Can there be too much progesterone?


#1

For my first 2 transfers, I did Progesterone in oil(PIO) and both were BFN. I am wondering if there can be such a thing as too much progesterone for implantation.I am doing progesterone suppositories and hcg shots this cycle. Don’t know if this is enough or should I add in PIO? So confusing.

Anyone have any thoughts on this?


#2

[quote=Miracle#1]For my first 2 transfers, I did Progesterone in oil(PIO) and both were BFN. I am wondering if there can be such a thing as too much progesterone for implantation.I am doing progesterone suppositories and hcg shots this cycle. Don’t know if this is enough or should I add in PIO? So confusing.

Anyone have any thoughts on this?[/quote]

I don’t know any doctor who thinks so. Most often, there is only a lower threshold, usually 15 or 20 ng/ml, sometimes 10 ng/ml. I’ve never seen a protocol with an upper limit. Some patients have very high progesterone levels because of follicular production, well above 100 ng/ml, and we temporarily discontinue their progesterone because they don’t need to use their supplements at that time, but not because we believe it would harm their pregnancy.

Low progesterone is a problem. One report suggested pregnancies should be kept above 6.5 ng/ml.


#3

I think the density of the lining can impact implantation but i think the solution to that would be thinners like aspirin or some women have pineapple - ofc check with your doctor first.


#4

Ghost I would love to hear your opinion…I had ER Friday and injected 100mg of PEO. However, I am using PEO that was leftover from IVF #1 and it says not to use after July 2011. I called my coordinator and she said it is fine, but that she would order some more but I won’t get it until Monday or Tuesday. Concerned that the PEO was bad I used a progesterone suppository last night and was going to do one this morning and evening, but I am concerned about too much progesterone. I was only supposed to do 100mg of PEO every other day until ET.

What do you think?


#5

[quote=Pinkandstrong]Ghost I would love to hear your opinion…I had ER Friday and injected 100mg of PEO. However, I am using PEO that was leftover from IVF #1 and it says not to use after July 2011. I called my coordinator and she said it is fine, but that she would order some more but I won’t get it until Monday or Tuesday. Concerned that the PEO was bad I used a progesterone suppository last night and was going to do one this morning and evening, but I am concerned about too much progesterone. I was only supposed to do 100mg of PEO every other day until ET.

What do you think?[/quote]

I don’t know of any RE that thinks there is too much progesterone for a pregnancy.


#6

I was on two shots a day for one of my cycles, and on one of the others I was on a suppository and the shot each day. The two shots a day was my successful pregnancy! I would not worry about too much, I have only heard of too little being a problem. I was on so much PIO because my levels had dropped for some reason. Good luck to you, try not to worry!


#7

Ghost,Is it advisable to do both hcg shots and PIO shots at the same time? Has anyone else done both? Tomorrow is my embryo transfer and I am still deciding if I want to do the PIO shots.


#8

The most common use for hCG injections in the luteal phase is to promote progesterone production by the follicles (and to sustain the follicles). A less common reason is an idea that it might directly promote implantation.

The risk with hCG injection is that in some patients it might increase their risk of OHSS. Not the case with progesterone. For that reason, most clinics wiill not give an hCG booster to patients at risk for OHSS. But otherwise, the use of one or the other, or both, is pretty common. It’s more common to just use progesterone alone.


#9

Thanks Ghost, I did 2cc PIO shots last night in addition to hcg shots 1000 units(very low dose) and progesterone suppositories. Embryo transfer is today. I will probably do PIO every other day. For my last 2 transfer I had slight sore throat and mild cramps right after transfer. So maybe it was more my immune system attacking the embryo and not too much progesterone. I am doing an FET so no risk of OHSS. I am also adding in immune treatments. I have read that for immune issues it is better to have higher progesterone. Have you read that?


#10

I go to the Cooper Center and Dr. Check loves progesterone. He likes it high and has done studies that show having extra progesterone in the luteal phase can help with immune issues. He does ultrasound and bloodwork 3 days after transfer to check the lining, E2, and progesterone. Mine was 66 and he wanted it higher so I added another suppository. He says that the more progesterone the better and something he is doing works because they do over 1,300 cycles a year and have about a 50% live birth rate.


#11

That’s interesting b&a. I have an lp defect and I never got progesterone for any of my 6 iui’s. I got standard dosage for ivf. probably need more than someone with a normal lp. hummmm

Alicia


#12

My RE also likes my progesterone to be really, really high. Last check at transfer it was over 100 and he increased my PIO. I am also on inserts which do not really absorb into the bloodstream. I am intrigued by the comments about it helping immune issues. i have never heard that before - now I have something new to google! Thanks ladies!


#13

[quote=sunrisec]That’s interesting b&a. I have an lp defect and I never got progesterone for any of my 6 iui’s. I got standard dosage for ivf. probably need more than someone with a normal lp. hummmm

Alicia[/quote]

Dr. Check always does high progesterone for IUI or natural ecspecially for LD. I have LD as well and he also found by doing a culture that I was progesterone defecient. He said most women with LD have low levels of progesterone and need heavy supplementation after ovulation. It is amazing how many women he has treated successfully with high fsh, low amh, and DOR with just progesterone after natural or IUI.