Very concerned about progesterone

quickquestion

3 Posts
Reply Posted on: Jan 27, 2012 at 5:28pm
Dr. Braverman

I am 41 and am 10 wks 4 days pregnant after my third IVF. This was an FET. I've had one miscarriage in the past. This pregnancy was from a genetically normal (all chromosomes tested) blast. All has looked fine. Heartbeat 180.

It seems there are 2 schools of thought regarding progesterone. I have been on 1cc progesterone in oil and 1 Endometrin per day. At 8 weeks 6 days, I was told to come off. I did. Two days later, my progesterone was 8.6 and I was told to go back on until 10 weeks at which point I should stop. At that point, even if my progesterone tests come back low, the doctor will not prescribe more. The argument is that 10 weeks is the standard and they don't treat low progesterone after 10 weeks since the placenta takes over (ideally).

I took it an extra few days past 10 weeks. I will be off of the progesterone for only 1 full day before the test (because of the weekend and lab is closed) and last time it was 2 days before the test. The test is tomorrow (I did not take the progesterone today). Here are my questions:

1) Will the progesterone drop enough in 1 day to know if I am at a "safe" level or will this result be inconclusive? They plan on giving me the results Monday, so I'd be off 6 days before I know.
2) If the progesterone is still low, is it safe to stay off the progesterone or am I putting the baby at risk? Or, is continuing to take it a risk?
3) Is it likely that a level of 8.6 at 8 weeks 6 days would be high enough a week later?
4) Should I buffer myself, continue to take some this weekend after the test and wait for the results? If so, how much should I take?
5) What is a safe level for 10 weeks 5 days?
6) If it is low, they will refuse to give me more. What should I do?

I hope this is clear. Thank you for your advice. I am trying to find an answer before I am off the progesterone too long and (possibly) put the pregnancy in jeopardy.

Dr. Braverman

2024 Posts
RE: Very concerned about progesterone Posted on: Jan 27, 2012 at 5:28pm
or the FET cycles I normally cover until12 weeks as there is no corpus luteum they are correct that the placenta takes over as ealry as 8 weeks, we just like to cover incase there is any delay. I think your risk is minimal. I can not make medical recommendations to you with out knowing your case. Understanding that , in any situation I dont see harm in continuing some progesterone for a few days.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

quickquestion

3 Posts
Reply RE: Very concerned about progesterone Posted on: Jan 27, 2012 at 5:29pm
Dr. Braverman:

Thank you very, very much for taking the time to respond. I am quite nervous about having low progesterone when I test tomorrow. It sounds like if it's still low tomorrow (at 10 wks 5 days), I might want to buffer myself a bit and continue the progesterone for another week.

Thanks again. I will sleep easier because of your response.

quickquestion

3 Posts
Reply RE: Very concerned about progesterone Posted on: Jan 27, 2012 at 5:29pm
Dr. Braverman

I have the results of my test. I was off PIO and Endometrin for 1 day. My level is down to 15. I assume it will go down more since they usually test after 2 days. Do you think I should keep taking the PIO and/or Endometrin for another week or is it unlikely it will go down to a dangerous level?
Thank you again.

Dr. Braverman

2024 Posts
RE: Very concerned about progesterone Posted on: Jan 27, 2012 at 5:30pm
again as I dont know all of your case I cant give advice specifically for you as that would not be fair to you. But in general continuing any progesterone until 12 weeks I do not see harmful in any way.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.