Progesterone supplementation

[somethingluscious]

I have an early scan next Thursday that will be 6w2d. It's 8 weeks after start of last menstrual phase, but I ovulate later around cycle day 25.

I'm waiting for hcg and progesterone blood tests, but I already know my progesterone is going to be on the low side. I tested it at 6 and 8dpo and it was 24.9 nmol/L at 6dpo and 18.6 nmol/L. Ideally for pregnancy it should be over 30. The previous cycle it was 9.29nmol/L at 7dpo, but I had a clear temp shift and 12-day luteal phase, so I think I may have corpus luteum insufficiency.

Judging from my chart in this pregnancy cycle I had a massive temp spike at about 16-17dpo when I also had some light spotting. The temps have gradually come down now over the last 7-8 days.

I had a MMC in late September, where my body temperature had gradually dropped and because of this I tested progesterone levels. They were 25.7 nmol/L at 18dpo / 4w4d and 17.2 nmol/l at 6w3d.

It feels like my temperatures are dropping down like they did the week of my previous scan with the MMC. I think they crashed at one point, then recovered and then I think the placenta tried to take over, hence the MMC. I am still waiting for a progesterone test from 22dpo, but have had sample errors and delays with earlier blood tests I sent at 15dpo and 19dpo due to royal mail strikes and the weather last week.

I have progesterone cream I can supplement with in the meantime, but I really want the EPU unit to give me progesterone suppositories because I think the same thing is going to happen this time and I know from testing, that my progesterone is on the low borderline side. My GP did an urgent referral to a gynaecologist consultant last week and he said to wait until I spoke to the EPU, which presumably is based on the NICE guidelines for progesterone supplementation - bleeding and heartbeat need to be seen (based on PRISM trial I think).

This is my 7th pregnancy. I have two daughters, but the losses between then were different as they were chemical pregnancies where the hcg didn't double or progress past about 5-6 weeks. I'm not sure what my hcg is like yet, but got a fairly strong FRER dye stealer at 25dpo yesterday. My test progression seemed fairly gradual, but steady from 11dpo.

Does anyone have any experience with taking progesterone USP cream or suppositories to support pregnancy in the first trimester or can offer any advice for when I go to the EPU next week?

The RCOG guidelines have changed to recommend progesterone support in the first trimester for women who've had miscarriages. I literally rang up my GP, quoted this and asked for cyclogest pessaries. I was given them immediately! They can be pessary or suppository (latter is easier) and the dose is 400mg twice a day. I have also been given them by an EPU last year but my GP couldn't see this, she just went off what I was quoting. Best of luck.

And at this point I hadn't seen a heartbeat and had just had some implantation spotting which I told them about.

I would have tried to get a private appointment elsewhere or paid for a private prescription & the GP said that might be quicker, but the consultant she referred to was one of the ones I could have gone to privately.

Hi @somethingluscious , I got a private prescription for cyclogest which I was using to help get pregnant as I had HA and have luteal phase defect. I got pregnant after 3 cycles on it and got another prescription for up to a 7 week scan which will then check if should keep up on taking it.

My GP said they couldn’t prescribe it when I went to discuss with them both when we were trying and when I got pregnant. I’m still only 5+5 but this is the first time after nearly 2 years of trying and on my scan yesterday everything seemed to be looking ok! So it has worked for me so far!

@somethingluscious Sorry I know this is an old thread, but I wondered if you could let me know which cream you used please

@Butterfly2000 I'm not on a cream but I am on cyclogest three times a day and lubion progesterone injections every evening. I am at 7+4