I had my blood drawn Friday to check estrogen and progesterone levels and for the life of me couldn't get the results! It took paging the on call folks at my local clinic twice - once yesterday, once today - to finally get the numbers.
So...
estrogen looks great at 1,043
progesterone looks...eh...
at 22.
Despite this, I was advised to cut all the progesterone supplementation by a different nurse than I usually deal with in Denver. She said my body "should" be able to produce it by itself by 12 weeks.
I'm not so inclined to do this, since the level is supposed to stay above 20, and it's barely 20 with the every other day PIO supplementation.
I'm hoping I can get in touch with my regular nurse tomorrow and get her thoughts.
God forbid I do something to jeopardize this pregnancy. Maybe my body "should" be able to provide the progesterone but I don't know that that means that it will.
You know?
Or maybe I'm being overly cautious... what do you think?
Mo
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I would get a second opinion. I am not sure if there is any harm in staying on progesterone for a longer period of time? But there may be some issues if you go off of it too soon, know what I mean? Good luck!
ReplyDeleteI do not think overly cautious is a bad thing. See what the other nurse says and your RE even & take it from there. You will need to come off the support it's all a matter of timing.
ReplyDeleteSo glad that all continues to be well.
If I were in your shoes, I wouldn't be dropping the PIO either. Extra progesterone will NOT hurt, not enough could. At least wait to talk to your regular nurse.
ReplyDeleteForget the nurses. Talk to Schoolie and your OB. Don't stop the PIO until you talk to both drs. Just my two cents. xoxo
ReplyDeleteYou can count me among those in favor of a second opinion.
ReplyDeleteI stayed on PIO far longer than it was prescribed (ahem), knowing (a) that there's little clinical evidence that it helps much if at all after about 8 weeks, (b) that there are few downsides/risks associated with it, and (c) that I was nervous as all heck about sustaining the pregnancy (I think I did quit about 12 weeks, but also, I was having no b/w done at that point so had no data other than (a-c) above).
My knowledge of the literature is out-of-date effective about 2006 (the point at which I was making those decisions, but unless the thinking on this has changed I think there are good arguments for keeping on keeping on.
I am agreeing with everyone else about waiting on another opinion. I refused to stop taking my metformin for my entire pregnancy because I didn't want to rock the boat. And yeah- your body should take that over about now but maybe it just needs a minute more. :)
ReplyDeleteThat 22 wouldn't give me the boost I needed to stop it either. Just because our bodies are "supposed" to take over at 12 weeks doesn't mean it does. I wouldn't stop if I were in your shoes...and I have been (regarding progesterone anyway). Hang in there! Like I told you before, I was on it until 18 weeks.
ReplyDeleteWith no reason to weigh in, other than a "gut" feeling... I say continue! Talk with your regular nurse or the wonderful OB before you do anything that doesn't seem right to you. You may not be able to trust your body, but you should trust your intuition!
ReplyDeleteYes Mo, wait to see what your regular nurse says. Double, triple check.
ReplyDeleteStay on it. There is no harm to stay on it. I took Crinone until my 3rd trimester, even though you're supposed to stop at 12 weeks. Who cares? It will give you peace of mind.
ReplyDeleteDelurking to say stay on the progesterone. I have read a blog by a woman who swore that in her case weaning before week 16 resulted in a miscarriage a couple of times (the second time the doctor insisted she quit at 12 weeks, she was uncomfortable but complied, and yes she miscarried...) People are different... And as long as you are on natural progesterone you should be perfectly fine if you stay on it. Best of luck!
ReplyDeleteI would totally wait to talk to your usual players before quitting. You will feel so much better about the decision....:D
ReplyDeleteI think 22 is a great, normal progesterone number. Of course, I was told it needs to be above 9 (maybe we were on totally different scales).
ReplyDeleteW/out injections, my progesterone was 9.9 at the end of the first trimester. Despite several more bleeding scares, my daughter turned out perfect.
However, I totally understand not feeling ready to wean off supplimental progesterone. You will have to do it one day, but it doesn't have to be today.
I'm 11weeks today with twins. Those placentas should be kicking in too. On Friday I had my progesterone checked after a single day without shots or creams or pills. It was a 20.
ReplyDeleteJust because it should make enough doesn't mean it does.
With my first daughter I stayed on the PIO til 16 weeks. I graduated from my RE and I don't think my OB even realized I was still on it. I didn't care. That stuff was (in my head) my life line. Even when I finally stopped I made them test my blood like 5 times.
There is zero harm in continuing the PIO. (well the butt welts don't feel great...) But there is a huge plus in continuing to take them - peace of mind. Even if it doesn't physically help, not worrying about the "should I's?" is so worth it.
stay on the progesterone. I know a few recurrent miscarriagers that only got through to a live birth by keeping progesterone supplementation going ALL THE WAY to the end of their pregnancy. Why take a risk when something as easy and (relatively) cheap as progesterone may be the only thing keeping it going?
