Your thoughts (progesterone support)

Your thoughts (progesterone support)

E&H
E&H

October 22nd, 2010, 1:16 am #1

I have a patient come from Australia who is taking pessaries of progesterone. Here we are giving 400 mg 3 x per day. I have known Aussie ladies before to miscarry so often due to not having enough progesterone support. Despite advice here this lady is only going to take 200 mg twice a day. I seriously know it just isn't enough for DE IVF. What are your thoughts? I often wonder if this is the reason so many people in Australia have miscarriage after miscarriage - it actually really annoys me. Previous patients coming here have had upto 8 miscarriages and I'm absolutely sure its because of lack of progesterone support. Anyway, I can't convince this woman to take more but I do know that it will not end well - Very sad!!!!
Quote
Share

Joined: August 30th, 2009, 6:49 pm

October 22nd, 2010, 2:35 am #2

Unfortunately, it seems her belief system is stronger than your knowledge. This is very unfortunate. I have been educated that more progeterone is not harmful so why not err on the safe side just in case.

You did your best and I can only hope her situation is positive.

Jenna
Last edited by jennatebo on October 22nd, 2010, 2:36 am, edited 1 time in total.
Quote
Like
Share

Anonymous
Anonymous

October 22nd, 2010, 1:30 pm #3

I have a patient come from Australia who is taking pessaries of progesterone. Here we are giving 400 mg 3 x per day. I have known Aussie ladies before to miscarry so often due to not having enough progesterone support. Despite advice here this lady is only going to take 200 mg twice a day. I seriously know it just isn't enough for DE IVF. What are your thoughts? I often wonder if this is the reason so many people in Australia have miscarriage after miscarriage - it actually really annoys me. Previous patients coming here have had upto 8 miscarriages and I'm absolutely sure its because of lack of progesterone support. Anyway, I can't convince this woman to take more but I do know that it will not end well - Very sad!!!!
I just do PIO and the RE has me on 2cc in the evening through the 2ww. No suppositories. Does this sound sufficient? Thanks.
Quote
Share

Joined: December 9th, 2008, 6:13 pm

October 22nd, 2010, 1:32 pm #4

I have a patient come from Australia who is taking pessaries of progesterone. Here we are giving 400 mg 3 x per day. I have known Aussie ladies before to miscarry so often due to not having enough progesterone support. Despite advice here this lady is only going to take 200 mg twice a day. I seriously know it just isn't enough for DE IVF. What are your thoughts? I often wonder if this is the reason so many people in Australia have miscarriage after miscarriage - it actually really annoys me. Previous patients coming here have had upto 8 miscarriages and I'm absolutely sure its because of lack of progesterone support. Anyway, I can't convince this woman to take more but I do know that it will not end well - Very sad!!!!
You said 400 mg 3x daily right? Do you know what the best is for injections? My clinic has me on only 1cc, which seems low to me. We've actually been doing 1.3 - 1.5 cc pio instead. But I was just wondering what your thoughts were on this... I'm a little ocncerned as if we get to u/s w/ h/b they will make us switch to suppositories and they only want 200 mg daily...?! Thoughts please!

ks
Quote
Like
Share

Joined: January 14th, 2010, 1:16 pm

October 22nd, 2010, 3:42 pm #5

I have a patient come from Australia who is taking pessaries of progesterone. Here we are giving 400 mg 3 x per day. I have known Aussie ladies before to miscarry so often due to not having enough progesterone support. Despite advice here this lady is only going to take 200 mg twice a day. I seriously know it just isn't enough for DE IVF. What are your thoughts? I often wonder if this is the reason so many people in Australia have miscarriage after miscarriage - it actually really annoys me. Previous patients coming here have had upto 8 miscarriages and I'm absolutely sure its because of lack of progesterone support. Anyway, I can't convince this woman to take more but I do know that it will not end well - Very sad!!!!
Interesting question. When I did my fresh donor cycle, my RE had me on prometrium 200mg 3x's day (along with 2mg estrace 2x's daily). With my FET's my RE does a low stim cycle (I took 150mg Gonal F daily until I had follicle(s) ready to trigger) so that your body will be making some estrogen/progesterone on its own but he still has me on prometrium 200mg 2x's daily as well as 2mg estrace vaginally.
As a pp said, you can lead a horse to water.....
Quote
Like
Share

