Saturday, March 6, 2010

New IVF Patient Mixed Up Suppositories & Took Progesterone Early - What Now?


Hello Doctor,

I am one day before fresh embryo transfer and I'm really worried. I'm currently on my first IVF. Two days before my egg retrieval last week I was instructed to use Clindamycin suppository at night for 3 nights last night being the day of my egg retrieval. Well, I mixed up the suppository bags and inserted 50 mg of Prog suppositories for first 2 nights instead of Clindamycin. I didn't realize this mistake till the day of my egg retrieval. So I ended using 2 Prog suppositories for 2 nights before my egg retrieval.

I told my doctor and he said this is a problem in that my uterus was exposed to progesterone too early therefore lining is not optimal for transfer...and that we need to freeze my embryos and do a frozen embryo transfer next month! I was just devastated to hear the news and asked for any alternatives. To make the long story short we are going ahead with a fresh single embryo transfer tomorrow with hopes that not too much damage was done. Given my history what are the chances of me actually getting pregnant? Would it take a miracle?

R. from the U.S.


Hello R. from the U.S.,

Keep in mind that miracles do happen.

I'm afraid that I agree with your doctor's response. Progesterone converts the endometrium from its growing state to its implantation phase. If the endometrium is out of phase with the embryo, then implantation will not occur. There is a very small (2 day) window for implantation. It is likely that the progesterone changed the internal architecture (cellular structure) of the endometrium, which will make it inhospitable to the embryo and implantation will not occur. But there is no way to know that for sure. You will just have to wait and see.

If you want to be absolutely sure, then you should postpone the transfer and freeze the embryos. Then do a frozen embryo transfer the next month. If you don't mind risking an embryo, then given it a try. I normally prescribe antibiotics on the day of the retrieval, but all clinics have their own protocols specific to how the physician prefers to tweek their cycles. Like I said at the beginning, miracles do happen.

I'm sorry and stay positive!

Good Luck,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
Monterey, California, U.S.A.

1 comment:

  1. Hello Doc.. my name is Rose, am 31 yrs old. Just about 9months now I have been having serious pain during my period. D pain comes for 1minute and go especially if I want to poop. D pain comes to anus . I think my circle is normal" 27and28" and is regular. It comes every month. last for 2 to 3days and not heavy. my worries is d pain. Doctor pls is there anything serious going wrong with me? Sometimes am unable to move or do anything when the pains comes and it last for seconds or minute in every 6hrs during my period. Pls help me. It's terrible pain.



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