What do you ladies know about elevated levels of progesterone before ER?

What do you ladies know about elevated levels of progesterone before ER?

Sara Q
Sara Q

September 7th, 2012, 5:13 am #1

Hey folks,

I feel like I'm full of questions this week. Please forgive me if it's getting annoying; I'm even starting to annoy myself. But to day was a good day, I had a positive outlook and got a lot of work done (Margie!)

Does anyone know anything about elevated progesterone levels before IVF trigger and/or ER? I was attempting to do work tonight but am so dam* tired, probably b/c of my sky-high progesterone, so I was doing some internet surfing about it. Didn't find so much about elevated progesterone at this point in the cycle, but I did find a bunch of stuff about elevated progesterone before trigger and ER.

Here are some of the links:

http://humrep.oxfordjournals.org/conten ... 0.abstract

http://jcem.endojournals.org/content/73/4/797.abstract


And links to forums where they are talking about it:

http://www.ivf-infertility.com/phpBB3/v ... 49&start=0

http://forums.fertilitycommunity.com/vi ... ne-er.html


I looked at these because I remember the Coo.per nurses telling me that my P4 had increased the morning before my trigger to 1.14 and then even more the day before ER to 2.2, so I'm assuming it was probably close to 3 at ER. According to these articles, those numbers could significantly reduce implantation potential of seemingly "perfect" embryos.

My old clinic never tested p4 during stimulation or before ER (crazy I know), but apparently one of the signs of premature p4 rise is bleeding through your p4 support before your beta, which I did 2 out of 3 times. Which may provide some sort of explanation for why we implanted 6 seemingly great embryos during those cycles and none took. Maybe it's something more than egg quality and immunology issues? Is that even conceivable?

Has anyone talked to an RE about this issue? What do you know about it?

I know it probably seems like I am driving myself borderline crazy, but I am having a callback with Check in a couple of days (before my beta) and I want to ask good questions so that I may better understand what the heck happened this cycle. I really wish he had been able to weigh in on what was happening, when it was happening. And I just can't shake this feeling that there is something other than poor egg quality going on here...5 8-cells of a 33 year old with no fragmentation transferred and nothing, ever?

If this cycle does not work, we will try one more, but that is it - DH and I talked about it last night. I'm going to be 35 next May, which means that we will have been at this for nearly 4 years. After that it's adoption and DE.

But if we're going to do one more, then I want to shake down every possible lead to solve this riddle.

Any thoughts?

Thanks,
S




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Anonymous
Anonymous

September 7th, 2012, 6:23 pm #2

those are expected P4 levels as you are heading into ovulation. The concern would relate more so if you are having the rise far sooner in your follicular phase but I think you stimmed for a good 10-13 days, right?

The first 2 studies may be relevant but they are a little dated (1991 and 1995). A piece of info missing from the study summaries is the amount of stim and antagonist/agonist drugs used and when they were introduced.

More background can be found here
http://humrep.oxfordjournals.org/content/26/2/498.full
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Sara Q
Sara Q

September 7th, 2012, 6:28 pm #3

I will take a look at the article you attached, thanks!
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b&a72
b&a72

September 7th, 2012, 7:56 pm #4

Hey folks,

I feel like I'm full of questions this week. Please forgive me if it's getting annoying; I'm even starting to annoy myself. But to day was a good day, I had a positive outlook and got a lot of work done (Margie!)

Does anyone know anything about elevated progesterone levels before IVF trigger and/or ER? I was attempting to do work tonight but am so dam* tired, probably b/c of my sky-high progesterone, so I was doing some internet surfing about it. Didn't find so much about elevated progesterone at this point in the cycle, but I did find a bunch of stuff about elevated progesterone before trigger and ER.

Here are some of the links:

http://humrep.oxfordjournals.org/conten ... 0.abstract

http://jcem.endojournals.org/content/73/4/797.abstract


And links to forums where they are talking about it:

http://www.ivf-infertility.com/phpBB3/v ... 49&start=0

http://forums.fertilitycommunity.com/vi ... ne-er.html


I looked at these because I remember the Coo.per nurses telling me that my P4 had increased the morning before my trigger to 1.14 and then even more the day before ER to 2.2, so I'm assuming it was probably close to 3 at ER. According to these articles, those numbers could significantly reduce implantation potential of seemingly "perfect" embryos.

My old clinic never tested p4 during stimulation or before ER (crazy I know), but apparently one of the signs of premature p4 rise is bleeding through your p4 support before your beta, which I did 2 out of 3 times. Which may provide some sort of explanation for why we implanted 6 seemingly great embryos during those cycles and none took. Maybe it's something more than egg quality and immunology issues? Is that even conceivable?

Has anyone talked to an RE about this issue? What do you know about it?

I know it probably seems like I am driving myself borderline crazy, but I am having a callback with Check in a couple of days (before my beta) and I want to ask good questions so that I may better understand what the heck happened this cycle. I really wish he had been able to weigh in on what was happening, when it was happening. And I just can't shake this feeling that there is something other than poor egg quality going on here...5 8-cells of a 33 year old with no fragmentation transferred and nothing, ever?

