Cyclogest - how long does your clinic advise to stay on it for during IVF?

[AliciaWhiskers]

Just wondering if I can get a consensus of what most clinics do.

I'm using cyclogest pessaries 400mg twice per day, starting from the date of my egg collection, for 15 days.

EC was 03/07
ET was 08/07
OTD is 19/07
I will run out of cyclogest on 17/07

As I had ET 5 days after my EC, the cyclogest doesn't even cover until my OTD.

This doesn't seem right to me. I queried it with my clinic, but they told me that was how they did it, and I didn't need it for longer.

In the clinic I had my EC/ET (I went to one clinic for scans and meds, and a different clinic for EC and ET) advise their patients to use the cyclogest until the 12th week of pregnancy.

So, what does your clinic advise?

I was actually told by my consultant last year that while they used to think that progesterone supported IVF pregnancy, and therefore would prescribe it for the first 3 months, there was a new, large study recently that has discredited this and it doesn't make a difference to success rates except in specific cases.

Having said that I was prescribed it up to my 6 week scan, although they were quite casual about it and not in the least bothered when I had a gap of a couple of days when I ran out. It sounds like your clinic has gone further but based on what my consultant said I would trust them.

I started taking them just before egg collection, and told to stop at 12 wks,
But my hospital consultant has kept me on them as I have a weak cervix and have had previous losses.

12 weeks. 27 for twins.

The most recent study that I can find (2018) says that you can stop on the day of a positive pregnancy test with no statistical difference in pregnancy outcomes (which is good to know) but mine would run out before my OTD!

I don't know whether to try and get some more, or just leave it (but then if the pregnancy didn't continue, I would always worry that it was my fault for not using the progesterone for longer). Given there is no evidence of progesterone causing harm, I think I'd rather use it than not.

I have to take mine until week 8. And just had to pay for a top up delivery 🙄

I was one 4 cyclogest a day until 12 weeks, the 2 a day until 14 weeks and 1 a day until 15 weeks. Also on lubion until 12 weeks

I was on 1 a day of 400mg Cyclogest between EC and ET and then 400mg twice daily from day of ET until either failed cycle confirmed by beta or up to 12 weeks of pregnancy

I wish there was some sort of consensus!

Ooooo I've been through this quandary, @AliciaWhiskers! Traditional school of thought was to take it up to the twelfth week of pregnancy. That's what I did, and oh my goodness, stopping it was terrifying. So I did LOADS of research and it turns out that recent clinical studies indicate that there is absolutely no need to take it for so long, except in a teeny tiny number of circumstances. So I'd be more relaxed about stopping it a lot sooner if I were to have further cycles.

Having said that, I think it's really odd that they haven't given you enough to take you to OTD. I never managed to wait that long anyway and always tested early. If I were you, I'd test on the 17th which is 9dp5dt - basically when your period would be due if it were a non-IVF cycle so good tests (FRERs) will show a decent positive. If it IS positive (fingers crossed!) you could phone the clinic and insist they give you more. I honestly think for peace of mind it's sensible to take it up until the viability scan at 6-7 weeks.

Was advised 12w but I took for a few weeks longer ans weaned down

Was worried if I went from 800 to nothing that I might miscarry

Thanks @RedPandaFluff, that’s really helpful. I probably will test early (as not sure I’ll be able to hold out until 19th!) but no idea if the clinic would agree to give me a further supply, as the nurse pretty much shut down my request before and just said “you don’t need it”.

I do wonder if because we had ICSI due to MFI, that’s why they aren’t that worried about me needing it?

Quite possibly, @AliciaWhiskers - if it's just MFI and you're checking out okay, ie your hormone levels/cycles are fine and you're producing the progesterone/oestrogen etc. that you need, that could be why they think you don't need it.

I think I needed it because my poor knackered old body went through an early menopause, which why I needed donor eggs plus every drug going!

I never had a progesterone blood test, and my LH and FSH are wonky as I’ve got PCOS. Don’t think they ever tested oestrogen either? Hmmmm. Bit late now!

Hmm . . . I do think that's a little odd, then. In all my time on this forum I've never heard of someone stopping progesterone before the viability scan. Six weeks is the absolute earliest I've ever heard people coming off it.

It's probably fine - if your fertility issues have been down to MFI there's no reason to think that your body doesn't know exactly what to do once it receives the embryo. But, after everything we go through to get to this point, "probably" isn't good enough, is it? We have enough to worry about.

How about phoning your clinic on Monday, ask to speak to someone other than the person who shot you down last time, and appeal to them to agree to provide more progesterone upon a positive result purely to give you peace of mind? It won't do any harm if it's not needed anyway. Any decent clinic should understand!

Yes, I’ll call on Monday. The consultant should be in then too so I can try and talk to her. I think the main thing is that it can do no harm, and therefore why not take it?

On this occasion it’s not even before the viability scan - it’s before I even do a pregnancy test!

Exactly. Really unusual.

Let us know how you get on - and if you get your BFP!

Not cycolgest but lutigest - up to week 10 with a FET. Our clinic do up to week 7(viability scan) with a fresh transfer.

I rang about it again today and the nurse has given me an extra week to cover at least until my OTD! That makes me feel a bit better!

Oh that's good - how are you feeling? And when are you going to test?

I can't quite remember, but I know if it was quite a while after OTD - possibly up to my 8 week scan. This was almost 5 years ago now though - but I do remember it varied wildly between cycle buddies at other clinics/in other countries back then too.