Progesterone levels too high?

[singleswimmer]

Hi there, I had my levels checked yesterday - transfer day (day 5 blast) in a fresh IVF cycle - and the clinic said they were “fine” and to continue with cyclogest 400mg pessaries three times a day (1200mg per day). I asked for the number and they said >254nmol/L which seems really high. They did explain earlier that because I had 10 eggs retrieved (from about 14 follicles over 10mm) that they thought this needed more than twice a day cyclogest because of higher estrogen levels creating relative progesterone insensitivity. Does anyone else have experience of high progesterone on transfer day? Does it sound ok?

[Purpledoggy]

Mine was 549nmol/L transfer day and got my BFP. There is some evidence high can be detrimental but in general too high seems to be better than too low xx

[singleswimmer in reply to Purpledoggy]

Thankyou!! They don’t measure it over 284 so who knows how high mine is 🤷🏻‍♀️but good to know I’m not the first :))

[singleswimmer in reply to Purpledoggy]

Btw Purpledoggy I read through your previous post and saw your rpt levels a few days later were only 75nmol/L - did you ever find out from the clinic if they were that high to start with?

[Purpledoggy in reply to singleswimmer]

If you mean my natural progesterone then that is quite low. I don’t know how high my progesterone was before my successful transfer day but it was measured through the clinic (at the nearby major hospital) on transfer day. I had it measured one more time around BFP and it was 160nmol/L so it seems to bounce around xx

[singleswimmer in reply to Purpledoggy]

Ah ok, so it went from 550 on transfer day to 75 to 160 in the same cycle? II'm going to try calling the clinic tomorrow, like you did , to check they haven't made some basic error... did you ever end up double-checking your transfer day result? It would be unusual for a major hospital to get that wrong.

[singleswimmer in reply to singleswimmer]

Thankyou btw 🙏

[Purpledoggy in reply to singleswimmer]

My clinic flat refused to look into it 🤷🏻‍♀️ They assumed it was correct and the lab doesn’t speak with patients directly. Yes the level seemed to really bounce around in the same cycle despite very consistent administration and sampling times. Seems to be a common thing though xx

[singleswimmer in reply to Purpledoggy]

Thankyou! You’ve possibly rescued my night’s sleep hehe.

[singleswimmer]

This article is quite reassuring fcionline.com/fertility-blo....

"Is progesterone safe for my baby and me?Natural progesterone, which is used during fertility treatment, poses no threat to a mother and child. It is important to note that the Food and Drug Administration (FDA) does not differentiate between natural progesterone and synthetic progesterone (progestins) in its warnings. Progestins are mostly used to suppress ovulation and are found in birth control pills. They are only used in preparation for fertility treatment. In older studies synthetic progestins have been linked to a slightly increased risk of certain birth defects if used during pregnancy. The FDA has conducted a thorough review of relevant published studies and has found there is no increase in birth defects resulting from exposure to any progesterone in early pregnancy."

[ChloeDE]

Progesterone levels also fluctuate a lot. Mine was as low as 29 and as high as almost 1000. My pregnancy was successful.

[WinnieM]

My doctor says the higher the better for transfer success

[singleswimmer]

Thanks++ Purpledoggy ChloeDE WinnieM - the clinic sent a reassuring email today and a friend of mine who’s an IVF specialist in australia also confirmed its fine. The irony is I think the high levels (and bloating - I felt like a beached minke whale carcass on waking this am) we’re partly responsible for my progesterone meltdown last night! But a lot more relaxed today. I know my IVF friend from when we did our hospital internship together and she’s just made the point that this clinic seem to know what they’re doing and so it’s time to trust them and try to switch off my doctor brain. I realised I DO trust this clinic, but because I changed to them after an endless series of problematic encounters with the previous clinic that created ridiculous amounts of unnecessary stress in retrospect, I have a ‘damaged trust’ hangover. As a doctor (with almost zero understanding of assisted reproduction prior to starting this as a patient) going through international IVF in a pandemic, I’ve decided to pen something about ‘trusting the clinic’ because it’s a theme that comes up in this forum, and while I think it’s good in theory I also think - to an extent - it has to be earned (through good communication, empathy, and clear rationales to aid decision-making). Anyway happily my current one has done this so I’m going to try to let go of the reigns now.

On a related note, this forum is v helpful for soundboarding and support - and such a wealth of experience contained in its posts! Will be curious to get others’ take on this trust issue, beyond what I’ve already seen posted.

[Purpledoggy in reply to singleswimmer]

I agree trusting the clinic is important but needs to be earned. (I feel the same way about all doctors TBH as I have had some real clangers over the years eg GP trying to tell me dermatophytes are commensals and you don’t catch them from animals, having sought advice as a vet student regarding the ringworm I just caught from a patient 🤦‍♀️). It doesn’t help that clinics do very different things, sometimes against current literature, which doesn’t inspire confidence if they aren’t willing to explain why (I do get the irony of this given current occupation 😜 but then I am willing to justify with literature what I do) xx

[singleswimmer in reply to Purpledoggy]

Yup def, totes agree with all of the above, well put 🙌🏻. Like you I have often felt the same way about doctor encounters when I’ve been a non-IVF patient or had friends/family with medical problems - always interesting and thought-provoking to be on the “other side”..