Progesterone Levels

[emmiettc]

I advocated for myself on progesterone testing this time around as I started bleeding a week before test date/a week after transfer date last time, which was well before a period is usually due and I was worried it was due to not enough progesterone. Also, with Utrogestan being 3 x 200mg a day and Cyclogest (which I’d used previously) being 2 x 400mg a day – it seems like it’s a smaller dose? I had a blood test right after transfer, and they said either no increased progesterone will be needed if levels are fine, a 4th dose of Utrogestan if marginal, or maybe injections if low progesterone.

They called this morning and said my levels were 43.1, and they consider anything over 35 is good (28-35 marginal, below 28 low). They didn't give units and I don't have anything to compare this to, so I just wanted to check on other people's thoughts or experiences. I know I should just go away and say great it's all fine, but just wanted other's experiences.

Thanks!

[OnRoundEleven]

Hello there. Firstly, good luck with your journey. I hope the transfer works for you.

In answer to your question, I've had a few progesterone level checks on day of embryo transfer acrosss a few different cycles. The progesterone levels have ranged from 41 nmol/L to 94, 112, 122, and 169. I have to admit my successful transfer was when my progesterone level was at 169 nmol/L, however, all the clinics I've spoken to advise that as long as the progesterone is over 35 nmol/L, it should be okay - however just below 100 is preferred. I think everyone responds differently to progesterone, so for my next cycle, I'm going to advocate for a fresh stimulation and egg collection, before they transfer my frozen embryo, as I want to increase my progesterone levels pre-transfer.

In terms of progesterone support, the two clinics that I've most recently attended, have suggested either 2 or 3 cyclogest pessaries a day (with rectal application being preferred as it apparently provides a more stable absorption to vaginal application), and then a prontogest injection every evening.

Post transfer, if the embryo implants, you should see progesterone rising each day. You do need the progesterone to remain over 100 nmol/L I believe.

I hope that helps. Good luck and best wishes.

[emmiettc in reply to OnRoundEleven]

Thank you for the detail here. This is all good to know. The clinic said they can't advise me to up my dose as they're happy with my progesterone level, but that it won't harm. Sounds like it's a positive thing to do, so it's difficult to understand why clinics wouldn't want to do these things just in case!

[DianeArnold Partner Nurse Fertility Network UK in reply to emmiettc]

Hi. Don’t forget your body is making it too, so if your clinic is happy with your result, hopefully you will be on the correct dose for you. Good luck. Diane

[soccerkt6]

Hi lovely, my doctor wanted above 60 nmol/L so I would up your dose a bit.

[emmiettc in reply to soccerkt6]

Thank you. This is helpful to know. I've been Googling like crazy.

[User819020]

Hi, not sure if this is any help but I had my progesterone tested on transfer day last week. They told me it was 45.5 they didn’t say any units to me either, the nurse I spoke to was only relying a message so couldn’t tell me what they wanted it to be just that they were happy with it and to carry on with the progesterone I was on.

I’ve just got a very early / faint positive.

Try and trust your clinic if they’ve said they’re happy with it. Good luck x

[emmiettc in reply to User819020]

Thanks. Congratulations on your early positive!!!

[User819020 in reply to emmiettc]

Thanks so much. Still hasn’t sunk in and still so early, so hoping it stays positive.

This was our fourth transfer and first ever positive after 4 years of trying.

Will keep my fingers crossed for you!! X

[HelzBelzUK]

Progesterone levels peak and fall so you will get different results depending on what time of day you get your bloods taken.

U.K. units are in nmol.. my clinic is in Greece and they measure in pmol so I have to convert everything but they do like it over 100nmol

Good luck with your transfer xx

[emmiettc in reply to HelzBelzUK]

Thanks!

[Twiglet2]

the testing on the day isn’t actually all that helpful as it can fluctuate throughout the day and the following days (so this amount might well be perfectly fine) so my clinic don’t even test the levels, if youve history of bleeding before test date previously they should just up your dose and I found the best thing is just adding in the lubion injection as well as your pessaries, that way you are getting it in 2 forms as some people dont absorb the pessaries as well as others. There isn’t really any harm in upping the levels so I would personally push for them to give you lubion if you can, puts your mind at ease about that being an issue at least xx

[emmiettc in reply to Twiglet2]

Thanks Twiglet. I have pushed but they say its unnecessary. I have 2 weeks of cyclogest left over so I am going to take those aswell as Utrogestan up to my OTD and then if it's positive I will get on to them about more progesterone. Also, if I get spotting I will get on to them (which would be too late for this round but I would have it noted for next round at least). Sigh, I will never understand clinics.

