Dear Kiwu Team, I’ve had five unsuccessful transfers. My doctor thinks it’s because the blastocysts all developed very slowly and only on Day 6. I got pregnant in 2024 during my first transfer, when I was taking Progynova three times a day and Cyclogest 400 mg vaginally twice a day.
Since my most recent attempts, I don’t seem to be absorbing vaginal progesterone very well anymore… despite taking 400 mg vaginally three times a day, my blood level on the day of transfer was only 5 ng. During the last transfer, I insisted on a blood test before the transfer and started supplementing with Prolutex one day before the transfer because my level was only 6 ng. With Prolutex, it then rose to about 12 ng. Would it make sense to start with Prolutex and vaginal suppositories from day one this time so that the levels are higher from day one, or is my clinic’s so-called “emergency protocol” sufficient—meaning I start as usual with vaginal suppositories and add Prolutex only one day before the transfer? I’m worried that my endometrium might not thicken enough due to the low progesterone levels and won’t be ready to receive the embryo by the time of the transfer.
I have no known endometriosis or adenomyosis. The only things that have changed since 2024 are my age (I’m 37) and a cesarean section —the isthmocele that developed as a result was corrected, but a polyp has reappeared because it grew back within 1.5 months inside the isthmocele—not into the uterine cavity. The chronic endometritis was treated twice with antibiotics. Killer cell counts were not elevated.
I’ll also have a PRP irrigation done before this transfer to support the uterus.
My immune system and coagulation are also normal.
So my question is: How can I best adjust my progesterone management for this transfer?
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