As Expected

Negative.

HCG < 5 (didn't leave the exact value)
E2: 25
P4: 15.3

Values 3 days post transfer:
E2: 360
P4: 47.6

How did my P4 go from 47.6 all the way down to 15? I was taking at least 800mg/day which is a LOT of P4!!

Also, my estrogen went from 360 to 26!? It looks to me as though my numbers all plummeted.

WTF?

They left the message on my blackberry as the battery had died (I didn't think to look) and left the numbers.

Ideas:
Bad suppository batch (inconsistently made)
I just can't absorb it all vaginally
It leaked out most of the time

Not sure what else explains it all.

Do some women just not absorb it or what?

I would love to retest my numbers. I think I have a "open lab slip" somewhere. I think I'll see if I can find a quest labs to knock one out today while I'm still on my progesterone.

Please...any and all ideas about this?

5DP3DT IVF9: Musings on Progesterone

Progesterone used to make me feel intense uterine cramps, make breasts hurt, and just cause me a lot of physical discomfort. Most of my cycles, I was on 200mg/day and maybe even 100mg/day on one cycle. All these symptoms on 100-200mg/day.

In this cycle I'm on 800mg/day of P4 supplements.

And I feel ... well ... nothing. My breasts are normal, smallish actually. I'm not feeling any cramps from the P4. Nothing to really make me think, "Is that the progesterone or am I maybe getting implantation twinges."

It's just rather quiet. Disturbingly quiet.

My last IVF cycle, I believe I had STABBING cramps at the time of implantation. That was the cycle I saw a very faint BFP that appeared for one day and then disappeared before beta day.

I have to wonder if the pain I was feeling in IVF8 was more a symptom of one hell of an immune reaction happening...or of typical implantation. The more I read of other women's experiences before getting a BFP, the more I think I had a major immune reaction. So many women state that they felt little around implantation, were pessimistic about the cycle, and then went on to a BFP.

One thing that comes to mind is that this is the first cycle I've done since my endo surgery at the end of June. Could it be that the cramping was co-correlated to the presence of endometriosis (stage 4) with progesterone levels? I know that endo can cause the body to produce progesterone at random times in the cycle and can cause the lining to be out of sync. Can progesterone conversely affect endometriosis?

Lastly, I wonder if it's age, and my body's lack of response to the progesterone, or something else. There's nothing special about my progesterone suppositories save that they're 400mg each. I should be recoiling in pain, but I'm not.

I wonder.

Anyone else notice a chance in how you feel with progesterone as you age?

I'm baffled.

4DP 3DT: IVF 9 Spiral Arteries & Progesterone Levels

Made the journey to an out-of-the-way ultrasound clinic to get a quick doppler of my uterine spiral arteries. According to Dr. KK, for IF/immune patients, the resistance index (RI) of the spiral arteries should be below 0.6. If not, then additional lovenox should be added to get the number down. Too much resistance to the blood flow means that it is moving slowly and can clot. Something detrimental to an embryo if it attaches and finds a clot rather than a nice blood source. More about this procedure here.

I'm typically on 40mg/day during a cycle, but if you look at standard dosaging on the lovenox website, one should take 1mg per Kg of body weight. For me that winds up being 79mg/day, or, two 40mg syringes a day.

Dosaging for general purposes *might* be the same as for IF, but I'm not really sure on that, so I increased to 70mg a day since transfer.

So, after 3 days of 70mg/day of lovenox, the U/S technician found that my RI wavered between 0.65 and 0.74. He took multiple data points to be sure, but the number likely means that even at 70mg/day, I'm still not taking quite enough. One thing I am unsure of, is that Dr. KK often does this sort of U/S on certain days of the cycle and I'm not sure if these values apply in the luteal phase when under P4 support. It's a calculated risk to up to 80mg/day, but one that I think isn't too unsafe.

So today I upped to a full 80mg/day, but I am unsure as to whether I should do even more while unsupervised. I've actually seen some of her patients reporting that they're doing 60mg, twice a day. Holy crap. Maybe 80mg isn't enough? I did a PTT test about 10 days ago and I was in range then, but how about now?

I put in a call to Dr. KK two days ago and am going to get on her list of patients. She can treat me remotely, so that's reassuring. (BTW: The U/S technician that did my doppler today was trained by Dr. KK's ultrasonagrapher - so he definitely knows what he's doing.

My other concern, besides getting the right lovenox dosage, is that doing a doppler around this time feels a bit risky. I'm not sure if it is though. Dr. Czech's nurse did a U/S on me yesterday to ensure that my lining had converted post transfer - it had - so is this sort of ultrasound anymore risky than a doppler one? I asked if the "intensity" of the waves used was any different and he said "no". So I think I should be ok. So then the concern of just having yet another wand up my hoo-haa, trolling up in my nether regions. He was actually quite gentle though - no complaints on that department, so I don't think I need to worry about physical jarring of the embryo.

Maybe I worry too much? I just feel that this is one major thing (RI) that's been overlooked in my cycle for the last 5 years and it seems, well....sorta big!?

They also did my blood work yesterday to see how my progesterone levels were - I'm doing 400mg twice a day (supps):

Blood values:
E2: 360
P4: 47.6

I've read that doctors really like to see this number above 30, but I've seen many ladies report values around 10.

They said to change nothing in my protocol. I have to be honest: I don't know if this is a good P4 number considering how much I am taking. I do realize that oral and vaginal suppository P4 yields lower blood P4 levels than, say, PIO. But I'm not sure what the "curves" look like for: method of delivery against amount of P4

Anyone have an idea what a normal range for P4 is after transfer if using the suppositories?