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Ideal time to start progesterone post ovulation debate

progesterone ovulation

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2 replies to this topic

#1 Sweet_Pea

Sweet_Pea
  • Member
  • 67 posts
  • Gender:Female
  • Location:Toronto, Ontario
  • Dx:Unexplained
  • My Clinic:Hannam, Create

Posted 24 July 2016 - 02:40 PM

Hi all,

 

I'm just dabbling with low dose gonal f and trigger (fully monitored of course) while I'm waiting for IVF 2.5 in September. It's so funny how using clomid, letrozole, or injectables used to be such a huge deal to me, but now I think nothing of it. If it wasn't for the $$$, IVF doesn't even feel like a big deal anymore.

 

Anyway, I was listening to an RE on a podcast, and she said taking progesterone the day after ovulation is too early (which is in almost every IUI protocol). She said it slows down the cilia in the fallopian tubes, and can increase the chances of an ectopic. She also said it should only be taken around the time of implantation, because taking it too soon can turn on the receptivity genes in the uterine lining too early (while the embryo is still in the tubes). Apparently the receptive uterus is only good for 24-48 hours, so the window can be totally missed even with a healthy embryo.

 

I've been doing the progesterone 1dpo for every cycle, but I'm considering doing it 3/4 dpo. Does anyone know any more about this? If there's some truth to this, it's very strange that virtually every protocol I've seen has us taking it 1dpo.

 

Thanks!


Me: 37, amh 11.9 pmol, AFC 14-26 depending on month

FSH 7-12 (12 happened one random time after a lot of meds. It's usually around 7)

Compound heterozygous for MTHFR

Hypothyroid

 

DH: 42, SA is perfect and DNA frag completely normal

 

TTC since July 2014

Many many rounds of meds (clomid, fsh, letrozole), 4 IUIs, 5 chemicals but nothing more

 

IVF #1 (Feb 2016):

BCPs 3 weeks, 450IU gonal, 75 IU luveris, and Cetrotide as antagonist

Cancelled because 6 lead follicles were over 1.5 cm after only 3 days of stims!

Should've kept going because I ended up with 12 follicles and estradiol was 11,000.

Obviously they wouldn't let me try naturally, but kind of wish I did. This process is draining sad.png

 

IVF #1.2 (March 2016):

Natural Start. Same protocol as above and same thing happened.

6 lead follicles took off and were over 1.5 cm by day 3 (wonder if this is d/t high dosage)

12 follicles, 6 retrieved, 4 mature, all 4 fertilized

3 perfect by day 3, all arrested by day 5, nothing to transfer

 

IVF #2 (November 2016)

Switched clinics to Create.

Currently in full workup. Doing immunology and clotting testing, along with hysteroscopy to r/o anything other RE may have missed

Will have natural start, and do letrozole with 275IU gonal F 

 

UPDATE October 2016: Natural BFP while waiting to start IVF in November. We're floored! th_abfp.gif

1st Beta 685 at 16dpo

2nd Beta 2468 at 19dpo

3rd Beta 5445 at 22dpo

4th Beta 11,618 at 25dpo (why on earth is my RE doing so many Betas?!)

U/S 6w4d:  perfectly on schedule. HB 132. RE said there's only a 5% miscarriage rate at this point!

U/S 10w3d: growth still on schedule. HB 173.

Harmony results came back. Looks like a healthy GIRL!!!

 

#2 LittleFlame

LittleFlame
  • Member
  • 40 posts
  • Gender:Female
  • Location:DC
  • Dx:Other
  • My Clinic:SGF

Posted 28 July 2016 - 04:40 PM

Wow, I have never heard of that before. The body would naturally start producing progesterone to prepare for implantation after ovulation - when the burst follicle turns into the corpus luteum (Not totally sure that's the correct term) it starts producing progesterone and will continue to do so until the placenta is at a point where it can produce it, I think somewhere in late first trimester. I know that women who have elevated levels of progesterone at retrieval or due to cysts (which also produce progesterone) often have to wait for the transfer until the levels go back down but the timing of the progesterone protocol seems highly calibrated to the natural cycle. Maybe the RE you heard speaking was cutting edge or slightly controversial. It might be worth it to talk to your own RE. It seems like a bad idea to change your protocol on your own without getting some expert advise - maybe put this question in "ask the RE" section? 


2010: At age 37, fall in love with husband (36). Start discussing adoption immediately as I am assume I can't get pregnant at my age and because I have always had very irregular and infrequent cycles  - will be diagnosed with PCOS in 2014. Spontaneous (and obviously completely astonished at our luck) pregnancy.

