ERA EMMA ALICE testing thread 8

[Gardenlady543]

@2021ivfagain @kerrym87 @Janefx40 @seven201 @thislittlebird @Spin101 @Enfys23
@CailinInUK @BewilderedBee @Loz2467 @Lori2022 @VenusStarr @clhiu @Faithhopelove83 @APSR @ChickenT2b @Mina209 @IVF22 @Lizzybeth1988 @AM08 @Fluffykins33 @Sar1010

Continued in from thread 7 :)

@Loz2467 if you are concerned then I think the doctor needs to speak with you about the result and how it might affect implantation

@2021ivfagain yes I used balance activ and probiotics after the antibiotic treatment. I didn't get side effects with vaginal clindamycin.

Thanks for setting it up @Gardenlady543

@Gardenlady543 Thank you and thanks for setting up the thread. Time is going so fast. I can’t believe we’re on thread 8!

Thanks for adding me @Gardenlady543

I hope everyone is doing well and that cycles are running as smoothly as they can.

Thanks for setting up the new thread @Gardenlady543

Started progesterone and had a freak out about it. Last time I took pio every other day and lubion twice on the the day inbetween plus cyclogest 400mg twice a day and also I had the corpus luteum. Progesteone was 145 and 136 on that, taken first thing in the morning before the dose.

This time I have changed to pio daily (no lubion) and also have the corpus luteum, I am supposed to do cyclogest twice a day but my specialist had said they were worried it would be too much, Dr Gorgy said he is happy if my level is over 80. I am thinking maybe I should just do 1x cyclogest and 1 x pio a day, does this sound like a good idea. I will have the level checked on transfer day and can increase up if needed.

Hi @Gardenlady543 what is pio? I wish I could advise, I keep freaking out and worrying myself that they've put me on too much progesterone supplementation and that's prevented implantation rather than helping it since it happens well naturally. If it's any help on transfer day they tested my progesterone and it was 178 and told me they were really happy and to continue with the same dosage (2 x400 Cyclogest + 2 25mg Lubion injections daily). I asked again on that call whether it was definitely good for implantation to have progesterone that high and growing and the nurse said yes and dismissed me.
With my last natural pregnancy I was on 2x 400mg Cyclogest daily from 1DPO (no Lubion) and implantation happened succesfully so perhaps I'm reading too much into it.

How is everyone else doing? I'm having a really tough time with the 2ww, tougher than i even thought to be honest and it's just 5DPT. Today I'm feeling extremely negative about it all and have decided things definitely have not worked, a feeling exacerbated by the fact that for the 2 days prior I had quite a lot of nausea as well as swollen tender breasts, all 3 symptoms I had very early on with my previous pregnancies, yet I know they can all simply be side effects of the progesterone. Today the nausea has gone completely, at least so far, breasts still feel quite swollen, but less tender. I knew it was the progesterone and tried to tell myself that all day yesterday, but it's hard not to hope for the best and let yourself be lead on.
I think I need a bit of a reality check, could please anybody on this chat that's been on progesterone supplementation experienced nausea during the TWW and ended up with a BFN?

Thank you xx

@clhiu so my last cycle I was on pretty much the same dosage as you, I alternated between 2 lubion on 1 day and pio the day inbetween. Pio is Progesteone in oil, it's a intramuscular injection that seems to have the biggest impact on improving blood levels, I also have the corpus luteum.

In my last cycle I was getting a lot of physical symptoms which seemed to be related to the Progesteone and so I'm keen to cut down a bit. I think the pio I'm taking daily with one cyclogest should hopefully be enough for me to get a good level but not so high that I feel unwell. It's so hard to know what to do, but I can always increase up on transfer day if needed, whereas reducing down is not really something I could do.

I think the hormones can cause a lot of symptoms so it's really difficult to attribute anything. I've seen so many people with zero symptoms convinced it hasn't worked and end up pregnant.

@clhiu I’ve had nausea on BFN and chemical cycles. Not much, a tiny bit on the BFNs, a bit more on the chemical but not tons.

Thank you both.

How has your situation progressed @thislittlebird?

@clhiu negative test. Started bleeding more heavily at work yesterday so I knew I was out but did a test anyway just in case and it was obviously white. I feel angry, I was sure that embryo tried to implant and my body had an immune reaction and fought it off but they told me I couldn’t take prednisolone. Feels like I’ve thrown a 5AA embryo down the drain.

@thislittlebird I am really sorry about the outcome you have, it's so so frustrating, especially from a 5AA embryo and if you feel like your immune issues were overlooked. Hopefully they will take that into account for your next transfer. I hope you get some euploids from your PGT-A tests.

@Gardenlady543 and@clhiu
From my personal experience, when I was pregnant my progesterone on transfer day was 155. They were really pleased. I even carried on taking progesterone passed 20 weeks as I had to wean off gradually. It is better for progesterone to be higher than oestrogen. If oestrogen is too high, it can impede implantation. Honestly, my progesterone stayed high and my toddler is now nearly 2.5 years old.

@thislittlebird I’m really sorry. It might not seem like it now, but it’s good you have more blastocysts. I’m keeping my fingers crossed for you.