If this cycle does not work, we will try one more, but that is it - DH and I talked about it last night. I'm going to be 35 next May, which means that we will have been at this for nearly 4 years. After that it's adoption and DE.

But if we're going to do one more, then I want to shake down every possible lead to solve this riddle.

Any thoughts?

Thanks,
S



I agree with the above person on the articles being dated and the details left out. Progesterone begins to spike after ovaulation which is why temps go up during the second part of the cycle so essentially your body is doing what it was supposed to. My last cycle with Cooper I was on twice the dose of progesterone then in my previous 3 cycles and that is the one that worked for me. Aneuploidy or incompetent embryos are going to be genetically determined upon ovulation when they split the chromosomes and prog. support is not going to effect that process or cause bad eggs( At least that is the consensus of most RE's) These studies are contridicting, once the eggs are removed the granulosa lutein cells that produce progesterone are removed with them which in a natural cycle stay after ovulation but the flushing process of retrieval washes them out. So in short no granulosa cells no progesterone which = no pregnancy this is why you have to take it until the placenta takes over. I did a total of 4 cycles and transfered a total of 8 embryos 6 of those being blastocysts and one being CGH tested normal all at the ripe old age of 27, so in your case I think it is a matter of finding the "golden egg" if you will, the question is how many times are you willing to do IVF with OE to get there.
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Joined: September 8th, 2012, 12:08 am

September 8th, 2012, 2:31 pm #5

Hey folks,

I feel like I'm full of questions this week. Please forgive me if it's getting annoying; I'm even starting to annoy myself. But to day was a good day, I had a positive outlook and got a lot of work done (Margie!)

Does anyone know anything about elevated progesterone levels before IVF trigger and/or ER? I was attempting to do work tonight but am so dam* tired, probably b/c of my sky-high progesterone, so I was doing some internet surfing about it. Didn't find so much about elevated progesterone at this point in the cycle, but I did find a bunch of stuff about elevated progesterone before trigger and ER.

Here are some of the links:

http://humrep.oxfordjournals.org/conten ... 0.abstract

http://jcem.endojournals.org/content/73/4/797.abstract


And links to forums where they are talking about it:

http://www.ivf-infertility.com/phpBB3/v ... 49&start=0

http://forums.fertilitycommunity.com/vi ... ne-er.html


I looked at these because I remember the Coo.per nurses telling me that my P4 had increased the morning before my trigger to 1.14 and then even more the day before ER to 2.2, so I'm assuming it was probably close to 3 at ER. According to these articles, those numbers could significantly reduce implantation potential of seemingly "perfect" embryos.

My old clinic never tested p4 during stimulation or before ER (crazy I know), but apparently one of the signs of premature p4 rise is bleeding through your p4 support before your beta, which I did 2 out of 3 times. Which may provide some sort of explanation for why we implanted 6 seemingly great embryos during those cycles and none took. Maybe it's something more than egg quality and immunology issues? Is that even conceivable?

Has anyone talked to an RE about this issue? What do you know about it?

I know it probably seems like I am driving myself borderline crazy, but I am having a callback with Check in a couple of days (before my beta) and I want to ask good questions so that I may better understand what the heck happened this cycle. I really wish he had been able to weigh in on what was happening, when it was happening. And I just can't shake this feeling that there is something other than poor egg quality going on here...5 8-cells of a 33 year old with no fragmentation transferred and nothing, ever?

If this cycle does not work, we will try one more, but that is it - DH and I talked about it last night. I'm going to be 35 next May, which means that we will have been at this for nearly 4 years. After that it's adoption and DE.

But if we're going to do one more, then I want to shake down every possible lead to solve this riddle.

Any thoughts?

Thanks,
S



I have read somewhere that Dhea could increase progesterone levels before egg retrieval but has no effect on implantation in that study. Have you been taking Dhea? Good luck and please let us know what happens.
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Sara Q
Sara Q

September 10th, 2012, 2:04 am #6

I agree with the above person on the articles being dated and the details left out. Progesterone begins to spike after ovaulation which is why temps go up during the second part of the cycle so essentially your body is doing what it was supposed to. My last cycle with Cooper I was on twice the dose of progesterone then in my previous 3 cycles and that is the one that worked for me. Aneuploidy or incompetent embryos are going to be genetically determined upon ovulation when they split the chromosomes and prog. support is not going to effect that process or cause bad eggs( At least that is the consensus of most RE's) These studies are contridicting, once the eggs are removed the granulosa lutein cells that produce progesterone are removed with them which in a natural cycle stay after ovulation but the flushing process of retrieval washes them out. So in short no granulosa cells no progesterone which = no pregnancy this is why you have to take it until the placenta takes over. I did a total of 4 cycles and transfered a total of 8 embryos 6 of those being blastocysts and one being CGH tested normal all at the ripe old age of 27, so in your case I think it is a matter of finding the "golden egg" if you will, the question is how many times are you willing to do IVF with OE to get there.
Thanks so much for your reply. Sorry it's taken me awhile to reply to it - I decided to take a couple of days "off-line," to try and get my mind of the IVF. We went to a friend's commitment ceremony, hung out with my MIL, etc.