2011(38) : Get married and our son is born. 

2012 (39): TTC for a sibling

2013 (40) : 4 rounds of clomid prescribed by Ob/Gyn

2014 (41): Referred to fertility specialist. Diagnosis - Advanced age and PCOS. 3 failed IUIs

2015 (42): Start IVF

May 2015: IVF#1 - 29 retrieved, 19 mature, 10 fertilized. 2 5-day blasts transferred (Assisted Hatching -AH used). 1 frozen (testing later revealed it was abnormal)

Chemical Pregnancy that ends in June.

Good to know the process itself works, but decide to bank & do PGS testing in 2 more rounds to try to find a good egg and avoid another painful emotional battle of hope and despair when a pregnancy is not viable. 

October 2015: IVF Retrieval #2 - 19 retrieved, 12 mature, 7 fertilize w/ICSI, 2 frozen, 1 normal.

Nov-Dec 2015: Freak out that out of almost 50 eggs, only 1, 1! made it to a chromosomally normal embryo. Start avoiding phalates, eating more plant-based proteins, and doing anything else I can find, legitimate or not, that promises to increase egg quality. It's a dark time. 

December 2015: IVF Retrieval #3 - 31 retrieved, 24 mature, 21 fertilized w/ICSI, 8 frozen, 3 normal

 2016 (43) : Start FETs

March 24, 2016: FET# of 1 blastocyst. BFN.

May 19, 2016: FET #2 of 1 blastocyst. BFN

July 20, 2016: FET #3. Planned to transfer 2 blasts, only 1 survived the thaw. Positive. Lost pregnancy just past 6 weeks.

No more Fertility treatments.  

 

 


#3 Sweet_Pea

Sweet_Pea
  • Member
  • 67 posts
  • Gender:Female
  • Location:Toronto, Ontario
  • Dx:Unexplained
  • My Clinic:Hannam, Create

Posted 14 August 2016 - 01:52 PM

Thanks for the reply LittleFlame! It was Dr. Alison Rogers from the Podcast "Beat Infertility". It's awesome - you should check it out.

 

I think what she was saying is that yes, progesterone is naturally produced immediately after ovulation from the corpus luteum. However, it's the peak progesterone when implantation occurs around 5-10dpo.

 

The progesterone given by these clinics is way past physiological production, and that immediate peak at 1dpo is not what the body would do naturally. Interesting thought, but at the same time TONS of women get pregnant after taking progesterone 1dpo. However, what if taking it a few days later can increases chances by a few more percent?

 

Something to definitely ask my RE, but I'm sure she'll say she's never heard of this.


Me: 37, amh 11.9 pmol, AFC 14-26 depending on month

FSH 7-12 (12 happened one random time after a lot of meds. It's usually around 7)

Compound heterozygous for MTHFR

Hypothyroid

 

DH: 42, SA is perfect and DNA frag completely normal

 

TTC since July 2014

Many many rounds of meds (clomid, fsh, letrozole), 4 IUIs, 5 chemicals but nothing more

 

IVF #1 (Feb 2016):

BCPs 3 weeks, 450IU gonal, 75 IU luveris, and Cetrotide as antagonist

Cancelled because 6 lead follicles were over 1.5 cm after only 3 days of stims!

Should've kept going because I ended up with 12 follicles and estradiol was 11,000.

Obviously they wouldn't let me try naturally, but kind of wish I did. This process is draining sad.png

 

IVF #1.2 (March 2016):

Natural Start. Same protocol as above and same thing happened.

6 lead follicles took off and were over 1.5 cm by day 3 (wonder if this is d/t high dosage)

12 follicles, 6 retrieved, 4 mature, all 4 fertilized

3 perfect by day 3, all arrested by day 5, nothing to transfer

 

IVF #2 (November 2016)

Switched clinics to Create.

Currently in full workup. Doing immunology and clotting testing, along with hysteroscopy to r/o anything other RE may have missed

Will have natural start, and do letrozole with 275IU gonal F 

 

UPDATE October 2016: Natural BFP while waiting to start IVF in November. We're floored! th_abfp.gif

1st Beta 685 at 16dpo

2nd Beta 2468 at 19dpo

3rd Beta 5445 at 22dpo

4th Beta 11,618 at 25dpo (why on earth is my RE doing so many Betas?!)

U/S 6w4d:  perfectly on schedule. HB 132. RE said there's only a 5% miscarriage rate at this point!

U/S 10w3d: growth still on schedule. HB 173.

Harmony results came back. Looks like a healthy GIRL!!!

 





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