Progesterone monitoring in IVF

[Berkshire22]

Hi everyone - can anyone help give guidance on progesterone monitoring in an IVF cycle?

I am in my second round, first IVF round led to miscarriage and failed FET so I obviously want to optimise everything I can,. but my clinic do NOT care about monitoring progesterone levels. A friend has had IVF in Greece and her progesterone levels were monitored before transfer, day of transfer - after transfer etc. and her progesterone pessaries were increased according to her blood results.

I asked my consultant (private treatment, not that that should matter but we are paying for everything and willing to pay more for tests or drugs) and she dismissed me completely - said they wouldn't be able to monitor/it wouldn't change outcome/results hard to interpret and that I was being prescribed more than enough progesterone. Well why the hell do some clinics monitor it then!?

Does anyone else's clinic monitor progesterone?

Hiya... I believe progesterone monitoring is difficult as it fluctuates a lot so any test done on the same day but at different times would give completely different readings.

All studies I have read show that 600mg vaginal micronised progesterone is "enough" and offering the right levels of absorption.

Happy to be corrected but this is as I understand it.

For what it's worth, 9 ivf cycles down, the only time I had progesterone monitored was after a BFP during 1 blood test.

@Berkshire22 My clinic doesn't. My first cycle drag transfer no Frosties AF sowed up at 8dp5dt - so naturally this cycle I questioned if I needed more progesterone and they advised no- that this was completely normal with a failed cycle.

I'm on 400 Cyclogest twice a day.

I got my BFP this time 9dp5dt.
6 weeks pregnant today. 🤞🏼 it's working x

My clinic in Spain do blood tests, progesterone levels checked the day before transfer and again when the beta blood test happens.
I don't know how much it helps but in my experience they generally like to test more. I don't know if it improves outcomes but at least you feel that all bases are covered and if you are a random outlier it will be picked up.

Good luck with this cycle.

@Berkshire22 she dismissed me completely - said they wouldn't be able to monitor/it wouldn't change outcome/results hard to interpret and that I was being prescribed more than enough progesterone

my consultant said exactly the same to me and my second transfer failed too. I moved clinic and my progesterone day of my mock cycle was 4 and day of transfer was 12 when it should be >50 and ideally >100. I was given progesterone in oil injections into muscle- painful but my levels shot up to >100 and my transfer worked.

also I was on more than the 600 @spinkupromise describes and my levels were still on the floor. I bled before OTD both times which was the indicator of an issue.

@spinkupromise thank you for your response, that is interesting to know - I'm sorry that you had to go through 9 cycles but so great to hear about you BFP x

@PMAmostofthetime Thank you - so great that your second time has worked! Obviously worried that this might be an issue for me and just want to have that base covered too x

@LongerthanMrTicklesarms Thanks so much, exactly - I do feel frustrated that clinics in the UK Greece/Spain (and some in the UK) test as it would really help peace of mind. If progesterone is so vital I can't understand it - especially as clinics charge for other 'add-ons' that aren't scientifically proven yet. I hope your treatment is successful x

@Hetoldme thank you for your response, wow that's interesting - that must have been really frustrating for you, thank goodness you moved and your second clinic picked this up. I'm sure your first clinic would argue that a failed cycle could be due to a number of factors but imagine going through that over and over again before they finally looked at progesterone levels, which is what I feel happens x

@Berkshire22 thanks but it was blighted ovum already a year ago and no luck since 🤯😭

@spinkupromise I'm so sorry, its so tough. Are you having a break from treatment? Wishing you so much luck if you're in a cycle now 💪 x

It's just hurdle after hurdle isn't it... yeah I'm hopefully in a FET cycle with last embryos ... first monitoring on Monday 🤞

Last cycle canx as I started bleeding while on estrogen priming.

They are worried I will prematurely ovulate which is apparently common in high fsh/low estrogen cases but I doubt it. Let's see... kindof have low. Hopes after it all...

@spinkupromise everything crossed for you this time.

I can understand that hopes are lower, I think hope can be exhausting so it is a way of protecting yourself without necessary feeling negative. I am seeing a hypnotherapist (more expense! But worth it) to help talk to my subconscious brain - so that my body isn’t in a state of fear/anxiety. It’s so frustrating when people say ‘try and relax’ as it runs much deeper than that.

I’m really hopeful for you