Fluctuating Progesterone Levels?

[bella99]

I have a question about progesterone levels.

I had a beta with a progesterone level done at 14-16 dpo (not exact sure of ovulation date). My progesterone level was 46.

Last week I had an ultrasound with an embryo measuring 6 week 2 day (I was either 6w2d or 6w4d at the time). The heartbeat was 128, so everything looked normal.

I also switched providers this week.

My midwife suggested going on prometrium before she knew my previous levels because of my history of miscarriage and infertility. We decided that we would recheck them before putting me back on it.

My levels on Monday were 19.1. The nurse said I shouldn't worry about the drop and that the level was normal and wasn't a problem, but I plan on calling tomorrow to speak directly to the midwife, for the very least for some reassurance.

Part of my thinks I released more than one egg which would account for the initial higher level, and when that corpus luteum collapsed, my levels went down. With my daughter, my progesterone was 90 at 14 dpo, and somewhere in the 40's two weeks level, which is a huge drop, but I'm pretty sure that was because of multiple eggs being released (used injectables).

I know this is long winded but I wanted some feedback.

Thanks

[~Adorkable~]

a good thing to remember is that levels spike and fall thru out the day, so any one test can be really far off the average. if you are not spotting, i would not worry too much.

infertility by itself does not mean you have progesterone issues.
how many miscarriages have you had and at what weeks?

if they are going to base decisions on tests, i would have them do a few tests over a few days and always go in in the morning before you eat. they say that is your most accurate level.

[~Adorkable~]

btw and i dont know this for sure, but i think that the hcg signal would keep all the corpus luteum active. i really dont think that each one is getting a signal from each baby or something like that.

in my last ultra sound they saw 4 corpus luteum that were huge and clearly still functioning, now granted i have two babies, but certainly not 4!

[MommyNicoleTX]

i personally would be concerned and seek more bloodwork. but that is because my progesterone fluctuated this pregnancy and i lost a twin early on. but my blood work in the 1st trimester was never above 20. above 20 is what they like to see. i was put on progesterone suppositories and have had no issues with keeping the other baby.

[bella99]

Actually, my midwife said anything above 11 and optimally, anything above 15.

Anyway, I talked to the midwife today. She agrees that it was likely a second luteul cyst that collapsed and therefore my progesterone dropped. There are reasons to believe that I may have released more than one egg.

She's not concerned with the progesterone level, but because we both knew it would make me feel better, she prescribed a low dose of prometrium until 12 weeks.

I have another u/s scheduled for the 21st to check on growth.