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Low progesterone,possible pregnancy.Endogest 200 mg safe?

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Practicing since : 2005
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Hi, I have low progesterone levels but I think I might be pregnant. Can I go ahead and start using Endogest 200mg? How many times a day?
Posted Wed, 11 Apr 2012 in Infertility Problem
Answered by Dr. Rhea Chanda 47 minutes later

Thanks for the query.

Please provide me with the following information.
Have you missed a period yet?
Have you done a pregnancy test?
Which day of your cycle are you on?

These details can help me to answer your query in a better way.

Anticipating your reply.

Above answer was peer-reviewed by
Follow-up: Low progesterone,possible pregnancy.Endogest 200 mg safe? 3 hours later
Let me give you a little background. I've been pregnant twice in the last year. The first time, naturally but my progesterone was so low that when I went in to have blood work to determine HCG levels, my progesterone was 3. The doctor said I would not be able to carry the pregnancy and it was too late to start progesterone. During the early part of this pregnancy, I had cramping about 1 week before my period would have normally started. The doctor thinks this was implantation cramping since I remained pregnant for just over 2 weeks after the cramping. I then went on to IVF because of my age. 8 days after embryo transfer, I had mild cramping. I was petrified - not knowing if it was the start of a new cycle or implantation cramps. Turns out, I was pregnant. Fortunately, the doctor had put me on progesterone right after egg retrieval to assist the development of the endometrium and to support the pregnancy. I miscarried that pregnancy as well. The IVF was too stressful and because the quality of my retrieved eggs looked surprisingly good, the doctor recommended we try on our own for a few months - especially since I should be more fertile after the D&C. So... she put me on 50mg of clomid to ensure I ovulated even though the opk's showed I ovulated the first month after the D&C at cycle day 14. I took the clomid and had an LH surge on day 13. The doctor did not want to put me on progesterone after ovulation because she wanted to check progesterone levels on day 21 to determine if I ovulated but said she would probably put me on it after the blood work. My progesterone levels were 13 and although she would have liked it to be 15 or higher, the fact that I use a digital ovulation predictor test and a regular dip stick opk, and had positive results on both for day 13, she felt like I had ovulated. I asked the nurse about progesterone when she called to give me the results and she said that I would get them after a positive pregnancy test. I told her the doctor said she would probably put me on it after the blood test and the nurse insisted I wait for a pregnancy test. I am frustrated and nervous. I am on day 23 of my cycle and I have mild cramping, just like the other 2 pregnancies, and I'm 5 days away from the end of my cycle. I have 200 mg of endogest and I'm very tempted to use it. If it doesn't hurt, I almost feel like - why take a chance? If I'm not pregnant, I'll stop using it. But if I am pregnant, maybe the progesterone will assist implantation and give me a head start on this delicate time. That's why I decided to consult with you. I also have vivelle patches left over from the IVF but I've been estrogen dominant for a few years now and not sure if I would really need the patches. Any guidance you can provide will be greatly appreciated. It's devastating to lose a pregnancy. I was pregnant with twins the second time - after IVF - and I was 10 wks along. We were so close to the 12 week XXXXXXX that we felt like we were almost out of the critical first trimester. I really want to give this pregnancy, if I'm pregnant, the best chance possible. I can accept a miscarriage due to a chromosomal problem - that's nothing I can control. But a miscarriage due to the nurse not wanting to ask the doctor and supplement the pregnancy with progesterone - that's unacceptable.
Thank you for your time. XXXXXXX
Answered by Dr. Rhea Chanda 5 hours later
Well XXXXXXX I can definitely sympathise with you in this matter. And I do understand what your problem is. I can only give you my opinion regarding this matter but whatever you do, should be informed to your prescribing physician.

Its very important that your doctor knows about your concerns. After all you and your doctor are the ones with the best knowledge about the case. Any changes that you make should be known to him/her.

Every doctor has different theories as to when to prescribe progesterone in such cases. There is no hard and fast rule that it has to be given at certain times but most doctors learn from their experiences and create a plan for the patient.

Personally, if I had a case such as yours, I would probably start endogest from day 16/17 till the pregnancy is confirmed. It may be continued till 12 weeks if there is a pregnancy, depending on the situation. Usually I give endogest 100 vaginally twice/thrice a day.

I suggest that you make an attempt to see your doctor again or at least speak on the phone. Express your concerns. I do not recommend starting endogest without your doctor's knowledge. As I said, everyone has a different plan and maybe he has too.

Hope that you succeed this time and good luck.

Above answer was peer-reviewed by
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