17p Shots Are too expensive - is there an alternative?

This piece is in reference to the recent news of progesterone shots becoming insanely expensive : http://blogs.wsj.com/health/2011/03/10/price-of-drug-to-prevent-preterm-labor-skyrockets/ I have a bit of a love hate relationship with progesterone - but that's partly because of my IVF experience with progesterone-in-oil shots, the fact that I'm on 17p shots, and the fact that with my PCOS my progesterone levels are always too low! I won't go into all of that, but in light of the price of 17p shots skyrocketing from 10-20 bucks to 1500 bucks a shot - I thought I'd share an alternative perspective on this dilemma.

Now we know that women at risk for pre-term labor need their 17p shots. Well... perhaps I should say they need progesterone supplements to prevent uterine contractions and reduce their risk of pre-term labor. The question is - although the 17p shot is the most common form of this - is it our only option. And if the 17p shot is suddenly above and beyond all of our means , what's the next best option.

I'm only aware of this because my perinatologist told me that I could have a second option if I was unable to tolerate the injections. I did Progesterone-in-oil shots during my IVF cycle and they literally crippled me. I couldn't lie down, sit, lay on one side, or walk without excruciating pain! After 3 weeks of being in unbearable pain, using heating pads for hours on end, and being miserable, I was switched to vaginal suppositories - endometrium. I told my perinatologist about this - and he mentioned that I could do vaginal suppositories instead of the 17p shots if I couldn't tolerate the shots. I decided to do some digging online to see what I could find on those suppositories.

From March of Dimes :  http://www.marchofdimes.com/baby/premature_indepth.html

Treatment with the hormone progesterone may help prevent another premature birth in women who have already had a premature baby. The American College of Obstetricians and Gynecologists (ACOG) recommends that this treatment be offered only to women with a previous spontaneous (not induced) premature birth who are currently pregnant with one fetus (21). Studies show that weekly injections of a form of progesterone (called 17P) reduces the risk for preterm birth by about one-third in these women (22).

Another study found that treatment with vaginal progesterone suppositories greatly reduces the rate of premature birth in women with a short cervix (most of whom had no history of premature birth) (23). A vaginal ultrasound can determine whether a woman has a short cervix. ACOG recommends that providers consider progesterone treatment for these women, but does not recommend screening all women for a short cervix (21).

Studies have not found progesterone treatment helpful in preventing premature birth in twin pregnancies (21). More studies are needed to clarify which high-risk women may benefit from progesterone treatment and which form of progesterone is most effective.


Research Findings From some online journal: http://www.jfponline.org/Pages.asp?AID=1888&issue=March_2005&UID=

.... large double-blind, placebo-controlled, randomized study established the effectiveness of 17 α-hydroxyprogesterone caproate in preventing preterm delivery.....Vaginal progesterone suppositories have also been shown to decrease the rate of preterm birth in patients at increased risk.


I guess my point is that we may have other options. If the FDA and Makena are going to screw us so badly that our pregnancies may cost as much as $30 000 out of pocket to save..... we may have to look to alternative forms of progesterone to keep our babies cooking.

Day 2 of the 2WW ( err 10 day ) Round 2

Well..... a few thousand dollars later and I've paid to have 2 more eggs dropped my belly to hope for the best. This time I had a FET cycle instead of a IVF cycle and I definitely liked it better. I'm still nicknaming myself a fish because they got 44 eggs out of me. Initially I thought I got only 6 embryos and that 2 had died. Turns out only 1 died - which is awesome because it means I spent 1 egg on IVF, 2 eggs on this cycle, and still have 2 frozen embryos left. Then even better - I still have 17 eggs in the bank!

Anyway I took the whole week as a work from home to try and keep my stress levels down. I did acupuncture for this cycle to help calm my nerves. Plus the research says it helps.

My transfer went off without a hitch. In fact it almost seemed too easy. Last time the doctor had to go digging for my cervix! Now it's pretty much up to my embryos and my womb to play nice and give me a BFP. I go back to work tomorrow, but I hate the waiting. After all I have no control over anything. The progesterone has given me a progesterack. And for those of you who are wondering what that is - well I jacked the term from another woman's post on another forum. It's pretty much your breasts after being on progesterone. Mine are HUGE!

I can only help that the relaxed nature of this cycle and using more than 1 egg will increase my odds of getting pregnant.

Furious with AF

Well... after my BFN - after my first IVF, I was looking forward to a long weekend. I had all kinds of festive activities planned. I was anticipating AF showing up about a week or so after I stopped my progesterone. In fact, I was expecting that worst case scenario, AF would show up right around the end of my weekend. Giving me at least 2 days of fun in the sun. Not only that - but I was looking forward to 5 days where I could actually enjoy some sexual activity with Dh. But NO - Mother Nature wasn't hearing any of that. 2 days after I stopped my progesterone... AF shows up! So I've had 1 round of sex in i think 6 weeks. Ugh!!! And my nurse warned me that this will be heavier than a normal period - as if a chick with PCOS knows what a normal period is!

So this is just my venting - because it's irritating that this is one more thing I'll have to give up for this. Can't exercise during cycles because of how sick I was, can't drink, can't take any caffeine, can't eat naughty things, and can't have sex. Ugh... is there anything else that this TTC mission hasn't taken away from me?