I'm 11w4d today and things are going pretty well! However I got my progesterone level checked on Monday (I get weekly progesterone checks as directed by my RE) and it came back pretty low at just 22. It's still a safe level, but my levels are dropping at a rate that they don't like to see. 2 weeks ago it was in the 50s and they reduced my progesterone dose down to 0.7cc shots every night. Last week it was 32. They told me to continue with 0.7cc. But Monday it dropped again so they are more than doubling my dose back up to 1.5cc! UGH!! I am told that this is all pretty normal but it still makes me uneasy. They are currently trying to wean me off of the progesterone-in-oil shots (PIO) and it's sort of a trial and error type thing so they are telling me that the low level is seen quite frequently. Once they increase the doses, the levels pop right back up again. I thought I was getting so close to being done with these shots though! The nurse I talked to said that usually women who had a Lupron trigger go off of the shots around 14-15 weeks. That's 3-4 more weeks! UUUUGGHHHH! Anyway, whatever lets me keep my baby, I'll be fine with!
The process of weaning occurs over several weeks where they gradually reduce my dose until my levels stabilize - then they reduce more until eventually I don't need the shots anymore. Right after egg retrieval and embryo transfer, women undergoing IVF don't make enough progesterone to support a pregnancy due to the fertility drugs and surgical procedures. In a normal menstrual cycle, usually one egg is released from a mature follicle during ovulation. The follicle sticks around forming a cyst-like structure called the corpus luteum that produces progesterone. This is what keeps the uterine lining from shedding if an embryo implants into the uterine wall. If implantation does not occur, the corpus luteum fades away, progesterone levels drop which triggers the uterus to release it's lining - resulting in a period. In IVF our eggs are surgically removed from the follicles which prevents a corpus luteum from forming and producing enough progesterone. Plus, with women given a lupron trigger (which is what I received) their ovaries are totally shut down which results in absolutely no progesterone being produced. With women who take the normal hCG trigger, some progesterone is still able to be produced because the ovaries aren't completely shut down - it's definitely not enough progesterone, but it's something. So we are either given progesterone suppositories or shots to keep our levels high enough so the uterus maintains it's lining and thus produces a healthy pregnancy. At some point close to the end of the first trimester, the placenta takes over progesterone production and usually progesterone support can be stopped. I am 1.5 weeks away from the end of the 1st trimester so theoretically my placenta should be ready to take over soon. But with women who had the lupron trigger, extra care needs to be taken to ensure that the placenta will be able to produce a level high enough so we may be on supplements for a bit longer. We'll see what my levels are next Monday but I'm definitely feeling the effects of the higher dose. Evil progesterone! I am so bloated today that I look like I'm 5 mos preggo! Glad I don't have to get a belly pic taken today - we'll see what it looks like on Saturday though. It may be worse!!
So the Doppler has been coming out daily since this progesterone stuff has been making me a bit uneasy. I found baby really easily Monday and today but yesterday was really tough and I got pretty freaked out! Turns out baby was hanging out on the right side instead of it's usual left side. I guess it just decided to go for a swim or something;) I didn't realize they could move that far though. Well, it took me 20 nerve-wreaking minutes, but I did find baby yesterday and was able to breathe a sigh of relief! Everyday baby's heartbeat was right on track, still between 160-170. So all I can do is assume everything in there is going great! I am just so thankful that I am getting my levels checked weekly. I think they are checking them so often because like I said above, I had the Lupron trigger. I don't know if women who had the regular hCG shot get monitored this closely.
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