Progesterone levels are always too low

Lene1980 · May 21, 2026 at 12:00 PM New

Dear team of experts,

As I suffer from endometriosis and adenomyosis, I know from past cycles that my body only absorbs progesterone very poorly in the artificial cycle:

- Under 2x400 mg Amelgen and 1x Prolutex, my value at transfer in was only 7 ng/ml.

- With 3x400 mg Amelgen and 2x Duphaston it was 8.5 ng/ml.

Both values are too low for successful implantation (especially with adenomyosis).

The clinic now wants to support with 2x400 Amelgen and 1x Prolutex. I find this very low and therefore don't want to take any risks and increase the dose to 3x400 mg Amelgen vaginally and 2x daily Prolutex.

The clinic said that with the high dose it is my responsibility. What is your assessment?

Kind regards

Lene

Vida Fertility Institute · May 22, 2026 at 2:51 PM New

Dear Lene1980,

We understand your situation very well. We also know that patients with endometriosis are less able to absorb progesterone. At the same time, we know that the progesterone value is very relevant for the transfer and that we should try to achieve values of around 10 ng/ml.

This is recommended by all expert commissions.

In our clinic, we would start the next attempt with Prolutex every 12 hours in such a case. In this case, we would also refrain from administering it vaginally.

Since you mentioned adenomyosis, I wanted to add something. Sometimes with adenomyosis it can be useful to induce artificial menopause for about 2-3 months before the transfer. This can keep the endometriosis "quiet" until the transfer.

I hope this information has been helpful.

Good luck for the next transfer.
Dr. Miranda Sanz

Lene1980 · May 23, 2026 at 11:42 AM New

Dear Dr. Sanz,

Thank you very much for your feedback.

I have now been in artificial menopause for 4 months. Without downregulation I have no implantation. In addition, the blastos were in the PGT-A and PGT-M. As I am KIR AA, I will first get the blasto back with C1/C1.

I hope that after 15 years of KIWU travel we will finally be rewarded with our 2nd miracle. I am slowly losing hope. Our son was born on the very first attempt (own eggs).

Best wishes

Lene

Lene1980 · June 5, 2026 at 3:10 PM New

Dear Dr. Sanz,

This transfer was also negative. I’m slowly running out of ideas on what to do next.
Do you have any tips or insights regarding diffuse adenomyosis, endometriosis, and laparoscopic surgery?

Best regards

Lene

Vida Fertility Institute · June 5, 2026 at 4:16 PM New

Dear Lene1980,

I’m so sorry to hear about the negative result. I know you must be devastated.

It’s not your responsibility to figure out why you’re not getting pregnant—that’s your doctor’s job.

In your case, I would very much like to review your medical history to check if anything was overlooked. Perhaps you have endometritis (inflammation) that is interfering with implantation, which is often the case with adenomyosis. But without a thorough review of your case, I cannot make a definitive statement on this.

Would you be willing to come to Spain for treatment? I would be happy to offer you an online consultation so we can discuss the best options for your next steps together. In that case, please send an email to contact@vidafertility.com

Best regards,

Dr. M. Sanz