I was told to cut my dose in half (for both my progynova and crinone) at the 11 week mark and then stop at once I hit 12 weeks. I have to be honest - the thought of stopping my meds terrifies me! I know bub's placenta should take over by then, but my silly bum ovaries don't make ANY hormones at all, and I can't shake the feeling something bad will happen. I discussed it with my Doc and he said it's always a nerve-wracking time - even he still gets a little uneasy when women just "stop", which is why we made the decision to wean (although it's quite a token wean if you ask me)... But I haven't heard about going until 16 weeks, Crystal... Some Docs are just ultra conservative. I will do some literature searching later today and see if I can come up with anything. You all know I love to read myself to death!
Lorna - what will power you have!!! I couldn't resist POAS Even though I knew it was probably too early I POAS d4p5dt and it was a BFN. Got my BFP the very next morning (d5p5dt). SO hoping you get your BFP this time!!!
Results summary (as far as important for this group):
Progesterone supplementation is necessary and recommended by various sources in early pregnancy via ART - self AND donor cycles (but generally only deemed necessary until 8-9 weeks gestational age).... Why? Well the corpus luteum (the bit of the follicle that is left behind when the egg pops out of it) is responsible for the production of progesterone in early pregnancy. Frequently in ART cycles, either the CL is removed during egg collection OR the medications we are given prevent the necessary rise in progesterone to sufficiently support implantation and early pregnancy. If we don't supplement, implantation is unlikely or an early miscarriage will likely result.
Between the 7th - 9th week (depending on which source you read), something called the "luteal-placental shift" occurs - basically where the production of progesterone is taken over by the trophoblasts (cells of the placenta), and the CL doesn't mean jack anymore. Some even argue that once foetal heart beats can be verified, the level of progesterone being produced by the placenta is sufficient to cease supplementation. However, most clinics supplement at least until week 10 (this seems purely theoretical though, and no studies to date have demonstrated an optimum duration of progesterone support). It seems to make sense that most go until week 12 - as this marks the end of the first trimester and the risk of miscarriage globally drops at this point also.
ALSO, specifically for you Crystal - there are important effects of progesterone on the endometrium in terms of immunomodulatory effects. Adequate progesterone levels cause down-regulation of NK cells and other inflammatory nasties in the uterus, which is why progesterone support seems doubly important in women with immune issues. I have NO idea (just guessing here) - but perhaps THIS is why your Doc says 16 weeks? (But I did note you also said he does that for singletons as well...?). Ask for the justification though, because there is no scientific evidence regarding this. (Maybe take in the following article, and ask him to explain why his clinic has picked 16 weeks, and what the evidence is to support that).
It has some info on immune effects of progesterone, Crystal. The last bit is about optimum duration of progesterone supplementation, and the longest duration they mention is 10 weeks for embryo transfer and donor cycles. If you're having trouble sleeping, you can read it!
Hope that answers any burning questions. Certainly makes me feel MUCH calmer about stopping in week 12 (although not completely! )
Thank you so much Jooba!! That all makes sense now I will have a read of the article it's quite interesting and he did mention that progesterone calms NKC in the uterus, however I also take IVIG and intralipids and steroids so I'm going to ask about why the progesterone as well thank you for that Jooba
Hi all, wow you lot are a mind of information, interesting to read about the progesterone. You all seem to be on a lot more than I am here. Its 3dp5dt today and I have had cramps all last night and today, I really hope that is the blastie snuggling in!!
Love syfy stuff..Crystal what was Znation like as was thinking of having a looksy at it?
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