Progesterone levels for FET

[GooniesForever]

I’m booked in for my third FET next week (first one ended in MC, second bleeding before test day).
Previously I was on cyclogest pessaries before and after FET but this time I’m on Lubion in the morning and 1 pessary in the evening.

I know I shouldn’t but I’ve been reading threads and lots of people are talking about low progesterone on transfer day and the risks of miscarriage due to low progesterone after FET.... I’m now worried that my previous MC and Failure were due to low progesterone as my levels have never been tested.

my transfer is in 3 days... is it too late to up the dose now? I’m not sure if I can ring the out of hours nurse line about this as it’s not an emergency but I can’t stop worrying... will obviously ring first thing Monday but will that be too late to get the levels up for Tuesday FET?

Do they usually test progesterone levels on the NHS? I’m not sure what they base the dose on but previously the upped my pessaries to 3 from 2 a day after I spotted with my first transfer so it can’t be dangerous to up it can it?

I am doing an FET this week too. Have you had any blood tests during the run up whilst you have been having scans? My clinic did a blood test After my 1st scan during this cycle to test both my estrogen and my progesterone level. This is a privately funded round but when I have had previous nhs round they also tested progesterone. Could yours have been done during other blood tests?

I don’t think you should up your medication, the clinic presumably know your history and are the experts, I’m sure they have considered this already and I think you should trust them. Its so hard not to worry at this point because you want everything to be perfect and to work but if it wasn’t this you were worrying about it would be something else. Give them a call on Monday to discuss your concerns but I’m sure everything is under control.

Good luck with this round, will keep my fingers crossed for you.

MrsSifB thank you for replying.
No, I’ve never had a blood test during a cycle before... now I’ve read up about low progesterone it seems to fit perfectly with what has happened with my previous two transfers, although I realise that doesn’t mean it it is the case!
The fact that I’ve never had a blood test during a cycle makes me think the possibility of me not absorbing the progesterone properly, or efficiently, and my levels therefore being too low seems a potential issue and I find it odd it’s never been looked into.... I have to admit that while each nurse or doctor I see is lovely I’m not too confident that there is anyone looking at the big picture....

Hi

Ive just been through something similar myself.
I had my levels checked the day of transfer. My consultant explained that there are studies out there, but nothing to prove this, that progesterone levels should ideally be 30 nmol/l or above (America measure theirs at 10ng/ml) for implantation.
He was doing a study himself so i was lucky enough to get mine tested. Mine came back at 27.9nmol/l.
Straight away at 1dp5dt, i was put on 25mg Lubion once a day, and i decided myself to add an extra pessary at 5dp5dt as i was worried my levels were still low. (I strongly dont recommend upping your dose without speaking to your consultant first)

Anyway, pre transfer, i was so positive about this cycle but once i got the news of my levels, i took a nose dive and all positivity went out the window.

I tested positive at 9dp5dt (yesterday) with lovely strong lines.
Obviously, im not out the woods yet, i have a history of recurrent miscarriage but today, i am pregnant.

Good luck and id deffo ask for a blood test purely for peace of mind. Being NHS they probably wont do it on the NHS but hopefully you can get the test done privately if they have that option.

X

I'm convinced I MC'd on my first cycle for this very reason as I then found out when I insisted they did test the next time that the pessaries dont work well for me. I don't know why they don't do the blood test as a standard procedure or just prescribe lubion at the outset. Particularly with private care - the blood test is about £40 which is a drop in the ocean compared to a whole new cycle!!

Thank you so much for your replies and good luck this week MrsSifB and congratulations Bearsmum15

MabelG That's what I'm beginning to think about my first MC and then bleed before test day as it fits with the progesterone being too low (even though I totally understand it might not be) surely to do a blood test would confirm one way or the other...

Previously I've been on cyclogest pessaries (2 up to 3 a day) but this cycle I'm on lubion in the morning and a pessary at night.

When I had spotting after a positive test in my first cycle they upped my pessaries to 3 a day (without any blood tests) so I assume it's safe and a standard thing? I obviously won't up anything until I talk to anyone but I definitely feel a bit let down and as if it's a bit 'one size fits all' as every appointment is a different nurse (I haven't seen a consultant since egg collection early last year) and I'm not convinced that they are considering my case as an individual rather than slightly tweeking the standard protocol....

Hey, I'm not sure if my thread was one you were reading, but the reason I asked for a progesterone test this time was because in my previous round, I started spotting at 5dp5dt and had a full period 8dp5dt.

I'm on an NHS round but had to pay for the progesterone test, its only £30 and probably worth it if you're worried. Mine was done on day of transfer (you can't test much earlier than this anyway because the levels need to build up from the pessaries). I would recommend having it done a day or 2 before though so you get the results before the transfer (my clinic has really screwed this up for me so if I can help someone else it won't be completely wasted!)

Good luck!

@GooniesForever hopefully you will be ok with the lubion added in (the injections absorb better than the pessaries) but might be worth getting your levels checked for peace of mind?

Surely it's in their interests to check as then they'd have better stats. Who knows - especially when it is such an easy thing to check.

Hi PineappleC it might have been your thread - I've read so many now my head is spinning!
I'm going to ring first thing and ask for a test, hopefully, the day before will be in time, I'm not sure how long it takes for the results to come back or time for the levels to increase if the dose is upped... might ask if they can delay the transfer by a day as my lining was only just thick enough at the scan last week....
Do you mind me asking how your clinic screwed it up for you? I feel a bit stupid to have only started looking onto all of this now but have been blindly trusting them until now.....

MabelG you would think that it was in their interests and I've assumed that until now but feel that the lack of blood test is a bit of a let down after two failures as it would be a simple way to rule out low progesterone, I'm not sure that there is one overall person looking at me though, just whichever nurse picks up my file on the day.... Reading up on it the lubion seems better for some people so fingers crossed, I might ask about changing to lubion twice a day instead of once and a pessary. It seems to be if I don't ask and push I won't get any answers.
I feel a bit of a fool for not pushing sooner, but having been quite traumatised by a previous (unrelated) health issue and the subsequent fall out due to a bullying and negligent doctor it's a bit of a weird one for me to work out how I feel.

@gooniesforever my FET was Thursday. They were apparently meant to test on Weds so they would have the results on Thurs morning before the transfer. Injections would've then been picked up at same time.

What actually happened is the person booking the test told me it was fine to do it on Thurs at same time as the transfer. My consultant was meant to ring up on Fri morning to get the results (injections would've been delivered on Sat...a bit late). I had to remind them on Fri afternoon to get the results, meaning it was too late to organise the injections being delivered until at least Monday. This means that I am sitting here with practically no progesterone in my system hoping my embryo somehow clings on. It's really shit and I'm really angry. So just make sure you get results and a plan for receiving any meds in good time!! X

PineappleC I feel for you so much, I know that feeling of anger so well. Have you got the injections now?

Finally spoken to them and they have said that the Lubion alone is enough to ensure the levels are high so no blood test... as the lubion is injected my levels cannot be too low... so transfer tomorrow....

@GooniesForever hope the transfer went smoothly! Yeah I guess if you're already doing injections that should take care of it - my spotting stopped almost as soon as I started injections so they definitely do the job even for critically low levels.

I did manage to get them in the end thanks! Although they'd actuslly planned on delivering on Tues, so I had to take a day off work to go to London to pick them up. There will be questions asked...😡

Good luck for your TWW 😊🤞