[Twiglet2 in reply to emmiettc]

NHS by any chance? As soon as I was paying for the lubion they were happy to hamd it out to me 🤪 xx

[emmiettc in reply to Twiglet2]

Hmmm it's not NHS. Ahhhhh I don't know now. I'm on 3dp5dt, so the embryo should have already embedded by now.... and I've added the Cyclogest in already..... is it too late for Lubion? Gah I wish my clinic would have just put me on it from the get go when I was raising these concerns.

[Twiglet2 in reply to emmiettc]

It should be absolutely fine! Try not to worry lovely 🥰 especially if you have added cyclogest yourself as well 🤗 have my fingers and toes crossed for you!! Xx

[emmiettc in reply to Twiglet2]

Thanks. I'm feeling a lot happier adding the cyclogest in xxx

[Twiglet2 in reply to emmiettc]

All I had with my son in my first pregnancy was cyclogest on its own so defo helps 🤗 xx

[Glaedy]

Hi,

Before my last transfer I too advocated for testing progesterone - they tested on the same day I had my FET although they made me feel that it's unnecessary because I was given a high dose of progesterone (pessaries) and it turns that I was right - my levels came back as 12.4! Which is considered super low as they want anything over 30, they quickly gave me Lubion shots and my levels went up to 35.8 and they were happy with it. But again not everything went perfect because I was still spotting from time to time, after 2 weeks I started having alergic reaction to Lubion and they told me to stop them, they gave me oral progesterone which I felt awful after taking it so they told me to stop and "hope for the best" because they were out of options.

Luckily for me, my embaby stick and I am now 25 weeks pregnant with this progesterone rollercoaster transfer 🙏 😅

[emmiettc in reply to Glaedy]

Thanks for this Glaedy. What a progesterone roller coaster! So glad you are past all that now and that your clinic listened to you. It's really helpful to hear other people's stories.

[StarsAllAround]

My clinic recently started a study into this. They are currently testing your progesterone levels the day before transfer and if it's below 100 increasing your dose. Mine was 59 the day before transfer so they increased my dosage I'm now on 200mg cyclogest every 8 hours (so 3 times a day) and lubion injection every 12 hours (so twice a day). The nurse told me that they are seeing more positive results since implementing this she said that they have found progesterone can dip massively in the middle of the day if your only taking it morning and night. Also your body will only absorb the progesterone you need any excess will be secreted in your urine so you can't overdose on. I am currently 10 weeks. My previous FET with them earlier this year ended in miscarriage at 7 weeks I had spotting on and off from before test day and was only on cyclogest twice a day for it my progesterone levels were not checked so I do wonder if that was the reason. If you can push for extra progesterone.

[emmiettc in reply to StarsAllAround]

Oh this is very interesting. Below 100! That's a far cry from my number. I wish they had tested before transfer, also; as day of transfer/day after transfer for results seems a bit late! I'm glad your clinic is having better results since implementing this. I don't know why clinics are resistant to and don't seem to read the same information as a lot of us going through the treatment, and we have to advocate for ourselves/do our own research, which seems a bit mad when it's their job day in day out and they're the doctors! I guess they have to actually go by scientific research and we mostly get our information from swathes of people who have been through the same thing. Really; thanks for your input. xxxx

[StarsAllAround in reply to emmiettc]

Yea I find it crazy when I started fertility treatment with them few years back they were against embryo glue they said it didn't work and refused to test progesterone as it wasn't needed. Now they use embryo glue and test progesterone for every transfer. 🙄

[emmiettc in reply to StarsAllAround]

Forgot to say many congratulations on your pregnancy! xxx

[Meliana in reply to StarsAllAround]

Thanks for sharing your experience because my progesterone level before transfer was 64 Ng or 160 nmol. My FET was 2 days ago so I've been worried that my level is too high and could interfere with implantation. I've been doing 50 mg progesterone injection in the morning and 200 mg progesterone suppository at night. My doctor said she is more concerned if progesterone is less than 20 ng. Will be interesting to find out the results of the study at your clinic. If you don't mind me asking- what was your progesterone level before you got your positive?