Going on progesterone without being tested first?

bananers · December 2011

I went in for my D&C post op appointment today. My doctor and I discussed my mc and future TTC plans and I asked her if I could be tested for progesterone levels next time (my luteal phase is on the short side) in case that could have been a potential reason for our loss. She said she could definitely put me on progesterone supplements but that she didn't feel like it's necessary to get tested since there is no harm in going on the supplements either way. This seems odd to me. What do you think?

steph&michael · December 2011

Completely normal, actually. I'm an L&D nurse at a large hospital(5000+ deliveries a year) and after talking with several midwives, drs, our fertility specialist and our maternal-fetal medicine specialists(to clarify: I chat with them at work, I didn't have appointments with tons of people) and they've all said that when you look at the research on progesterone, it doesn't actually make much sense to go through the hassle of testing because adding progesterone can NOT harm a pregnancy, it can only help. When I get pregnant again I'll be on progesterone suppositories right away. HTH.

bananers · December 2011

steph&michael:
Completely normal, actually. I'm an L&D nurse at a large hospital(5000+ deliveries a year) and after talking with several midwives, drs, our fertility specialist and our maternal-fetal medicine specialists(to clarify: I chat with them at work, I didn't have appointments with tons of people) and they've all said that when you look at the research on progesterone, it doesn't actually make much sense to go through the hassle of testing because adding progesterone can NOT harm a pregnancy, it can only help. When I get pregnant again I'll be on progesterone suppositories right away. HTH.

Thanks for the reply. This makes me feel better. Not that I don't trust my doctor but it just seems contradictory to all the posts I've read about people getting tested. Why do you think people go through with the testing then?

steph&michael · December 2011

I think if you've gotten to the point where you truly need to work with an RE then it makes sense to do it as part of the full panel of testing, which tests for a lot more than just progesterone deficiency, but to test for it if that's the only thing you're testing for....you might as well just do the suppositories. It'll fix it(according to some studies....but that's too much to get into) if that's the problem, and if it isn't the problem, it won't hurt.

Additionally, some women need to go on clomid in order to fix their luteal phase and therefore achieve a viable pregnancy, but that's pretty rare. Testing would be helpful to see if that's necessary.

AppleJack83 · December 2011

:raises hand: My Dr has perscribed progesterone for once I get a BFP without testing first. She said there's no conclusive studies either way but it can't hurt. Not a huge bout of confidence, but I am hoping that's what I need

ktsnshn · December 2011

My OB gave me progesterone suppositories to start using as soon as we start TTC again. The plan she gave me was to start using them a day or two after a positive OPK and then use them until AF shows up or I get a BFP. She said that because there is no evidence that the could hurt a pregnancy and could only help. She will test my progesterone with my betas the next time, but I will not have any progesterone testing before.

bluebonnetmeg · December 2011

I was given a progesterone script without being tested as well. The only thing they said was to make sure I had ovulated before using them (it can prevent ovulation if you take them too early.) Good luck!

itsmevkb · December 2011

The idea would be to start using the progesterone right after you ovulate so that it will be in your system when you get pregnant. Using progesterone during the 2ww will almost certainly lengthen your luteal phase as well. If you're using suppositories there wouldn't be much point in testing your blood levels of progesterone as the suppositories but the progesterone into the tissue right where it's needed and it doesn't all make it into your blood stream so the level in your blood isn't really an accurate reflection of how much progesterone there is. There's no such thing as you having too much progesterone so it can only help, not hurt.

Brie2010 · December 2011

PetraStonegirl:
Progesterone support during the 2ww and then the rest of the 1st tri is an empirical treatment. Can't hurt, might help. Many doctors take this approach and just write the prescription.
One of the reasons you see people getting testing, instead of just getting the prescription, is because there are some doctors who feel that because there is no direct evidence (that they give credence to) that it might help, and it is an expensive treatment that many insurances don't cover, they need a documented reason to prescribe it.
I agree that progesterone is expensive (my compounded suppositories were $575 for 12 weeks worth, not covered by insurance). However the bit about the test being expensive is bull. Quest Diagnostics charges $78 (insurance didn't even blink and covered $45 of that).
But, the other reason you will see women getting tested, is that it's a diagnostic tool to evaluate the 'strength' of the ovulation. For example, I had abysmal progesterone levels at 7DPO (with clear thermal shift), and my OB interpreted that as me Oing immature eggs thus failing to develop a strong corpus lutem. This and the failure of our Clomid cycles was the reason my RE moved me right to injectables, to control the maturation of the eggs directly.

Have you tried Prometrium? My midwives in my first pregnancy prescribed Crinone supps, which were about $450/month AFTER my very good insurance.

Luckily, the pharmacy (and every pharmacy in my area) was out, so they subbed Prometrium, which can be taken orally or vaginally. I pay $40 for a 30 day supply now. While I obviously haven't had success yet, after 4 days on Prometrium my progesterone went from 8 to 41, so we know it works on that level.

Anyway, something worth looking into.

OP: I was tested for low progesterone in my first PG because of spotting. By the time I started supplementation, it was already too late. Because of this history, my new OB and I agreed I will supp from 3DPO-14DPO (or longer if a BFP) just in case. If this strategy doesn't work in the coming months, we will proceed to more in-depth testing.

ReeceFamily · December 2011

ktsnshn:
My OB gave me progesterone suppositories to start using as soon as we start TTC again. The plan she gave me was to start using them a day or two after a positive OPK and then use them until AF shows up or I get a BFP. She said that because there is no evidence that the could hurt a pregnancy and could only help. She will test my progesterone with my betas the next time, but I will not have any progesterone testing before.

This is exactly what my OB said. He also warned me about the side effects (tired and bloated). Oh, joy!

RedRose84 · December 2011

I went on progesterone during my pregnancy and my levels were normal. My doctor wanted me to take them "just in case" and said there was no harm in doing so. I think it's a nice back up and makes you feel better too. Maybe it will help your LP too. :]

Want a personalized experience?

Going on progesterone without being tested first?

Re: Going on progesterone without being tested first?

Choose Another Board

Search Boards