Progesterone Pessaries vs injections ?

[Saya85]

Hi,

I used pessaries last time after a fresh cycle and I strongly feel it isn’t going to work again, as my body just doesn’t seem to respond to progesterone tablets (even on microgynon) or pessaries- and it just didn’t seem to stay in (?!). I started bleeding well before the 2ww ended but heavily again... even if embryo implantation was unsuccessful would you have expected heavy bleeding despite still being on pessaries and tablets?

(By heavy I’m talking ‘flooding’ sorry tmi! 🙊)

My doctor this time said oh no we’ll stick to protocol for the frozen transfer (!) - ugh I wish they would just think outside the box. She seemed on board when I spoke to her in July.

What’s your opinion ladies? Should I push for injections? Are there blood tests /scans and things to look out for that would indicate if I should have injections instead of pessaries?

I feel I went along with all their suggestions for fresh without Q- and the short protocol and EC all went extremely well! But I don’t want to just take chances with the next FET.

I have a host of thyroid and deficiency issues as it is, I’d rather they get this right.

Thanks for any advice

Does anyone

[Vicky35]

Hi,

I can’t give advice at the moment but I am in a very similar situation and will also prefer to have injections for my FET.

I am 6dp5dt (first IVF) and started bleeding very heavily with very large clots ( sorry TMI 😬) 4dp5dt. We were told we had a very good blastocyst so I can only assume it’s an issue with the Pegesterone pessaries?

It certainly rubs salt into the wound that you have to continue with pessaries until OTD which is Wednesday.

When this started I felt so alone as I hadn’t heard much of this happening to others. I just wanted to let you know I am thinking of you and can update you re what my clinic says once I have a follow up.

I hope your next follow up and cycle goes well.

[Saya85 in reply to Vicky35]

Aww Vicky I’m so sorry to hear that- it sounds almost identical to me.

However I was quite bloated/swollen from mild OHsS, and my ET was difficult- she had to go in 3 times just to get the embryo in. So I’m not sure whether that affected my chances.

I’ve been on microgynon again for a few months and it seems to be working better but there’s still that doubt in my mind.

I wish they would do some tests before OtD whilst ur bleeding to maybe get an idea of our progesterone levels whilst taking the pessaries? Maybe that’s something you could ask on Monday? Or a scan or something for the lining.

Hope all goes well for you at next cycle- they often say frozen works better as less drugs in your system... here’s hoping for both of us 🙏

[Vicky35 in reply to Saya85]

Poor you, it sounds like a really tough cycle for you. Apart from being much more uncomfortable than I expected after EC everything went much better than we expected. I think this made the suprise of bleeding before OTD so tough. Good idea about bloods whilst bleeding. I’m going to ask about that next week.

I really hope your next cycle works for you!

[ditsy999]

Hi lovely, I was just on pressaries for my first cycle which ended up with me bleeding before the 2ww was up. So for my second cycle I did research and insisted on Progesterone Injections aswell as taking the pressaries. They felt I needed more progesterone support. I would definitely push for the injections aswell. They are not cheap if you are paying privately, but I feel like they gave me peace of mind.

[Saya85 in reply to ditsy999]

Thanks! Do you know if they should do any blood tests or something that would point out if you’re more likely to have issues?

I think I need to find out the research again on injections and put it to her again.

What’s got my goat is being charged £200 for the consultation where she basically dismissed my suggestions (which she’d previously suppprted ) and just flapped with consent forms while I filled her in on my history!

So what exactly was I consulted for? Nor did she actually inform me about the treatment plan- saying the nurse would...

I let some things go last time because was nhs funded but I’m paying privately this time and expected better service!

She’s a fantastic doctor but I don’t understand why they have so many issues when they are not even dealing with nHs workloads!

If this is the state of private healthcare God help us... we need to fight for the NHS!

[Saya85 in reply to Saya85]

Also can I ask roughly how much they cost you?

[ditsy999 in reply to Saya85]

Hi,

No mine didnt do any blood tests but they did agree with me when I said I think I need extra progesterone support after I miscarried on the 1st cycle. I am paying £11,100 + Drugs cost. I did a 50% refund 2 cycle through Access Fertility. So I have 2 fresh cycles aswell as many frozen as possible with any extra embryos I have. So far I have done 1 fresh cycle and 2 frozen transfers which were unsuccessful. I am due to start my 2nd fresh cycle next year, so at the end if i am unsuccessful, I get half the money back. The one thing that I didnt realise is that the drugs are an extra cost every time you do a fresh transfer or a frozen transfer. I would tell your Consultant that you would like to have injections aswell as pressaries to help maintain your progesterone level after transfer.

[Saya85 in reply to ditsy999]

Ah thanks. Sorry I meant do you know how much the progesterone injections cost.

Yes I think I will try to fight again to have it considered !

[ditsy999 in reply to Saya85]

Hi, They cost between £8-£10 per injection. I got them from Asda, which is the cheapest place you can buy them from as they don't add any markup to IVF prescriptions.

[Saya85 in reply to ditsy999]

Oh wow brilliant- thanks for the heads up.

[KatieB84]

I had the horrid pessaries first round and my period came few days before OTD on time. I asked my clinic for the injections this time and they let me have them no trouble xx

[Coracle]

Hi. I had my last cycle at a clinic which has v good success rates, although I was unsuccessful. They were much more aggressive with the progesterone. I took utrogestan orally and vaginally and also crinone pessaries. AND Lentogest intramuscular injections three times a week to my bottom. They took my blood few days post transfer and added on Lubion subcut injections to tummy as well! Asda cheapest for everything except the Lentogest I think. Got that via online company, massively cheaper. Can find u name if you want. The only thing is I felt pretty rough on it all, and doing all that as well as ckexane injections I felt a bit like a lab rat. I would avoid the Lentogest if you can and go for all the others xxx

[Saya85 in reply to Coracle]

Wow that sounds a lot! Can they not do scans /tests to check your levels whilst treating you?

I’ve replied below what I was taking

[Cinderella5]

How much did you get told to take pessary wise last time?

I started bleeding before the end of my 2ww. I was so frustrated as I'd asked about extra support after this happening once. When I asked the clinic they said it was unlikely that I wasnt getting enough support, first cycle I was on crinone gel and second cycle was changed to pessaries, 300mg per day (3x100mg). I spoke to my new clinic and they disagreed so gave me stronger pessaries and had to take 800mg (2x400mg) per day and said if I had any sign of bleeding to take another 400mg. I didnt need the extra one as the higher dose did keep the bleeding away but was still unsuccessful but I defo think its worth asking if you can up the dose. I was convinced this was the reason and now I know for sure that the original dose the NHS had me on was not enough!xx

[Saya85]

Thanks ladies- I was on utrogestan vaginal pessaries 3xday (can’t remember exact dose 4-800mg?)

And progynova oral tablets

Whilst I was on microgynon my body would often spot and have heavy bleeding especially if taken back to back.

Reading your comments I think I should push for extra support if there’s no harm in doing so!

[Cinderella5 in reply to Saya85]

I definitely think you should push for more! Its only for a couple of weeks and Im glad I did. I know I didnt get my pregnancy but at least I felt like a had a chance this time as opposed to it being over on day 7 of the 2ww.xx