Suggestions for P4/E2 monitoring?

Suggestions for P4/E2 monitoring?

Erin
Erin

May 22nd, 2012, 3:07 pm #1

So, I found out that C.ornell wants to start tapering my P4 at 7wks (and I'm going a bit rogue already with continuing my E2 that they don't seem to think is necessary after implantation). I am not comfortable with this. My E2 makes me nervous- it's been between 175 and 265 on a Climar.a patch. P4 has been between 42 and 62, but I'm on 1cc PIO + 100mg Endometrin 2x/day.

Does anyone have any advice on how to continue E2 and P4 support and get monitored for it? I have extra PIO, Endometrin and Climara available, so I can just keep using it on my own and hope for the best, but that makes me nervous too. I'm in MA but don't have an OB yet, but I doubt any of them will know much about this. Has anyone dealt with this? If it wasn't too expensive I'd be willing to pay a third party to keep up the monitoring and refills. Thanks in advance!
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smrc
smrc

May 22nd, 2012, 3:16 pm #2

I was in the exact same boat at C.ornell a few weeks ago - C.ornell likes to release you at 8 weeks, which I think is the reason for the tapering at week 7.

I was extremely nervous and stayed on my p4 and went back to C.ooper for pg monitoring. C.ooper has been weaning me off my p4 slowly (I am almost at week 12 and have cut my p4 dose in half at this point).

When I pushed back a bit with C.ornell about coming off p4 cold turkey so early, they did say I could just stay on until I saw my OB and have my OB wean me. (My OB herself wanted me to stop the p4.)

You could have your OB run frequent p4/e2 tests, if you have no other monitoring options, although you may have to push your OB a bit to do this.

I know how nerve-wrecking this all can be!

SMRC

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anonymous
anonymous

May 22nd, 2012, 3:25 pm #3

So, I found out that C.ornell wants to start tapering my P4 at 7wks (and I'm going a bit rogue already with continuing my E2 that they don't seem to think is necessary after implantation). I am not comfortable with this. My E2 makes me nervous- it's been between 175 and 265 on a Climar.a patch. P4 has been between 42 and 62, but I'm on 1cc PIO + 100mg Endometrin 2x/day.

Does anyone have any advice on how to continue E2 and P4 support and get monitored for it? I have extra PIO, Endometrin and Climara available, so I can just keep using it on my own and hope for the best, but that makes me nervous too. I'm in MA but don't have an OB yet, but I doubt any of them will know much about this. Has anyone dealt with this? If it wasn't too expensive I'd be willing to pay a third party to keep up the monitoring and refills. Thanks in advance!
but please continue with E2 support. Your P4 is looking good. But E2 is usually higher at this point. Can everything turn out fine with the levels you have? SURE! But please do wait a bit longer until your placenta has taken over before doing anything with the E2.
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Erin
Erin

May 22nd, 2012, 3:33 pm #4

I was in the exact same boat at C.ornell a few weeks ago - C.ornell likes to release you at 8 weeks, which I think is the reason for the tapering at week 7.

I was extremely nervous and stayed on my p4 and went back to C.ooper for pg monitoring. C.ooper has been weaning me off my p4 slowly (I am almost at week 12 and have cut my p4 dose in half at this point).

When I pushed back a bit with C.ornell about coming off p4 cold turkey so early, they did say I could just stay on until I saw my OB and have my OB wean me. (My OB herself wanted me to stop the p4.)

You could have your OB run frequent p4/e2 tests, if you have no other monitoring options, although you may have to push your OB a bit to do this.

I know how nerve-wrecking this all can be!

SMRC
Thanks so much SMRC! I'm sorry but I can't remember- did you use C.ornell for this cycle? I did consult with Coop.er and have been thinking about calling them to ask them to monitor me from here, but I feel awkward asking since I ending up going to C.ornell instead for my cycle. I also worry about using an OB since they tend to be a bit conservative in MA and I fear I won't be able to find one that will know what they're doing. Thanks so much- it totally is VERY nerve-wrecking!
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Erin
Erin

May 22nd, 2012, 3:37 pm #5

but please continue with E2 support. Your P4 is looking good. But E2 is usually higher at this point. Can everything turn out fine with the levels you have? SURE! But please do wait a bit longer until your placenta has taken over before doing anything with the E2.
I will not stop the E2 support. I do seem to be a low estrogen person- my E2 I think barely got to 600 on my last 2 cycles, with 4 and 3 mature eggs and about a 10mm lining on each cycle. So it seems maybe my body does more with less estrogen, but I am in no way willing to risk it, and I wish it were higher. One way or another I plan to keep up the E2, but would like someone to follow it. Thanks so much for your input!
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same anon again
same anon again