@2021ivfagain @clhiu thanks. I’m not in a good way today, really wish we had the PGT-A results back already because I just feel in limbo right now. If we need another cycle we’ll need to save up for a few months, and we probably will need one. I don’t know if I want to do another retrieval but it feels like we probably should since the second cycle was a waste of time.

I had really high progesterone on transfer day (611 or something like that) but I’m convinced it’s not staying high despite being on meds. I start spotting and then bleeding between 6 and 8 days past transfer, I wish I’d booked a test for one of these days but it’s too late now. I’ve got a history of low progesterone.

@Gardenlady543 When you took the vaginal clindamycin, was your vaginal ph already high? My symptoms have been better, but on norethisterone and I thought I would just use canesflor twice a day and not feeling so good. I’m concerned about taking vaginal clindamycin whilst I’m taking norethisterone which raises ph anyway. Did you have to work hard to lower ph again after completing clindamycin?

With regards to progesterone, your levels will be good anyway as you are younger and have naturally high levels. I would ask your clinic or the specialist to run through your plan. At my clinic, 100 or more is optimal for progesterone, but 80 is still a good level.

@Gardenlady543 thank you for adding me. I think PIO daily and 2 x cyclogest makes perfect sense. My understanding is that taking different forms of progesterone together has a better effect. I think cyclogest lasts for 12 hours so best to take one pessary twice a day.

Not sure about your specialist but I'm not sure there is such a thing as too much progesterone. It can be annoying for you to have to keep taking it but as far as I know there is no negative impact on the embryo from having high progesterone. @clhiu that is a response to your post too!

@clhiu sorry you are feeling crap. There really is no way to know. I really thought I knew it all. I'd had 5 transfers and had every result going (2 chemicals, 1 BFN, 1 success, 1 miscarriage) and was 100% sure I knew my body and my response. I was totally certain my 6th transfer hadn't worked but it had. So I'm now in the camp is there is no way of knowing. But actually I think that's what makes the 2wW so hard. We are used to being able to get an answer at our finger tips and this is one of the few things when we can't

@thislittlebird I'm so sorry. This is so rubbish. I was really hoping for you. Sending love x

@Janefx40 I was going to do PIO 100mg daily in the morning and cyclogest 400mg at night, do you think this is ok? It's a natural modified cycle so I have my corpus luteum as well. Dr Gorgy said I should do cyclogest 400mg twice a day and PIO every other day.

I'm really sorry @thislittlebird ❤️

@2021ivfagain I took it ages ago and was able to get a normal microbiome right after.

@Gardenlady543 Thank you. That is reassuring. I will ask to take it the beginning of next cycle.

As far as progesterone is concerned, last November when I did the era, Emma, Alice and nk cells biopsy, I took 400mg cyclogest twice a day and 1 lubion twice a day. So that was 850mg daily and my progesterone was 113 when I had biopsy. I’m doing same protocol as you-stimulated frozen transfer with trigger so I’ll have corpus luteum.

As time has passed, I have asked to increase my progesterone and will be taking 3 x400mg cyclogest a day and one lubion twice a day. So that will be 1250mg a day. I have always been told to space out cyclogest 12 hours apart. If taking 3 times a day, I suppose I would take one at 8am, 2pm and then 8pm.

@Gardenlady543 to be honest I'm not sure whether progesterone supplementation is necessary at all in natural cycles and for those who don't have an issue making progesterone. As we are in the supplementation game however I've never quite understood the point of taking PIO every other day or 1 cyclogest because to me, that just means it is wearing off completely so your progesterone is being allowed to drop and then being boosted again. But Gorgy probably knows more than I do!

Why do you want to take less than the clinic recommended tho? The PIO isn't fun but cyclogest is pretty inoffensive so why not take the 2 recommended?

@Janefx40 I have taken cyclogest in all my cycles and never got anywhere, so my thought was I needed PIO which increased Progesteone better than other forms, so I thought if I do anything at the correct timing it should be PIO and use cyclogest to supplement. Everyone thinks the amount I'm on is too much I'd kind of pushed for it and then freaked out and thought I should reduce down a bit by a cyclogest. But like you say that means my levels could be fluctuating so maybe I should take 2 x cyclogest a day. I know that increasing up on transfer day doesn't impact on live births so I could go up on Monday if the level isn't high enough. I guess I'm just worried because I got physical symptoms last cycle. I don't know what to do :( I took a PIO in the morning and cyclogest at night yesterday but could go to PIO once a day and cyclogest twice a day today.

@Gardenlady543 may I ask who thinks it’s too much? Because I keep worrying mine it too much too given the amount of symptoms I’m getting.

@clhiu I'm worried as there are studies showing too high is bad, it only seems to be RIs who want it high. My clinic is worried it was too high last time but are quite flexible and said I could do what I want. Dr Gorgy also told me over 50 is fine, over 80 is good. I'm more worried as I had physical symptoms last time.

@Gardenlady543 Thank you, yes you have mentioned those studies before and that’s what’s had me worried too especially since low progesterone hasn’t been my issue in the past, I worry they’re over-doing it. I don’t understand why fertility clinics have such a blaze’ attitude towards this and seem to just think the more the merrier if there’s studies showing the opposite is true. Just another of those extremely confusing aspects of fertility treatment that just leaves you wonder without sure answers 🤷🏻‍♀️. If implantation fails for me in this cycle for example I will forever be thinking I should have insisted on less progesterone. Very frustrating.