Am I on enough progesterone?

[BellaRosex]

Hi all,

I'm on my second FET (after a natural MMC at 10.5 weeks and a MC at 5.5 weeks with my first FET).

For my first FET, I was on Crinone 8% gel, once a day (which I was really worried about as everything I read, people seem to be on at least two a day or a combination of other progesterone). When I started spotting at 5w2 days, I called my clinic and asked if I could increase my progesterone. I was told categorically no. I couldn't understand this because my clinic has NEVER tested my progesterone so they never knew whether what I was given in the first place was even enough. My fertility doctor seems to be skeptical that people need extra progesterone and seems to think my body will just take what it needs from the meds he gives me. Needless to say when I had the inevitable miscarriage, I was devastated and am constantly questioning whether progesterone could have been an issue.

During my consultation for my second FET, I mentioned my concerns and he suggested that I could switch to Lubion. I immediately said yes as I thought an injection would be more "guaranteed" in terms of progesterone absorption. However when I came home and researched this, I am still concerned that this isn't enough. Basically he is proposing that I only be taken one injection of Lubion 25mgs a day and NOTHING else. I asked him if I could increase it to twice a day (because this is what I'm seeing online) or at least use it in combination with something else. Again, I was told no without any blood tests ever having been done.

I feel like I'm being set up for failure and another MC. Can anyone offer any advice? Has anyone here been on just one Lubion injection a day and it worked out fine? Feeling really lost.

Hi, the clinics vary with their approach to progesterone, some are very heavy handed some are light. I read, and this is what my clinic believes as well, that progesterone is unlikely to be the cause of miscarriages or implantation failures unless they are very low eg less than 30 nmol/L. It's the other way round. After what you have been through, I totally understand why you are worried though. I feel your clinic should be more sympathetic and at least offer you a test to put your mind at ease.

Are you on medicated FET or natural FET? One Lubion per day is okay for a natural FET as your body also produces progesterone. But on a medicated FET it probably is not enough. Most people usually have additional progesterone like cyclogest pessaries or something.

For context, I have done natural FETs and on one Lubion per day. My progesterone level before transfer usually ranges 41 to 51 nmol/L. You need minimum 30.

Testing is the only way to confirm how much you have it. If your clinic refuses to test, can you get one done privately? At least it would give you some peace of mind and something solid to discuss with your doctor.

Wishing you the very best for this FET 🍀

Just wanted to add that I have not been successful yet, but I don't think it's due to my progesterone level.

Hi, sorry to hear of your MCs. I just wanted to flag there is a huge difference between a medicated and natural FET cycle. If you are doing natural theoretically you might not need any progesterone support, whereas medicated you don’t make your own progesterone until the placenta takes over towards the end of the first trimester so you absolutely need it. I’ve only ever done medicated FETs so have been given pessaries and lubion, but they’ve always tested my progesterone level on the day of transfer. If you really want to check you could just pay privately to check your progesterone level. I did this as I felt I was taking so much in excess. I think it cost about £60 maybe?

Thanks so much for your responses! To add, this is a fully medicated FET so I'm wholly reliant on the medication he gives me 😞. I think I probably will pay to have a private test but even then I'm not sure my doctor will do much unless it was significantly low. It's crazy that this isn't standard practice in all clinics to test. I've emailed Tommy's to try and get some advice. Hopefully they send something that I can share with my doctor.

Thank you both for taking the time to respond 🙏🏻

I didn't absorb pessaries well and bled early on my fresh transfer which didn't take, I got lubion for the frozen as my peovesterone qas always just over the clinic threshold of 35 when having a transfer and I wanted to cover all bases. That one took and I have a 15 month old now, I did private tests before coming off lubion at 12 weeks and it was through the roof so placenta was doing its work but I do think the lubion helped me at first as I habe spotting on my normal cycles so lowish progesterone naturally.

Hi @BellaRosex if it’s fully medicated then x1 lubion a day seems very low. My standard protocol for all 3 medicated FETs I have done is x2 25mg Lubion per day AND x2 400mg cyclogest pessaries, so one injection and one pessary both morning and night. I stopped the injections at 10 weeks then down to one pessary at 12 weeks and nothing from 14 weeks.

This does seem a lot vs other clinics but equally I know my clinic has very good success rates. When I checked my progesterone was pretty high but it’s not done any harm it seems (14 weeks now and have finished my meds and all looks fine).

In case it’s helpful I did my bloods through ultrasound direct.

I was fully medicated. First transfer 2x cyclogest. I started spotting early and added lubion, but the transfer failed.

Second transfer 2x cyclogest and 1x lubion. Moved to 3x cyclogest as I started spotting and I’m now 9wks pregnant.

All changes to the progesterone were by my request, the docs were reluctant but agreed as ‘can’t do any harm’. I really had to push and ask multiple times. They didn’t do any progesterone testing at any point.

Thank you so much for sharing your experience. I think I'm going to insist for more. I can't live with the "what ifs" and I can't go into this next FET already feeling like it's going to fail.

All the best with your pregnancy ❤️

I am on my 5th FET and on 3 cyclogest and 1 lubion, I still don't don't think that's enough. I always start spotting from 6dp and my body itches all over, when researching these are signs of low progesterone. My clinic wouldn't prescribe anymore, even if blood test showed low levels, so they won't allow me to have one. Absolute joke.

If this one fails, I'm getting progesterone checked privately next time.

Update: I contacted my clinic again to plead for more progesterone before my next round. They responded with a no.... No explanation and no recommendations of a blood test just a no.

I'm losing faith.

Can I just ask if you took anything else along with the Lubion or just the Lubion?

Thanks

@BellaRosex hey, at first for a few weeks it was pessaries and injection then I just took lubion, once a day. My progesterone was sky high at 12 weeks when I came off it, it was 35 a few days before transfer so I just wanted a different type of progesterone as I just didn't do well on pessaries only.