Progesterone

On progesterone:

I was tested on Wednesday when they did the IUI.  They said my level was 4, when they want to see 20 - 40.  However, from my reading the 20-40 should be later than ovulation day.  Does anyone know what progesterone levels should be at what day of pregnancy?

Seems that supplementing progesterone is controversial!

Anyway, they said it's low and want me to supplement (I have had 3 early miscarriages now with no found cause).  So I think I should do as they said and with monitoring so the dose can be reduced if my natural levels can hold their own.

Anyway, what have you ladies found out / been told is the best form of progesterone to treat low progesterone.

It's a matter of cost for me too, as everything is out of pocket..

My obe can get me oral meds at about $3.50/day (oralprogesterone 3 x 100 mg/day).

She can also get me the injectable oil at about $4.50/dose as a special favour and at cost (though the 'commercial price from the fertility centre is $45/dose).  She's giving me 8 vials today.  But if I use that every 3rd day it will only last until I know if I'm pregnant.  I am hoping she can get more for me at this price if it is 'needed'. The price from the fertility is exorbitant.  Injections aren't pleasant, but at least this is affordable if I can get it wholesale price.

Crinone Gel costs about 13.50 per dose from the fertility centre.  If I have to use this for 3 months it is really really expensive.  I don't know if I can get this 'at cost' anywhere else (as I now know the centre uses a *10 markup!).

She wants me on all 3 at the moment (nightly crinone, oral 3x/day, plus injection every 3 days).  Is this overkill?

[Heather5]

Wow! That's a lot of progesterone. I was on crinone and prometrium after my IVF, but in an IVF cycle, you won't produce any progesterone on your own, so supplementing is critical to success! Using all three after an IUI, where you do produce progesterone on your own, seems like a lot lot to me. Also, your natural progesterone rises after ovulation, so it will probably be higher in a few days anyway. I've honestly never heard anyone having their levels drawn the day of the IUI. It's almost always done about a week after. And also, my RE liked to see a level over 12 at 7dpo, others say 10 to 15 (depending on whether or not it was a medicated cycle), so a level of 20-40 on the day of IUI seems very high! So are you in the Philippines? If so, maybe they use a different measuring system there (I know they do in Canada). Also, what have your progesterone numbers been in the past, without supplementation?

[Super_sally888]

Hi Heather,

This is the first time I've had levels drawn.  In retrospect I should have had them done before.  And they only did levels because I insisted I wanted to test before agreeing to meds.

The RE suspects a luteal phase defect.  But yes, I am questioning the 20 - 40 range (nMol/L) so soon after IUI.  Like you said I've seen that it would normally be tested at day 21.

Anyway, I discussed with my Obe today and she's given me an order for a repeat levels.  I have started the crinone and did the first progesterone shot just now.  However, I think I'll test at D21 anyway and if my levels are really high I may be able to reduce the doses to keep them at the upper end of the range.

If I get a positive HPT at D28 we continue with everything (but will monitor levels and adjust dosing).  If I get a negative test I have to go get a blood test to check for qualitative levels, and then if still negative after 1 week stop all meds and wait for period.

[Super_sally888]

ok.  I found out.

ng/mL x 3.18 = nmol/L

Therefore, my 4 was actually about 1.25 ng/mL (you unit) which is actually low considering I should have just ovulated or be about to ovulate.

Your 12 would then be about 40 for DPO7.  The centre does IVF as well so maybe their range reflects this too.

[LALEAH]

My comment is not in the league of your experience but I make it anyway.  I was prescribed a vacinal cream of progesterone during the first three months of my pregnancies.  It was mixed by hand and only available at one pharmacy in a very large city.  My OBGYN was one of the best (high risk) and the pharmacy reputable.  There is no conclusive proof that it works, but I swear by it.  I lost 2 babies.  When I changed to this OBGYN I had two perfectly healthy pregnancies and no problems.  Best wishes.  

[prayin4miracle]

I don't know anything about the progesterone meds ..... I have been luck so far with mine being ok....BUT I do feel your pain on the everything is out of pocket..... they told me today they want us to pay as we go, they don't do payment plans for fertility treatments....that is so upsetting....

If we can do IUI this cycle ..... it might just decide that this is the last go.....