anemic....baby was a chromosomally normal boy
-developed a blood clot in leg 1 1/2 wks post D&C...saw a hematologist and had testing done and everything came back normal, will still treat me with Lovenex on next pregnancy

-First cycle since m/c....Gonal F, triggered with 8 mature follies, T/I - BFP!
-13dpo beta 106, progesterone 21.4
-15dpo beta 260, progesterone 12.2
-16dpo beta 411, progesterone 16
-20dpo beta 845, progesterone 19 (went in for u/s to rule out ectopic, couldn't see anything yet, but lining was thick)
-22dpo beta 1158, progesterone 18
-24dpo beta 1655, progesterone 20
-5w?? u/s showed 2 sacs...one measuring 4w0d, the other measuring 5w1d....possibly vanishing twin???
-6w u/s showed TWINS! 2 h/r's....121, 119. both measuring 6w1d! SCH 1cm
-At 7w pg, tested positive for lupus anticoagulant, on lovenox to treat it, TSH was 2.55
-7w2d u/s showed 2 babies measuring 7w4d & 7w3d, h/r's 158 & 153! SCH 2cm
-8w1d u/s showed 2 babies measuring 8w3d & 8w2d, h/r's 185 & 179! SCH 3cm
-10w2d u/s showed we lost baby A measuring 9w1d and had no h/r...baby B measured 10w1d with a h/r of 180...praying for Baby B to hang on, SCH gone, started thyroid med
-11w1d u/s showed Baby B measuring right on track, h/r of 174
-12w1d had a red bleeding episode & u/s showed Baby B measuring 1 day ahead and a h/r of 168, bleeding likely caused by Baby A's passing
-13w1d had some red spotting & u/s showed Baby B measuring 2 days behind and h/r of 157
-14w...baby measured 14w3d...and I suffered a horrible, very sudden miscarriage...another angel baby...that makes 4.
Saw Dr Mary Stephenson at U of Chicago for recurrent pregnancy loss....dx with Lupus Anticoagluant and Incompetent Cervix, will be treated with lovenox
5-25-11 - Had a Transabdominal Cerclage placed by Dr Haney at U of Chicago

Gonal F with Timed Intercourse (self medicated/unmonitored) BFN
Gonal F with Timed Intercourse: 7 follies in play - BFP at 10dpo!!!
12dpo hcg level 80.5, progesterone 16.8
14dpo hcg level 295, progesterone 18
6w3d u/s showed 1 baby with a h/r of 120, measuring 6w4d
7w3d u/s showed baby with h/r of 160, measuring 7w3d
7w5d u/s showed a possibility of TWINS! Baby A (the original) measured 8w, h/r 167...Baby B, hiding in the upper uterus measured 6w6d, h/r 176...time will tell if Baby B will make it
8w4d u/s showed Baby A doing well measuring 8w4d and h/r of 185....Baby B measured 7w3d and no h/r detected My 5 angels better help me out through the rest of all this
9w5d u/s showed Baby A measring 9w5d, h/r 188
10w5d u/s showed Baby A measuring good, h/r 175
11w3d u/s shoed Baby A measuring 11w4d, h/r 169
12w6d u/s showed Baby A measuring 13w2d, h/r of 167
13w5d u/s showed Baby A measuring 13w6d, h/r of 156
15w5d u/s showed Baby Girl measuring about a week ahead! h/r 164
17w4d u/s showed Baby Girl with a h/r of 156, cervix measuring 5cm+
19w4d, u/s showed Baby Girl with a h/r of 151, cervix measuring 5cm
23w4d, u/s showed Baby Girl with h/r of 149, cervix measuring 5cm. Baby weighed 1lb 14oz and is in the 80th percentile...her belly in the 97th....talked a little big about GD
27w4d, u/s showed Baby Girl with h/r of 151, cervix measuring 5cm...baby weighed 3lb 4oz, 87th percentile, pass GD test!
29w4d u/s showed Baby Girl with h/r of 148, cervix 5cm
31w4d u/s showed Baby Girl with h/r of 129, cervix 5cm and weight is 5lb 5oz! BIG GIRL!!!
35+ weeks and counting!
TTC: Since Nov. 2006
Diagnosis: Ovarian Dysfunction & PCOS
26 Years Old
cd3 FSH 16.8
cd10 FSH 13.6
7 Unmonitored Cycles of Clomid
3 Unmonitored Cycles of Letrozole
Positive CCCT
TAB for cysts
1st Cycle of 150iu of Menopur with Timed BDing - 5 mature follies - BFN
TAB for cysts
2nd Cycle of 150iu of Menopur with Timed Intercourse - 4 mature follies in play - BFN
3rd Cycle of 150 iu of Menopur with Timed Intercourse - 2 follies - BFN
1st Cycle of Gonal F - 1 follie & cyst on right - BFN
TAB for a cycle
2nd Cycle of Gonal F = BFP!!!!!
11dpo Beta=27.9
14dpo Beta=120
16dpo Beta=210
18dpo Beta=429
21dpo Beta=1064
5w6d - baby measuring 3mm, h/b 101
6w6d - baby measuring 6mm, h/b 126
7w6d - baby 18mm, h/b 171, measuring ahead at 8w2d! RE noticed enlarged yolk sac so keeping a close eye on that
8w6d - baby 2.52cm with h/b of 174
9w5d - baby 3.22cm with h/b of 180 measuring 10w1d
10w6d - baby 4.34cmcm with h/b of 174 measuring 11w1d
12w u/s showed baby at 11.2cm with h/b of 162 - unfortunately, that evening I suffered a horrible m/c of a chromosomally NORMAL girl.... RIP my angel girl...you were loved....

