How many hours of progesterone for medicated FET?

[Meliana]

Hi everyone,I have found this forum to be incredibly helpful both as a source of support and for all the great info and tips from others. I'm wondering what your clinic considers to be the standard hours of progesterone for a fully medicated frozen embryo transfer?

I'm getting ready for my seventh transfer with my last good quality day 5 4BB embryo and I've been told 5 days or 120 hours of progesterone is enough. The only positive pregnancy test that I had was after 132 hours of progesterone but that was with a different clinic and that transfer ended in a chemical pregnancy. To complicate things further I had an ERA done in January 2022 that stated I was receptive at 152 hours of progesterone exposure. The next transfer though of a perfect untested day 5 3AA embryo however was negative for pregnancy. My last transfer also followed the ERA but was negative so my doctor wanted me to repeat the ERA or otherwise do the standard at their clinic which is 5 days of progesterone.

Because the ERA test did not work for me the first time and there is conflicting evidence about whether this test is effective, I decided to just go ahead with this frozen embryo transfer at the standard hours. Now of course my self doubt is creeping in and I'm questioning whether 120 hours is enough. So I'm just wondering how many hours of progesterone did your doctor consider the standard for a medicated frozen embryo?

[Lelo3479]

Hi Meliana, Sorry to hear you've not got your wish so far. I did a bit of reading on Progesterone, and it seems you can have too long on progesterone before transfer as well as too short, it's always complicated. The ERA is only good for 6 months too. The standard is 120+3 as during trials that was the median. Sorry I have no definitive answers. Best wishes x

[Meliana in reply to Lelo3479]

Thanks for taking the time to read my long post and reply. Realistically I know my chances of success at this point are low as this will be my seventh transfer. I think Ill just have to follow what my doctor said and hope for the best. I'm not sure where you are on your IVF journey but hope you are also successful!

[Sunshine809]

Hi, can you ask your clinic to do a blood test to check your progesterone level before transfer?

Mine generally does a blood test 2 days before, but as the clinic is in Spain we couldn't make the dates work this time so we're having the blood test a couple of hours before the transfer. They were fine with that because in the past my progesterone level has been fine, but if it's not they'll give me extra to take that evening.

Best of luck!

[Meliana in reply to Sunshine809]

I appreciate your reply. And yes my doctor asked me to come in the morning before my transfer to check my levels of estrogen and progesterone. It's just that there are conflicting studies about the optimal hours of progesterone exposure - apparently about 80% need about 5 days or 120 hours in a medicated FET which is the standard but for those with recurrent implantation failure 25% have a different window of implantation. My previous clinic used to have a standard of 120 hours of progesterone , but then after their research showed additional hours were needed for most people they changed their standard to 132 hours which was my chemical pregnancy. Obviously since this will be my seventh transfer I know I'm complicated.. I'm trying to stop googling anything else about this now and go into this transfer with a positive mindset. Good luck to you too! I hope you get to have a healthy uneventful pregnancy.

[DancingQu33n]

I’ve always done 5 days for an FET. My clinic does a blood test a few days before to check you’ve got high enough levels before the transfer and will add in extra if needed. I’m already on pessaries and injections so think I must be getting plenty and have never needed to up my dosage after the blood results. What dosage are you taking?

In my first fresh cycle I bled in the tww with just pessaries. That’s never happened again since adding injections

[Meliana]

It's good to know that 5 days worked for you. I'm doing 50 mg (1 mL) progesterone daily and 200 mg progesterone suppository at night. What has been your dose? Even that seems to vary widely with some people saying they take 1.5 ml or 2 ml progesterone etc. My doctor will check my levels though the day before transfer.