Brand new BFP, and a question on progesterone dosages

ReeceFamily

Hi!  I got my BFP this morning.  I am excited in a very subdued, worried kind of way . I can actually imagine a real baby at the end of 9 months, which I could not last time (my mind was in a darker, more pessimistic place), so I hope that is a good sign.

And so the paranoia begins !!  Because of my history of miscarriage, I am on prometrium, those yellow 200 mg pills, orally, once per day.  My first appointment with my OB will be at about the 6.5 week mark. I have two questions for you all:

1) I am totally paranoid that this prescription isn't sufficient, and I'm trying to decide whether to bug my OB to re-evaluate my prescription. I have heard that you should insert the pill vaginally, that it is more effective?  For those of you taking progesterone, what dosage are you taking? And what method?  Yellow pill orally?  Yellow pill vaginally?  Some other sort of suppository vaginally?  Anyone know any good research on this?  I can't find any.

2) Also - any thoughts on whether I should push for hormone testing before the 6.5 week mark?

Sorry about all the questions! I'm really looking forward to getting to know all of you in the coming weeks (and hopefully months)! 

monkeymommie

I have no good research and just know that nit everyone recommends progesterone supplements.  My dr. told me with ds#2 8 years ago (same low progesterone problem then as now) that the research just showed that high progesterone was associated with healthy pregnancies but the exact correlation wasn't known (like a what comes first chicken or egg kind of thing).  Of course, he told me that 8 years ago so people might know more now!

But to answer your dosage question, I am on 200 mg pills (yes, a little yellow pill) that I take 3 times a day vaginally.  So for whatever reason I am taking a lot more than you, and am taking it differently.  I think a test at 6.5 weeks is probably fine.  I got tested at 7.5 weeks and started progesterone then, and for DS#2 I got it around 6 weeks.

benoitfan

RF, I am so freakin happy to see you back here!  Whoo hoo!

As for your progesterone questions, I have no experience, so I'm no help there.  An appt at 6.5w is probably fine, but if you want a little re-assurance before then, call the doc and request repeat beta draws now.  You could also ask for repeat progesterone tests so you can see if the oral tablets and dosage are working for you.  Given your loss history, your OB should be willing to order the blood draws.  If they aren't willing to give the orders, could you approach your GP/family doc give the order?

GL to you RF.  I hope you get all the answers you are looking for and some early rea-assurance that this is infact your rainbow baby!  Congrats!

ReeceFamily

Thank you for the warm welcome, I am excited to be here with you again!

And good advice - I just touched base with DH on this and he basically said just what you said.  I'm going to call my OB again tomorrow! 

ReeceFamily

Thanks for the input, I am going to ask a few follow up questions of my OB!

SaintCity

I have no info to share on progesterone, but just wanted to say "welcome" and congrats on your BFP!

ShellBear+

Congrats!  First off yes I would ask for an hcg and progesterone check right now.  With your history they should be willing to do that.  Its more for peace of mind that things are progressing normally.  Also you may not even have low progesterone. 

 I am taking endometrin suppositories but I am seeing an RE.  My last pregnancy my OB did prescribe me oral prometrium as you describe.  My RE told me that is basically useless and they don't use that.  I don't know but that is just what she told me.   If you do have low progestorone I would at least ask your OB about taking them vaginally or getting something else.  I know others talk about using crinone. 

GracieBlue

I have no advice but I wanted to say congrats.  I remember you from the June BMB.  I am so freaking excited for you!!!

kac003

Hi, I am new to the bump and the forums.  After 7 years of TTC with infertility treatments we finally got our BFP. 

I was on a progesterone suppository called Crinone, since we conceived this baby through IVF I started it the say of my embryo transfer and took it for the first tri-mester.  I did one in the morning and one at night. 

I would definently ask your OB to check your hormones now, if anything it will give you piece of mind to see that everything is going good!

itsmevkb

I am all about the progesterone so my advice would be call your doc now and ask for a higher dose and yes, use it vaginally rather than orally.  There are tons of studies out there showing that progesterone taken orally immediately begins to be broken down by your liver and isn't nearly as effective as using it vaginally or using injectable progesterone in oil.  Just be aware that when you use it vaginally it is absorbed into the tissues and is not accurately reflected in your blood levels.  So, your levels are actually higher than your blood tests will show.

With my last pregnancy (which was successful) and with my current pregnancy, I use two yellow pills (200mg each) in the morning and two at night for a total of 800mg per day.  It's a super high dose but hey, you can't have too much progesterone and this way I'm confident I'm getting enough.  Using them vaginally is messy but just wear a liner.

Good luck!

hmontty

I take progesterone because I do not produce enough naturally to get pregnant or maintain an early pregnancy.

With DD, I took 400 mg once a day through 14 weeks, and that worked fine. Had my level tested at like 4 weeks and it was over 20. Never had it tested again, but everything progressed well.

With this pregnancy, I went in at 6w4d specifically to ask them to test my progesterone, on a hunch. Baby was on track with a HB, but despite being on the same prescription as with DD, progesterone was only a 13. My doc doubled my dose to 400 mg twice a day. I go in again at 8w2d for another test.

So yes, I would have your level tested. Even if your current dosage worked before or seemed sufficient before, obviously things can change.

Personally I have heard that the pills do not work as well as suppositories. Progesterone has a very short half-life, and the pills do not keep the levels in the bloodstream higher as long as suppositories do.

I use pharmacy-compounded suppositories, which use natural (not synthetic) progesterone. You just stick them in with your clean finger. I like them. My current (new) OB only prescribes the pills, but I insisted on the suppositories, which I have shipped from Glen Rock Medical Pharmacy in New Jersey. He was OK with that.

I am not sure you should stick the pills into your cervix. Maybe some people use them that way, but they are probably designed to dissolve in the stomach and not in the cervix. I have to question their efficacy if used as a suppository for that reason.

kirac

I take 2 200mg/day as a suppository.  It is more effective as a suppository than orally.  My fertility doctor says 2 or 3 a day is usually recommended.  You should ask for a test.  GL.

EEG08

I got pregnant through IVF and I am on progesterone vaginal suppositories, 100mgs 3x a day.  I go weekly for blood work to check my level. I would bug them for at least blood work since this is the time when your level has to be sufficient, plus you would worry less, and that is always good for you and the baby.

ReeceFamily

Thanks for the great info!  Do you have to have a prescription for the suppositories, or can you just order them on your own?

itsmevkb

ReeceFamily:

Thanks for the great info!  Do you have to have a prescription for the suppositories, or can you just order them on your own?

You need a prescription but the if you're using the yellow, prometrium capsule like pills those can be taken orally or inserted vaginally.  They don't give you a different kind based on oral or vaginal (at least not of prometrium).

EEG08

It is a prescription.