May 22nd, 2012, 4:18 pm #6

Thanks so much SMRC! I'm sorry but I can't remember- did you use C.ornell for this cycle? I did consult with Coop.er and have been thinking about calling them to ask them to monitor me from here, but I feel awkward asking since I ending up going to C.ornell instead for my cycle. I also worry about using an OB since they tend to be a bit conservative in MA and I fear I won't be able to find one that will know what they're doing. Thanks so much- it totally is VERY nerve-wrecking!
maybe do a spearate post. Meg is one, Holleigh, karma, newbie, maybe kristen?? Oh and of course JulesM (she's a nurse herself too!). And PhoebeMass. maybe they happen to be near you and can make good recommendations for an OB sensitive to IF.
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smrc
smrc

May 22nd, 2012, 4:29 pm #7

Thanks so much SMRC! I'm sorry but I can't remember- did you use C.ornell for this cycle? I did consult with Coop.er and have been thinking about calling them to ask them to monitor me from here, but I feel awkward asking since I ending up going to C.ornell instead for my cycle. I also worry about using an OB since they tend to be a bit conservative in MA and I fear I won't be able to find one that will know what they're doing. Thanks so much- it totally is VERY nerve-wrecking!
C.ornell for my successful cycle but had been with C.ooper previously. C.ooper was willing to take me back and pg monitoring with them has not been too costly so far - and preserved my sanity (which is priceless!).

My OB has actually been helpful too, and I think she would have done the monitoring/weaning if I had asked, although I don't think all OBs are as sensitive to p4/e2 requirements.

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jkl
jkl

May 22nd, 2012, 4:50 pm #8

So, I found out that C.ornell wants to start tapering my P4 at 7wks (and I'm going a bit rogue already with continuing my E2 that they don't seem to think is necessary after implantation). I am not comfortable with this. My E2 makes me nervous- it's been between 175 and 265 on a Climar.a patch. P4 has been between 42 and 62, but I'm on 1cc PIO + 100mg Endometrin 2x/day.

Does anyone have any advice on how to continue E2 and P4 support and get monitored for it? I have extra PIO, Endometrin and Climara available, so I can just keep using it on my own and hope for the best, but that makes me nervous too. I'm in MA but don't have an OB yet, but I doubt any of them will know much about this. Has anyone dealt with this? If it wasn't too expensive I'd be willing to pay a third party to keep up the monitoring and refills. Thanks in advance!
You could just keep taking it and not do the monitoring. If your levels have been good on the dosages you have been taking then I wouldn't worry too much. Or aren't there those independent labs (labcore or something?)

I'm not sure what E2 levels are supposed to be in pregnancy, i don't think docs know much about that.

Glad things are going well, are you having an u/s soon?

jkl
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Erin
Erin

May 22nd, 2012, 4:57 pm #9

C.ornell for my successful cycle but had been with C.ooper previously. C.ooper was willing to take me back and pg monitoring with them has not been too costly so far - and preserved my sanity (which is priceless!).

My OB has actually been helpful too, and I think she would have done the monitoring/weaning if I had asked, although I don't think all OBs are as sensitive to p4/e2 requirements.
I will give Coo.per a call and see if they are will to do OOT pg monitoring for a fee. I think I'd also feel much better having them watch over this, since everyone else I've talked to seems to say that E2 doesn't matter. I guess the worst they can do is say no.

I forgot to say earlier- congratulations on being 12wks! That is wonderful! Hope you're doing well and thank you so much again.
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Erin
Erin

May 22nd, 2012, 5:07 pm #10

You could just keep taking it and not do the monitoring. If your levels have been good on the dosages you have been taking then I wouldn't worry too much. Or aren't there those independent labs (labcore or something?)

I'm not sure what E2 levels are supposed to be in pregnancy, i don't think docs know much about that.

Glad things are going well, are you having an u/s soon?

jkl
One month's worth of PIO at 1cc/day, 2 refills of 42 Endometrin supps (though need to start using the first refill tomorrow), 3 more Climara patches + 1 refill of 4 of them (changing about every 5 days b/c the E2 of 175 was after almost a week on the patch) and 30 tabs of estrace. I agree that most docs don't seem to know much about E2 in pg or think it's an issue, but reading this board has made me think it does. Ugh.

I am currently 5wks and 3 days and actually had my 1st u/s yesterday! I have one little bean with a gestational and yolk sac growing in the right place measuring 5wks 1 day (of course being 1 day behind made me nervous, but I was told it was within the margin of error...). So I guess things are going well. I don't have tons of symptoms, which also makes me nervous (are you detecting a theme? ). In any case, thanks for asking! Next u/s looking for a HB is 5/31. Hope you're doing well!
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