ReplyDeleteI vote with the others - I would stay on the progesterone rather than risk it. In my case, I was at 17.45 after being off of all progesterone for 2 days at 13 weeks, and ultimately our RI had me go back on suppositories (rather than PIO, but I'm sure PIO would be fine if that's what you're more comfortable with) for 3 more weeks, with weekly checks to see how my levels were. Since I was at 13 weeks, Dr. Sch's nurse said they couldn't make any recommendation because they can't treat patients beyond that point...
ReplyDeleteWell, if it was me, I would definitely keep on for another week or two (because I wouldn't just "accept" the 12 week thing - that would be crazy for us infertiles :)) - regret management and all that jazz!
ReplyDeleteIf there's nothing to say that it'll do you or the baby significant harm, I'd stay on the progesterone. ANYONE who has been through losses will know how important it is to do all you can to support a pregnancy - whether it seems rational to the medics or not!
ReplyDeleteHonestly, this pregnancy is too hard fought to drop the PIO because a nurse who doesn't really know your situation told you to ... 22 is too close to the cut off. I'd stay on it and keep an eye on it in case you need to increase it again.
ReplyDeleteMaybe your fab ob will switch you to p17?
ReplyDeleteI would probably be overcautious, too. But, FWIW, my RE NEVER tested my progesterone after transfer; I asked her to do it once, when I started spotting. Came back ~60 and we never looked back. Ditto my pregnancy with LG, only a mid-luteal p4 level, despite massive supplementation...
ReplyDeleteActually I take that back. She did test once after transfer but would not have tested after confirmed pregnancy, except I freaked out when spotting. Ditto estradiol levels.
ReplyDeleteI was told there was a (small but real) danger of excessive progesterone after 14 weeks -- that it could have effects on the fetus. Very sorry I don't remember what, but I think it also depended on whether it was a boy or girl... I did not want to stop, as I felt thatI should not abandon what had gotten me to that point. Get a second opinion.
ReplyDeletewell, at some point you will have to wean. its not like your numbers are well below 20... get opinions from your OB, and go with that... 22 is a great number, especially if you are only on every other day, this is great! it seems like you have access and ability to have levels taken on your own whim, so, when you do wean, just keep checking in. that baby is growing, and the placenta really is making its own at this point.
ReplyDeleteAh weaning is SOOOO agonizing!! Yes, get a 2nd opinion. And honestly Mo, I had to rub the sleep out of my eyes this AM to make sure I was reading your blog title right "Blood Work Results as Weaning Continues"...I don't know about you but pinch me because I can't believe you are at the weaning stage already!! So incredibly excited for you!!
ReplyDeleteI would absolutely wait for your regular nurse in Denver to confirm. I'm with you ... can't be too cautious!
ReplyDeleteIt's all regret management.
ReplyDeleteIf you will feel better talking to all of your doctors and nurses before you make any changes, by all means please do. And if it were me, i'd ask whether there were any downsides to staying on it for more time, because if there are not, then I would keep it up well into 2T. But man, am I excited that you are already at 12 weeks!!
In your shoes I'd definitely be nervous about dropping it.
ReplyDeleteThat said, with my current pregnancy (I'm 36 weeks) my progesterone, even with twice daily doses of Prometrium only ever got up to 11.6 or something super sucky like that.
My midwives never bothered with PIO or suppositories since my spotting (which precipitated the progesterone supplementation) stopped.
They weaned me off of them around 12 weeks and all was fine. However, I don't have your track record and I know for sure in your shoes I'd be reluctant to drop it.
Hopefully your regular nurse will have insights that help you decide.
Yeah I would def get a second opinion! If it's not hurting anything and you're so close to being on the verge then why would you stop cold turkey, look at how far you have come. I would wait for your regular nurse and see what she says.
ReplyDeleteI think you should do what feels most comfortable even if that's staying on the progesterone. But, for what it's worth, I'll tell you what happened with our progesterone. Fern was on the supplement for ten weeks. Her levels were always fine/ok, but not great (can't remember the exact numbers). When she stopped the supplement the number dipped to around 16 (?) I think. CCRM nurse said it was fine. We got the OB's office to order another test a few days later and it came back 12.5. We completely freaked out. Our OB's office refused to comment on the progesterone or prescribe action since they don't usually order those tests, only saying, yeah, it's not great. CCRM wasn't really treating us anymore either but we cornered our nurse who ended up telling us that progesterone levels are unreliable at that point in pregnancy and it was fine. It didn't feel like a great answer at that point, to be honest, and we were still scared out of our minds, but it did turn out well. I know it's impossible not to worry about less than amazing numbers but I hope it's a little helpful to hear our story.
