* Author Topic: Is measuring progesterone level before embryo transfer usual practice?  (Read 1368 times)

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Offline artistliz

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Thankyou Northern for taking the time to share this. What you have highlighted is completely the heart of the issue. As you say sometimes despite everything IVF doesn't work. We always accepted the uncertainty and genuinely felt we just wanted to try and would be at peace knowing we had tried and done our best. I could be at peace but not sure right now how to...as progesterone is clearly not insignificant and obviously good levels important for implantation. Just having peace of mind to check the levels would have been enough xx

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    Offline artistliz

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    Does anyone know out of interest why some clinics take progesterone very seriously and monitor it? And others don't? Bearing in mind the amount of clinical research out there showing the importance of not too high and not too low progesterone levels...

    Offline Stacey10

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    The clinic I went to in the Czech Republic routinely checks it on the day of transfer, it has to a minimum of 30, if itís under that you risk bleeding before your test date, as progesterone not only changes your lining to receptive, itís stops your lining from coming away. If itís too high it can impede implantation as well, but once implantation has taken place there is no such thing as too high. Some ladies do not absorb progesterone very well and do better on injections, Iím not sure, maybe theyíre not placing them in high enough etc, Iíve always been told that after popping them in you should be still for 20 min and the progesterone should be absorbed by then, and by be still I mean, not racing around, so if you have an office job etc go and sit at you desk for 20 min etc. Many ladies who have immune problems use a high dose of progesterone to start. All of this is for a medicated cycle, not a natural cycle. ďIím usually on 1000mg per day and my levels range between 60-80 from transfer and in early pregnancy.

    Offline artistliz

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    Thankyou Stacey. It seems therefore it is totally pot luck really depending on the clinic and whether they do test. And if you aren't informed about all the issues yourself then its in the lap of the gods....

    Offline Northern

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    it is totally pot luck really depending on the clinic and whether they do test. And if you aren't informed about all the issues yourself then its in the lap of the gods

    Completely agree with this artistliz - in hindsight I really wish I'd known more during my time with Gennet, if I'd known to ask then at least we could have ruled it in/out as a potential issue.
    It amazes me too how some clinics see it as a basic standard to test and others don't bother.

    I'd really like to see some clear charts on what levels should be at certain points in cycle, and the variations in fresh/frozen/natural/medicated etc and what effect all this has.

    It's also frustrating as it shows yet again that you really do need to be your own doctor in ivf - especially after repeated failures.

    Offline Stacey10

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    They should be concerned with the level, the cynic in me thinks itís no skin of their noses as they get you to cycle again, then more money for them, the cynic in me also thinks itís a fine line as to how many the clinics get pregnant vs how many times they can get you to cycle. As much as we like to think they have our best interests at heart, the bottom line is, itís a business for them, and that business is making money.

    Offline artistliz

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    Stacey and Northern you are both absolutely right. I have been totally naive about the whole process despite thinking I was pretty well informed. I always knew it was massive big business and a conveyor belt but foolishly thought the clinics had our best interests at heart. And yes I've learned too late to be my own ivf doctor

    Offline Pognut

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    One counter-argument to that might be that the NHS don't measure it on transfer day as a matter of course, and they don't have a profit motive, it works better for them if it works first time!

    Having said that, I had private treatment after NHS cycles, and when my private clinic did test me before transfer they found my levels were a bit low and upped my dose (it didn't make any difference, no luck at all so far). But my private and NHS clinic's success rates were pretty similar, so who knows...

    Offline AmberJ

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    Pognut, as an ex employee of the NHS I suspect they do the absolute minimum in terms of testing because it increases the cost to them. This can be very short sighted since it may mean that if the woman has a mc she may be able to have another free round on the NHS. Unfortunately, I see it in so many areas of NHS healthcare. Crisis management as opposed to preventative management is the norm.

    Offline missl73

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    My clinic do test as routine despite the director of the clinic really not believing in it! He thinks it is not proven and doesn't think the evidence supports it but presumably other doctors at the clinic do and they hedge their bets and do it just in case as it's not harmful to do so? I think there is some evidence that testing progesterone levels in blood isn't always accurate as a measure of the level of progesterone in your uterus. However, personally from my own experience where I have always fallen pregnant on every cycle (all with very high grade blastos) except for the one where my progesterone was very low, totally believe it's necessary particularly for medicated FETs where your body is not producing it's own. Different forms of progesterone administration are more/less effective and in my case, pessaries were not enough the best thing was intramuscular injections of progesterone in oil (e.g. prontogest) which is more expensive and much more unpleasant but works extremely well. I would always ask for protogest as my progesterone support for any future FET cycle.