How much progesterone prior to FET?

[RockPig]

Hi ladies, I’m wondering what dose of progesterone others have taken to prepare for FET?

After 2 failed transfers of good embryos and I wondered if low progesterone could be my problem so I did a mock cycle to see what was going on. I used the same dose (2x400mg cyclogest/day for 5 days) at the same point in my cycle as I did during my last 2 FETs.

The blood test results came back yesterday at 663nmol/l (or 208ng/ml). The normal range for women in the second half of their cycle is 5-20ng/ml so that’s really high. I’ve previously read that anything over 30 is good so at first I was happy, then I started wondering if it was too high.

I’ve just come across this study ncbi.nlm.nih.gov/pmc/articl... which suggests that serum levels over 20ng/ml on day of transfer are associated with lower pregnancy rates. The suggestion seems to be that too much progesterone makes the endometrium receptive too early so now I’m wondering if the dose is too high.

So, my question is what dose have others used when preparing for FET? My Dr told me that all clinics “everywhere in the world” use this dose - is that true? Has anyone had success with a lower dose?

Thanks for reading this far and sorry for the long post!

[NatureLover78]

I do one Cyclogest pessary 2 days before tfr, then the day before, one in the morning and one at night which then continues at that dose x

[RockPig in reply to NatureLover78]

Hi Nature Lover,

Thanks for replying. That’s interesting, my clinic has me start on 2/day 5 days before transfer. Do you mind me asking how old your embryo was? Mine were both 5 day blasts.

[NatureLover78 in reply to RockPig]

I've had 3 transfers so far. 2 have been 2 day tfrs and one was a 3 day. Each time I have done the same x

[RockPig in reply to NatureLover78]

Ah, that makes sense. Thanks

[Cinderella5]

Hey I can only give you my story, so I usually take 2x400mg of cyclogest. Due to recurrent implantation failure my consultant decided to have me on progesterone for 6 full days instead if 5 in case we were missing my implantation window. I did get my 2xBFP doing this however my levels when checked at my BFP were only 19nmol/l which is around 6ng/ml which is really low. So I guess what I'm saying is this dose for most ladies does work for the majority but for some we need more support and will be on much more next time. Yours does sound on the high side so perhaps you need less and I'm not sure that is good for implantation as I've done a fair bit of reading up on this like you. We are going to test my levels on test day and see how I'm going and adjust from there. I haven't heard back yet what they think the optimum levels are but from my own reading around 80nmol/l which is around 25ng/ml. However I've seen a few ladies on here that their clinic aim for around 100nmol/l. What has your consultant said about your progesterone levels?xx

[RockPig in reply to Cinderella5]

Hi Cinderella,

Thanks, that’s really helpful. I know from previous posts that you’ve had problems with low levels - that was actually what prompted me to test - so the results were a bit of a surprise. I haven’t discussed the results with my consultant yet (it was a home test) but the last time I raised it she basically told me that the same protocol works for everyone and flat out refused to test my levels on transfer day. Your experience just goes to show that’s not true. I’ve come across similar figures to you from my own research, which does seem to suggest my levels are far too high.

Glad you’re starting to get some answers now. Do you have a date for your next FET yet?

[Cinderella5 in reply to RockPig]

Can I ask if you're doing a natural transfer? Do you take other medication before hand like progynova that suppresses your own body producing progesterone? It's frustrating when consultants have a one size fits all approach but hopefully with this evidence they will reluctantly test your levels at the clinic now! I dont have a date to transfer as such but I'm starting meds on October's AF so shouldnt be too long even if it seems like it!😂 Good luck with your clinic.xx

[RockPig in reply to Cinderella5]

No, it’s a medicated FET so I will be taking progynova for first half. I didn’t take the progynova this time so that might have inflated the result a bit but I’m pretty sure I’m not ovulating so not sure it would make much of a difference. October’s not too far away now, it will be your turn this time.

[Cinderella5 in reply to RockPig]

Ahhh I was thinking if you didnt take progynova then you would have ovulated and your natural progesterone may have affected things however if you dont ovulate then I'm not sure!🤔 Puzzling! Defo worth discussing with the clinic! No October will be here soon I'm just impatient!!🤣🤞🏻xx

[Solly-44]

Hiya,

For my first I had 3 x 400mg cyclogest a day, for 5 days before. For my second I had 2 x cyclogest and 2 x lubion injections a day for the same time.

I felt absolutely awful the 2nd time and am convinced my progesterone intake was way too high, but hadn’t seen this study before.

I’m having my levels checked for the first time next transfer day but am skipping the lubion this cycle. For me it wasn’t worth it unless they confirm I really need them.

