The quest for cyclogest

[Holly5633]

Hi ladies,
So having just suffered my third chemical pregnancy (two back to back) all at 5.5 weeks I am pretty certain I have a progesterone deficiency. I have lots of signs - brown spotting before and after period, heavy periods, migraines, fatigue and tender beasts.

I have an appointment with my GP on Friday and I am looking for advice on how to persuade a reluctant GP to prescribe me cyclogest. I know there is no real evidence of it helping but you can’t ignore all the women on her who have had success after taking it.

I have been referred to the recurrent miscarriage clinic but the wait is long and I really want to be able to give progesterone support a try.

My only other option is to pay £££ to see if a private consultant will prescribe it.

Any advice on how I can persuade my GP would be much appreciated!

No real advice on persuading a GP I’m afraid. I had my cyclogest from an IVF cycle and I had to pay for it, even though the cycle was an NHS one (private clinic though).

The nurse who did my IVF 7 week scan told me that the NHS has put cyclogest on its red list because of the price. I’m not sure if that is true but her view was that I could try and change the clinic prescription to a GP one and pay less, but I might well be unsuccessful. I was happy to pay though. I generally found my GPs very reluctant to help with anything fertility related after a referral. I found the fertility consultants much more helpful and proactive.

Also, I found the pricing a bit random, for one bunch of 6 weeks I paid £90 and for the next I paid £50. Not sure if someone over or undercharged me somewhere!

You could also look at herbal supplements whilst you are waiting for your referral - some people swear by Maca and Vitex but I didn’t take them so can’t really recommend.

Good luck and I hope it all works out for you.

No advice on persuading a GP but I paid through the CRGH for it which is in central London. I think it worked out about £20 for 28 pessaries which I used morning and evening from the day after ovulation, so £20 a month. You'd probably need to pay for an initial consultation there too but they readily give it to women who may need it.

Do you have another GP or a fertility nurse at your practice? I have a gynae/fertility nurse (I don't know what her job title is!) at our surgery and she will always prescribe me the progesterone (utrogestan or cyclogest) that I've needed even though it's to supplement our private IVF treatment. It's saved us £100s over the years not having to pay the clinics fees for them. Keep pushing, I think some GPs just don't understand how crushing miscarriages and TTC can be x

bnf.nice.org.uk/clinical-medicinal-product-information/cyclogest-pessaries.html

It's unlicensed for this indication so your GP will probably be unhappy to prescribe it. The recurrent miscarriage clinic are better placed. If the wait is too long for you see someone privately. (GP)

Holly5633 As far as I know GPs are not allowed to prescribe progesterone, but I might be wrong. I did several medicated cycles with timed intercourse (Clomid and then Menopur, plus trigger injection) and it took me ages to convince my fertility clinic to give me progesterone, despite several blood tests showing low progesterone. They only gave it after 3 unsuccessful cycles and I finally got pregnant so I do believe it helps. UK doctors (as opposed to those in the US or mainland Europe) don't believe it makes a difference. There are many reputable studies showing it does, so maybe print a couple to bring to your GP? You might end up needing to pay for a private consultation to get it... On the cost front: if you have an NHS prescription, you can get a prepayment certificate. You only pay £29 for 3 months or £104 for 12 months, and get unlimited prescriptions for that amount: www.nhsbsa.nhs.uk/help-nhs-prescription-costs/prescription-prepayment-certificates. I've been on 200mg Cyclogest twice a day, from two days after my trigger injection. Ovulation needs to be confirmed in one way or another to start taking it. I'm 12w and have started weaning off. If you have any questions, feel free to send me a private message.

I think it depends on the trust your with.

My GP prescribed it when I asked but didn’t seem to know too much about it.

My current consultant (different trust) was horrified I wasn’t on cyclogest right from the start of my pregnancy when I saw him, and he promptly prescribed me double strength cyclogest which I came off at 20 weeks.

It’s hit or miss, but I would definitely ask and use recurrent miscarriages as your reason for wanting to take it.

Have you had your progesterone levels (day 21 bloods) checked yet? You don’t mention whether or not this was low but if it hasn’t been done I’d say the first step would be to ask your GP to have that checked.

My GP just prescribed me cyclogest after I requested it. I’m with a private clinic and went through IVF, I have been told I need to take it for the next 12 weeks after the embroyo transfer and they said it’s cheaper to buy through NHS which I have done as the actual IVF cost has been hefty.