Progesterone levels during IVF

[IVFroundone]

Hello,

I'm wondering if people who had success with IVF could share what their progesterone levels were?

My problem has always been low progesterone (29nmol/L) resulting in mid-cycle spotting so pre-IVF, I was put on pessaries to support this which raised my progesterone to 77nmol/L.

Currently on my first round of IVF and the doctor said they would be focusing on "pumping me with progesterone to ensure no risk of mid cycle bleeding" so I'm taking pessaries x2 a day as well as the intramuscular progesterone in oil injection.

I've just got my blood test results and my progesterone is 34nmol/L. The nurse said they are "happy with anything over 30". But I feel given my history, this seems v low? Especially considering I'm supposedly being "pumped" with the highest doses of progesterone?

Any advice would be so appreciated!

I tried to conceive for 8 years eventually getting pregnant twice by IVF (first ended in miscarriage but now nearly 6 months pregnant with my second pregnancy). We were diagnosed with unexplained! I have always been adamant that my struggles were due to hormonal issues rather than physical but this was my theory. My progesterone levels have never been tested by my GP or clinic so it is difficult for me to pinpoint if this was the actual cause.
The reason I felt this, I used to spot 5/7 days before my period each month which I mentioned numerous time to the clinic but they didn't seem to think this was an issue.

My first transfer I was prescribed 2 pessaries a day, this did result in a pregnancy but sadly ended at 8 weeks. Obviously, there is no firm reason why this happened but a comment was made at the scan that the gestational sac was very small, I googled this and one of the potential reasons for this was low progesterone, the clinic didn't mention anymore on this so the next 2 transfers continue with the 2 pessaries a day (also 2 estrogen tabs for the frozen transfers), both failed to implant with good quality embryos.

The 4th transfer I was adamant I needed more progesterone, they agreed to this very easily and increased to 4 estrogen as was a frozen transfer, 2 daily pessaries and 1 lubion injection. Now 6 months pregnant :)

I obviously cant confirm if this was the reason for a successful pregnancy, my clinic didn't do any progesterone testing on the first 3 transfers so I paid privately for a test on the fourth transfer. At 14dp5dt and after a positive test the results showed 132nmol/L which is very high although no real cause for concern.

If your concerned then I would push for an increased dosage again especially as you have already been diagnosed with low progesterone. I was advised to continue with the progesterone until 10 weeks and start to wean off until the 12 week mark. This give me no end of stress so I continued taking the meds until 15 weeks, I was only able to do this as I had meds left over.

Good luck on your transfer, hopefully all will go well for you :)

Hi @SH998

Thanks so much for your reply and congrats on your pregnancy! ❤️

Our situations sound very similar - can I ask if you spotted during your IVF cycles? Like you, I spot every month from day 5/6 DPO l (even the month my progesterone was high enough) . I have my transfer tomorrow and already know I will be anxiously awaiting spotting during the tww!!

@IVFroundone thanks so much it’s been a long emotional road but I finally got my dream. I’m sure you will too :)

The first transfer I didn’t spot at all, that was a positive which was later lost. The second one I was literally spotting on transfer day so knew within a day it hadn’t worked. The spotting continued throughout the week until I stopped the progesterone that time. The third transfer again I spotted but this wasn’t until about day 5/6 after the transfer. I knew that both of them were period spotting by the look and smell of it (sorry if TMI).

On the last and final transfer I spotted from day 5 on and off until about day 14 but the spotting was different. It was maybe only once a day and very light and pink (other spotting was browny). Although I knew the spotting was different you still think the worse and I feared it had failed.

I really wish you all the best I know how emotional the whole process can be. If you need to ask anything please do so, nothings off limits lol 😂

Good luck for tomorrow x

@SH998 thank you so much!!

Hi @IVFroundone there are a few studies that have tried to define the optimum progesterone levels, clinics usually have quite a low level for where they want it to be. So the nurse is probably quoting that rather than what your doctor advised in your case. The specialists that deal with complicated patients (reproductive immunologists) what very high levels such as over 80 and over 100 and given your history you likely should be aiming up there. I took the same regime as you 2 x 400mg cyclogest + 1 x PIO (+ I had my own follicle). PIO is the best formulation to increase levels so I would ask to double that to twice a day and repeat the progesterone level. Where abouts in the cycle are you? Have you had a transfer yet?

Hi @Gardenlady543

Thanks for the reply.

I am going in for my first fresh transfer this afternoon.

I woke up to a reassuring message from my clinic saying that my progesterone will likely be rising significantly daily (the blood tests I received yesterday had been taken on Tuesday morning and I have had 3 PIOS and x6 pessaries since) so they expect it will be higher. I think I didn't take into account that the bloods this cycle weren't taken on day 21 like they usually are so they're not entirely representative.

So I am hopeful (for now!!)

Thank you 😊

Also, she was confident in saying that with the daily PIO I can expect my progesterone to be in the hundreds! Although they won't be routinely testing during the two week wait. But mad to think it could be that high!

@IVFroundone most people have their level taken the day before/ the day of transfer and if it's low and the dose is increased people have the same success rate as those who had good levels to begin with. I monitored my own levels using medichecks in the two week wait as some people have a significant drop during that time. My levels were 150-178 at the time of transfer and in the two week wait and I'm now 34 weeks after 4 years of implantation failure and a lot of IVF.

@IVFroundone good luck for this afternoon's transfer, I have everything crossed for you :)