Like I said above in my subject heading, I obviously didn't read those 2 articles too carefully.... I have since then though and I agree with your post. The articles are dated for sure, and there are definitely details left out. The ariticles originally did catch my eye b/c one of the Cooper nurses seemed concerned about my P4 levels BEFORE ER, not at all after. But like a lot of stuff IF-related, I don't think there's any real consensus as to what the consequences of that could be. The only consequences of sky-high progesterone after ER seem to be me not fitting into any of my clothes and taking 3 hour naps.

I think I was just trying to prepare myself for the worst, you know? It's hard to get your hopes up over and over just to be disappointed. It's weird though, because for most of my life (and still in most areas of my life) I'm just naturally an optimist. But I think I've got some pretty deep scars from IF, and I my default is to think, "nothing is ever going to work." I really, really want it to work and obviously I still have a bit of hope otherwise I wouldn't keep trying, but it's hard to acknowledge that feeling without being devastated. I think it is a matter of finding my "golden egg," and I honestly don't know how many times we're willing to do IVF to get there. And it's not really the logistical strain or even the financial strain that's most troublesome in the "golden egg search." Obviously, it's the emotional wreckage the process causes that scares me. Since it had been almost a year since my last IVF, I'd forgot how difficult the process really was.

Thanks again, b&a

Best,
Sara Q
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Sara Q
Sara Q

September 10th, 2012, 2:09 am #7

I have read somewhere that Dhea could increase progesterone levels before egg retrieval but has no effect on implantation in that study. Have you been taking Dhea? Good luck and please let us know what happens.
I didn't know that! But I don't take DHEA at all - I did though off and on for almost a year in 2011. I don't really think it did anything for me though, besides raising my testosterone levels, which are already on the high side. Hmmm, I wonder if higher testosterone (naturally) has any effect on p4 levels before ER. Interesting....

Thanks for replying.

How are you doing???

-S
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b&a72
b&a72

September 10th, 2012, 3:46 pm #8

Thanks so much for your reply. Sorry it's taken me awhile to reply to it - I decided to take a couple of days "off-line," to try and get my mind of the IVF. We went to a friend's commitment ceremony, hung out with my MIL, etc.

Like I said above in my subject heading, I obviously didn't read those 2 articles too carefully.... I have since then though and I agree with your post. The articles are dated for sure, and there are definitely details left out. The ariticles originally did catch my eye b/c one of the Cooper nurses seemed concerned about my P4 levels BEFORE ER, not at all after. But like a lot of stuff IF-related, I don't think there's any real consensus as to what the consequences of that could be. The only consequences of sky-high progesterone after ER seem to be me not fitting into any of my clothes and taking 3 hour naps.

I think I was just trying to prepare myself for the worst, you know? It's hard to get your hopes up over and over just to be disappointed. It's weird though, because for most of my life (and still in most areas of my life) I'm just naturally an optimist. But I think I've got some pretty deep scars from IF, and I my default is to think, "nothing is ever going to work." I really, really want it to work and obviously I still have a bit of hope otherwise I wouldn't keep trying, but it's hard to acknowledge that feeling without being devastated. I think it is a matter of finding my "golden egg," and I honestly don't know how many times we're willing to do IVF to get there. And it's not really the logistical strain or even the financial strain that's most troublesome in the "golden egg search." Obviously, it's the emotional wreckage the process causes that scares me. Since it had been almost a year since my last IVF, I'd forgot how difficult the process really was.

Thanks again, b&a

Best,
Sara Q
I had the same feelings and for us it was not the money or logistics either because we would have gone to the moon and back. After the 3rd failure I was ready to give up but the hubby pushed for one more cycle we even got in a huge fight because of it, I was physically and mentally burned out and man am I glad I did. I had the same problem read study after study but at the end of the day everybody is different and does not fall into "the study statistics". All is not lost yet you could have one of those little embies snuggling in right now, like my hubby always said was we need to plan for the worst but hope for the best. You will have success one way or the other, there are other women on here that have had much worse stats and now have 1 or more kids, I know that is not very comforting at this time but it is just something I kept saying to myself.
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Joined: September 8th, 2012, 12:08 am

September 11th, 2012, 12:12 am #9

I didn't know that! But I don't take DHEA at all - I did though off and on for almost a year in 2011. I don't really think it did anything for me though, besides raising my testosterone levels, which are already on the high side. Hmmm, I wonder if higher testosterone (naturally) has any effect on p4 levels before ER. Interesting....

Thanks for replying.

How are you doing???

-S
I am stating my stim meds tonight and very anxious since this is my 6th ivf. It is starting to get harder to be positive. I do hope you have success sometimes even the doctors don't know the relevance of the some of the blood work that is done so try not to worry too much. Good luck.
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