ReplyDeleteLooks like many have had the same experience. We were told we "could" stop the progesterone at 12 weeks, but my dr. also made it clear that if it made me more comfortable, he supported me continuing. Maybe it's a placebo effect, but when I was pg with the twins I'd take ANY kind of reassurance! Definitely get that second opinion, even if you're just looking for someone to say it's okay to keep going for a bit more even if it's just to ease your mind.
ReplyDeleteMo, this is exactly what happened to me when I weaned. In fact, I was even lower than you, at 18 when they told me to stop everything. And everything turned out fine.
ReplyDeleteSeriously, I think your numbers look perfect. You shouldn't have a super-high level of progesterone, you should be right where you are. And I think too high progesterone at this point can even be harmful to the fetus, harmful to its developing reproductive organs. So talk to your nurse, but be ready to stop. More isn't better in this case.
If it can't hurt (other than your tushy) I would stay on it. As others have said its all about regret management. I am so thrilled you are at 12 weeks. We want this to result in a live take home baby.......... You are in uncharted territory --- my vote is to stay on it. Of course its not my tush getting stuck!!
ReplyDeleteHugs
My Dr told me it couldn't hurt to continue with the supplements so we always went the full 12 weeks even though most clinics only go to 8 or 10. However, you may want to ask how the blood levels change as the placenta starts making the progesterone. Is is so localized to the uterus that the blood levels drop? or should they continue to see it higher? I'm not sure on this one. Personally...I never had a single blood draw for either estrogen or progesterone...My Dr. said they are often misleading and not necesary. He said he could tell everything from an ultrasound (lining, placenta etc) and didnt' need that. I understand your need for it with your history....so I would definitely just keep up the PIO if you want.
ReplyDeleteI actually have a girlfriend who had some bleeding at 20 weeks and they put her back on the PIO every other day for the rest of her pregnancy. So...there are many schools of thought....and if you feel like you NEED this in your gut...then keeping up the every other day PIO may be just what you need to stay sane and feel better.
Hang in there. I'm still so very thrilled for you and Will.
kd
Oh...and the only known issue with excess progesterone is a condition called hypospadius. It happens with boy babies where the urethra grows out the underside of the penis head verses the tip. It is kind of crappy to fix (usually done before age 5), but overall no long term issues or harm to baby.
ReplyDeletekd
Stay on it! It can't hurt and you want to cover all your bases
ReplyDeleteCCRM really pushes weaning by 12 weeks. I was warned that it could harm the fetus too ( by CCRM nurse). My numbers were similar to yours--barely 20 and they wanted me off pio. But my pg was too hard fought and my OB agreed. She was totally fine with staying on PIO longer and monitored me on it for 15 weeks. Maybe others had lower values or weren't monitored as much and everything turned out fine, but they are not you . Trust your gut and ask your OB for her thoughts and if she will monitor you with a more gradual weaning. Worked for me and my baby is fine.
ReplyDeleteMeant to say "through" 15 weeks above.
ReplyDeleteFWIW, my son does have hypospadias... and my understanding is that the "defect" occurs much earlier, like 6 weeks gestation, as the urethra is forming. Can't speak to the issue of staying on progesterone supplementation later in pregnancy, but I don't think continuing at this point causes *this* particular issue. The urologist did not indicate that he thought progesterone supplementation was a factor, even knowing that Tiny Boy was an IVF baby...
ReplyDeleteI would definitely get a second opinion if you're worried about it Mo - no regrets, right?
ReplyDeleteI would stay on the progesterone till you're out of the first trimester. That's what I did for my own sanity.
ReplyDeleteXoxo
Ocgal
I'm with you TOTALLY on this one.
ReplyDeleteXOXOX
kate
Mo, this is the Anonymous 2w1d behind you from CCRM (Alina). I stopped PIO last Thursday and my progesterone level today is 13, despite 3 suppositories a day. I am freaking out. My advice is do not stop PIO if you are at 22. Ask them to be on it for another week or two. Or keep weaning off slowly. I think you are on 1CC every other day. Maybe go to .5 CC every other day and then check your blood? If you are still at 22, you can be on this lower doze. I was in the 30s before they started weaning me off. I really hope it turns out ok for me... Dr. G at CCRM does not want to reintroduce shots... :( Good luck! You are doing so well! It's such a joy to read your blog!
ReplyDeleteI admit it, I had almost given up hope for you guys, especially after the hideous run of bad luck you had leading up to this pregnancy (and the previous 5 years aswell, obviously). There is nothing on earth I am happier to be wrong about than that though!
ReplyDeleteI almost want to say thank goodness that Depot Lupron stuff is so evil, as it seemed like not wanting to waste the time you spent tearing your hair out on that stuff, was the main thing that was pushing you to try with your body one more time when the DE thing fell apart. If depot lupron wasn't so awful you might never have found out that your perfect embryo was there waiting for you after all. Silver linings and all that!
I wouldn't cut back before talking to your regular nurse. Not a chance in hell.
ReplyDelete