How do you know the placenta has taken over?

liz4paws

Sorry I'm a PW this morning. 

I'm supposed to start weaning off my meds this week (9w) and stop completely at 10w. My RE doesn't plan to do bloodwork and we will just stop blindly and it has me terrified. I've read online REs have lots of differing approaches as to when and how to do this, but it seems like mine is a little earlier than most with no bloodwork involved. I'm thinking about going an extra week before weaning/stopping because I have leftover PIO and I just don't want to take any chances.

How did your RE decide to stop your meds? And is there any way to definitively know the placenta has taken over? Or at least a good indication of it? This going blind stuff is scaring the bejebus out of me. I tend to have low progesterone anyway and am on 2mL which is 2x what most people take. Way too much at stake to get this wrong, as we all know!

PhillyJ33

My RE stopped my meds cold turkey at 10 weeks- no blood was drawn. It scared the crap out of me (as much as I was looking forward to ending PIO injections) but it all worked out. He has been doing this forever so I just put me trust in that... If you are scared, can you ask for bloodwork to be done? That sounds like a reasonable request!
As far as your placenta question, I have no idea of there is any way to tell from a testing perspective. Hopefully others can help!
Good luck!!

jezebel57

i stopped PIO at 8 weeks due to an abscess with no bloodworm done.  i stopped estrace and crinone at 12 weeks blindly.  i was freaking out because i was thinking "but how do i KNOW?!!!".  i think 10 weeks is absolutely fine.  i've heard anywhere between 8-12 is typical.  

MJC1116

It's scary. My doctor stopped me cold turkey at 9 weeks and I still had 3 schs, which I know is unrelated but in my paif head it seemed scary. During a previous us, re found the placenta and told me it "looked good." No blood work either. By that point, i trusted her wholeheartedly. It is scary but trust your re that you'll be ok!

missusw218

I also stopped Estrace and Endometrin at 10 weeks. I was worried, but those were the RE's orders, so I followed them! I haven't had any unwelcome surprises, so I guess everything is a-ok!

FutureMrsW9

My graduation day was 11/14, so a little over 8 weeks, and I stopped my meds on 11/26, at exactly 10 weeks and haven't seen my RE since nor had any bloodwork other than what my OB drew at my first appt with her, which I have no idea what she was even looking for.  I think your protocol sounds normal.  I was worried, too, and my nurse said I could wean if I wanted but it really wasn't necessary so I said screw it, I'm sick of shooting up PIO everyday and just stopped.  Now I'm 15+ weeks and going strong :-)  The only thing I really noticed at first were some mild cramping and nausea picked up for a few days, but I think it was just from the fluctuation in hormones, which is to be expected.

liz4paws

Thanks so much, ladies! I'm glad to hear that some of you stopped this early and it was okay. I emailed my RE nurse earlier this week and asked for a blood work confirmation but she hasn't responded and I kind of think she will say no (that's just how they are.) Just because I have leftover PIO, I think I'll keep going for a week and then taper but I feel better about it. Just wish there was a way to know! Thanks for the support.

Jenn06L80

I had low progesterone my whole first trimester and was on PIO and Crinone.  My RE told me I could stop at 10 weeks too.  I also had leftover PIO and Crinone so I just alternated them every other day until they where done at around 12 weeks.  

liz4paws

Thanks, ladies! My RE nurse just called to tell me she would allow me to extend the weaning to be completely off by 11w. After that, she was concerned going too long could affect baby's sex organs. She said I could drop my dose of PIO and estrace to half this week every day, then go to every other day next week, then be totally off after that. 

She also explained that the placenta can sustain the baby on lower levels of progesterone than what was required in the earlier part of pregnancy (>20 is what my RE originally wanted.) So doing bloodwork tends to stress patients out because it can come back at like 13 and still be perfectly fine. Figured I'd share the outcome since I didn't know the sex organs thing or the lower p4 levels once the placenta kicks in.

I point blanked asked her if they have ever had problems with the stopping of meds at 10w, and she quickly said no. That gave me peace of mind too.

Thanks for the support and I'm happy with my REs plan!

RosyGlow

missusw218 said:

I also stopped Estrace and Endometrin at 10 weeks. I was worried, but those were the RE's orders, so I followed them! I haven't had any unwelcome surprises, so I guess everything is a-ok!

Same here - except for me it was Progesterone and Estrace. I stopped at 10 weeks, and it was cold turkey! I was worried, but my RE told me that it's fine...that 10 weeks is slightly longer than needed anyway! Good luck @Liz4Paws, I'm really excited for you! 

amb2013

I remember that fear! My office stops progesterone early, like around 9 weeks. I explained how nervous I was especially since my levels dipped to 7 at one point. So they kept me on longer, I don't remember exactly but I think around 11 weeks. My RE said so many patients are nervous about stopping and he worked with me to make me feel better about it. He said REs tend to over do the progesterone.

curlylocks3

I stopped completely at 11w4d, no bloodwork. The only thing that I did different is that my RE wanted to wean me off the PIO (I was on the same dose as you) around 9.5 weeks and have me take Endometrin until I totally stopped. I was worried about spotting, leaking, etc, so asked to stay on PIO and they said if I wanted to I could, they were just trying to save my achy butt!
I was really nervous about it but happily surprised that being off the meds seemed to help my nausea a bit too