Joined: August 17th, 2005, 11:44 pm

October 22nd, 2010, 7:07 pm #6

I have a patient come from Australia who is taking pessaries of progesterone. Here we are giving 400 mg 3 x per day. I have known Aussie ladies before to miscarry so often due to not having enough progesterone support. Despite advice here this lady is only going to take 200 mg twice a day. I seriously know it just isn't enough for DE IVF. What are your thoughts? I often wonder if this is the reason so many people in Australia have miscarriage after miscarriage - it actually really annoys me. Previous patients coming here have had upto 8 miscarriages and I'm absolutely sure its because of lack of progesterone support. Anyway, I can't convince this woman to take more but I do know that it will not end well - Very sad!!!!
do what it takes. Let her know the risk of loss. I have been to several clinics and they felt you could not get too much, the risk was in too little. My progesterone level was also carefully monitored every step of the way, including BW 3dpt, along with an US to see if the lining had converted (if not, P4 was increased). I have done 7 cycles and my final cycle consisted of 2.5cc's of PIO, and 200mg Prometrium 2x/day. I did the suppositories the first two cycles, but got severe irritation. The clinics I worked with believed that PIO was the gold standard and accurately measured in the blood. The vaginal progesterone was just a back up.

Give her a link to this website.
Quote
Like
Share

Joined: October 9th, 2008, 2:53 am

October 22nd, 2010, 11:12 pm #7

I have a patient come from Australia who is taking pessaries of progesterone. Here we are giving 400 mg 3 x per day. I have known Aussie ladies before to miscarry so often due to not having enough progesterone support. Despite advice here this lady is only going to take 200 mg twice a day. I seriously know it just isn't enough for DE IVF. What are your thoughts? I often wonder if this is the reason so many people in Australia have miscarriage after miscarriage - it actually really annoys me. Previous patients coming here have had upto 8 miscarriages and I'm absolutely sure its because of lack of progesterone support. Anyway, I can't convince this woman to take more but I do know that it will not end well - Very sad!!!!
Hi E&H,
Tell her about me. I never got proper progesterone support until I went with you then bam pg first cycle with you.
Tell her you cannot be held responsible for her non compliance. Why isn't she taking the 400mgs? I just can't understand why someone would go to so much trouble with a cycle and then not comply.
I hope it ends well.
Maybe tell her the added progesterone is the reason for your high success rate.
good luck, TH.
Quote
Like
Share

Joined: October 9th, 2008, 2:53 am

October 22nd, 2010, 11:14 pm #8

Unfortunately, it seems her belief system is stronger than your knowledge. This is very unfortunate. I have been educated that more progeterone is not harmful so why not err on the safe side just in case.

You did your best and I can only hope her situation is positive.

Jenna
My RE here said 'you can't have enough progesterone. It will not hurt you to have more so take it'. These are his exact words. TH.
Quote
Like
Share

Joined: October 9th, 2008, 2:53 am

October 22nd, 2010, 11:20 pm #9

You said 400 mg 3x daily right? Do you know what the best is for injections? My clinic has me on only 1cc, which seems low to me. We've actually been doing 1.3 - 1.5 cc pio instead. But I was just wondering what your thoughts were on this... I'm a little ocncerned as if we get to u/s w/ h/b they will make us switch to suppositories and they only want 200 mg daily...?! Thoughts please!

ks
Hi KS,
from my weakened memory state... the pessaries come in different strengths I think e.g. 200mgs and 400 mgs.
I did a cycle at E&H's clinic and took the 400mg pessaries firstly four times a day then three times a day.
I had two episodes of bleeding so both E&H and my RE here said to increase the 400mg pessaries to four times a day again which I did and the bleeding ceased.
I have PCOS which apparently means I need extra progesterone support. My OB and RE here said it wouldn't hurt to increase the progesterone. My OB is also a RE at a fertility clinic here and that inconjunction with E&H's high success rate and always excellent advice meant I took more progesterone.
I am 29 weeks and two days today.
Before I left for Kuala Lumpur my sister told me 'do whatever E&H says to do as she has a high success rate' - so I did and here I am
best wishes, TH.
Quote
Like
Share