Good luck! X

[RockPig in reply to Solly-44]

Wow, that is high! I don’t feel too bad on it but I

Have noticed I come crashing down after I stop taking it,

Ike major PMT. Good luck with your next transfer. XX

[Poppy_2018]

My clinic monitor progesterone levels really closely. I was on a medicated FET and 5 days prior to transfer was on cyclogest 400mg twice a day and lubion injection 25mg daily. On the day of my transfer they checked my levels and increased my cyclogest to three times a day (not sure what the actual progesterone level was as I forgot to ask). The day of my hcg bloods they also checked my progesterone levels and said they were 80 (not sure what units as I didnt write it down). I had a positive hcg and they asked me to increase my lubion to twice a day. I'm now 9 weeks pregnant and continue on lubion 25mg twice daily and cyclogest 400mg three times a day x

[RockPig in reply to Poppy_2018]

Hi Poppy, thanks for replying and congratulations on your BFP! From what I’ve read 80 nmol/L is normal for women in their first trimester. It sounds like some women do indeed need much more progesterone than others. Hope everything goes smoothly for you from here on in. XX

[Poppy_2018 in reply to RockPig]

Thank you so much 😊. It's so funny how clinics seem to have different protocols around progesterone and indeed seems like many ladies need a lot more to get the desired levels! I hope you get your answers about your progesterone levels and your next cycle is your BFP! 🤗🌈🤞xx

[Rach82]

This is my first FET. I've been on 3x 400mg cyclogest, plus 3x 4mg progynova daily. It was 3 day transfer so took the cyclogest for 3 days prior. The clinic took a blood test on transfer day to check progesterone level was high enough; it was fine so I didn't need lubion as well.

I don't ovulate naturally so was on the full medicated cycle. The manufacturer's recommended dose of cyclogest is 400mg twice daily. I guess I needed more though.

I hadn't heard of progesterone being too high before, interesting. Best of luck for next time xx

[RockPig in reply to Rach82]

Hi Rach, thanks for replying. Yes, this sounds like the standard dose and it seems to work for most folks so I’m wondering if my strange result was just because I skipped the progynova. I’m so desperate for answers I think I’m clutching at straws. Not sure where you are with your cycle now but good luck wherever you are!

[Rach82 in reply to RockPig]

Thanks i am 3dp3dt so early days, trying to avoid symptom spotting and Doctor Google 😅

[Baypony]

I had 800mg progesterone and started 6 days before transfer. I was also on 6mg Progynova. These doses stayed the same until 12 weeks of pregnancy when I reduced to half and then stopped. I didn’t have any progesterone tests at all. We had 1x 5d blastocyst transferred. We were successful first time. Good luck for your journey xx

[RockPig in reply to Baypony]

Congratulations Baypony! It sounds like most people are on a similar dose, maybe the consultant was talking sense after all! Hope all goes smoothly for the rest of your pregnancy. Xx

[Wishingfortheday]

I was on the same doses of Cyclogest and Progynova as Rach above, only had to have it for 5 days before transfer as it was a 5 day embryo transfer. The doses seemed really high to me compared to other cycles where I was given 200mg Utrogestan 3 times a day. However the high dose cycle has worked - I should mention there are other factors that were different for me this time as well, most importantly that this was our first time trying with donor eggs instead of my own. But it seems the high dose Progesterone certainly did not hurt, and may have contributed to success!! Wishing you all the luck in the world for your next transfer xx

[RockPig in reply to Wishingfortheday]

Thanks Wishingfortheday. Glad it worked out for you. Higher doses certainly seem to do the trick for a lot of folks. Hope all goes smoothly for the rest of your journey. Xx

[Klndmr]

Hey hun. I was on 800 mg if cyclogest day (400 am and 400pm) and injection of Lubion every 3 days as well xx

[RockPig]

Hi Klndmr, thanks. It sounds like a lot of ladies are on more than just 2x400 mg of cyclogest. Hope you’re journey is going well XX

[Kikiwaits]

In my (successful) fresh cycle I took vaginal suppositories, but I can’t remember the dosing at this point. For three FET cycles I have done 1cc injections of progesterone once daily, except for the first day (5 days before transfer) where I had two shots. The first FET failed and I had surgery to remove a hydrosalpynx and endometriosis. Second FET was successful, but ended in miscarriage. The third also worked and I’m almost 9 weeks pregnant (and still getting daily injections). I know my progesterone levels were probably checked with beta HCG bloodwork, but I’ve never been told the results.

Good luck with your next cycle!!

[RockPig in reply to Kikiwaits]

Thanks Kikiwaits. Glad it worked out for you and good luck with the rest of your pregnancy. Xx