First cycle of Gonal F with Timed Intercourse since m/c - BFN
2nd Cycle of Gonal F with Timed Intercourse - BFN
TAB for a month on bcp's
3rd Cycle of Gonal F - BFP
-11dpo beta=14.9
-14dpo beta=45.7
-16dpo beta=140
-18dpo beta=366
u/s at 6w1d showed heart-rate of 114!!!!
u/s at 7w1d showed heart-rate of 141!!!!
u/s at 8w showed heart-rate of 179
u/s at 9w showed 2 SCH's, h/r of 197
u/s at 10w showed h/r of 175
u/s at 11w showed h/r of 180
u/s at 12 w showed h/r of 188
12w2d...m/c'd baby at home, lost too much blood, had to have emergency D&C...severely anemic....baby was a chromosomally normal boy
-developed a blood clot in leg 1 1/2 wks post D&C...saw a hematologist and had testing done and everything came back normal, will still treat me with Lovenex on next pregnancy
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futurebeauty
futurebeauty

April 26th, 2012, 11:02 pm #7

I am currently 7w3d, taking crinone morning and night after an otherwise unmedicated FET.

C.ornell wants to wean me off of the crinone next week (stop completely next Tues and go in for b/w 3 days later) before releasing me to an OB.

I am absolutely terrified about going off the p4 cold turkey and just wondering if I should be pushing C.ornell to take a different/more gradual approach or running to C.ooper for help.

I ovulated the cycle of my FET so would have a corpus lutuem making p4 but the total stopping of crinone is making me so nervous.

Any thoughts would be appreciated!!
SMRC
I could care less what an RE thinks at this point. This is an expensive baby inside you right now and if you happen to m/c due to low P4 then I can guarantee that your clinic will barely blink an eye and you will have to somehow pick yourself up.

I stayed on all my meds until 12 wks and they pretty much forced me to stop. I kept the crinone going but stopped the prometrium and estrogen and guess what, baby died at 12 wk 6 days after an awesome ultrasound at 12 wk. It could have been the meds or some immune thing that we are still testing for but who knows. Don't risk it.

Good Luck,

FB
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Laura
Laura

April 27th, 2012, 2:44 am #8

I am currently 7w3d, taking crinone morning and night after an otherwise unmedicated FET.

C.ornell wants to wean me off of the crinone next week (stop completely next Tues and go in for b/w 3 days later) before releasing me to an OB.

I am absolutely terrified about going off the p4 cold turkey and just wondering if I should be pushing C.ornell to take a different/more gradual approach or running to C.ooper for help.

I ovulated the cycle of my FET so would have a corpus lutuem making p4 but the total stopping of crinone is making me so nervous.

Any thoughts would be appreciated!!
SMRC
This sometimes takes until 12 weeks. I've read that 8-9 wk is the average time the placenta successfully takes over. I would be very careful about stopping p4 before then. It won't hurt to take it longer. My OB even told me that even if I didn't need it, it would be fine to take it if it made me feel better. Which I did. Even though I m/c'ed those babies, I know I did everything I could to keep them.
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ALM
ALM

April 27th, 2012, 3:51 am #9

I am currently 7w3d, taking crinone morning and night after an otherwise unmedicated FET.

C.ornell wants to wean me off of the crinone next week (stop completely next Tues and go in for b/w 3 days later) before releasing me to an OB.

I am absolutely terrified about going off the p4 cold turkey and just wondering if I should be pushing C.ornell to take a different/more gradual approach or running to C.ooper for help.

I ovulated the cycle of my FET so would have a corpus lutuem making p4 but the total stopping of crinone is making me so nervous.

Any thoughts would be appreciated!!
SMRC
I don't remember, but I think it was at 10 weeks, and then they released me to OB. I was on crinone as well. It was a much more expensive P4, but I pulled out that insane PIO needle the 'night of' me starting shots and couldn't do it. Maybe stay on it for 2 more weeks for sure, then make your decision one week at a time after that.

CONGRATULATIONS!!
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juliemam
juliemam

April 27th, 2012, 1:17 pm #10

I am currently 7w3d, taking crinone morning and night after an otherwise unmedicated FET.

C.ornell wants to wean me off of the crinone next week (stop completely next Tues and go in for b/w 3 days later) before releasing me to an OB.

I am absolutely terrified about going off the p4 cold turkey and just wondering if I should be pushing C.ornell to take a different/more gradual approach or running to C.ooper for help.

I ovulated the cycle of my FET so would have a corpus lutuem making p4 but the total stopping of crinone is making me so nervous.

Any thoughts would be appreciated!!
SMRC
I'd ask them to stay on until the 2nd tri at least. I wonder why they want you off before your placenta kicks in?

I'd ask if there is harm in staying on it longer (I don't think there is but sometimes asking it that way gets the dr explaining and then you can say: so... why can't I stay on it?)

and insist on blood monitoring during the wean to make sure in your head and by fact that yes, your placenta is doing it's job.

--that is why there are so many losses between 8-10wks, the placenta not stepping up as it should.

Go with your gut. If your current Dr doesn't do what it takes to make you feel confident, well, go see another. I've seen that done here on this bb a few times (MrA, didn't YOU do that? I forget now)

good luck and keep us posted.
hugs
jm
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