Polycystic Ovary Syndrome (PCOS)

Does Crinone enter Bloodstream?

Question:

I guess the header says it all.  I’m going in for bloodwork on Monday. I was originally scheduled for progesterone level, but I had an LH surge on CD 8 and from BBT chart, I probably ovulated on CD10.  So Monday is due date for AF assuming I did ovulate.  (I have PCO and started Metformin Oct 7)   So a couple days later (after ovulation) I started my Crinone 8% twice a day and my baby aspirin.  I’m just wondering if I go in on Monday and HCG level is negative can they also do a progesterone level and it tell me if in fact I did ovulate or will the Crinone mess things up.  Another question – assuming I did ovulate and am not pregnant and have not started AF as of Monday will that mess prog test up or will prog have already dropped inducing AF to come shortly? Thanks for any help!!!!! Nicole

Response:

Crinone does not enter the blood stream and is therefore not measurable in the blood. This is one of the drawbacks of crinone. Your progesterone levels may actually be higher than the blood says they are. Also, progesterone level, rising or falling are not an indicator of pregnancy. The only true test is an hCG level that doubles every 2-3 days. Good luck. SharonM

Response:

Crinone does not enter the blood stream and is therefore not measurable in the blood. This is one of the drawbacks of crinone. Your progesterone levels may actually be higher than the blood says they are. Also, progesterone level, rising or falling are not an indicator of pregnancy. The only true test is an hCG level that doubles every 2-3 days. Good luck.

Sharon, Thanks for the response.  I didn’t think Crinone entered bloodstream, but wasn’t sure.  I’ve only had my progesterone tested on CD21 a couple of times and was never told what the level was.  (This was before I started on the IF trek).  I don’t think I’m pregnant and was hoping I could have progesterone level checked tomorrow to see if it is high enough to support pregnancy.  I’m just curious as to what my level is. The only thing I meant by the "falling progesterone level" was that when the progesterone level falls is what induces AF to come.  Since tomorrow is 14dpo for me and assuming I’m not pregnant, I didn’t know if progesterone level might already be falling since AF is due and I may not get an an answer to my question about whether my prog level is high enough to sustain pregnancy by checking prog level this late in cycle.   Nicole

Response:

Trisha, Sorry, but I think you’ll be looking at some sore arms and veins…… Yes, you forced me to do some homework!!  Crinone (both 4% and 8%) *does* enter the bloodstream, albeit at low levels, according to the manufacturer…who had to have checked for such, as they attained FDA approval. Wyeth-Ayerst’s (manufacturer) press release says this about Crinone….. "…the bioadhesive gel offers the technological breakthrough of a sustained release of progesterone, with low levels of absorption into the blood stream…." also…….  "Our study was conducted in women whose bodies do not produce progesterone, so there was never a doubt where the endometrial support was coming from."   To read the press release for yourself, here’s the URL: http://www.ahp.com/releases/wa_051497.htm

Response:

I HAVE A QUICK QUESTION…DID YOUR DR TELL YOU TO TAKE CRINONE 2 TIMES A DAY? WHEN WE DID OUR LAST CYCLE I DID IT ONLY AT NIGHT, MAYBE THATS WHAT WENT WRONG WITH MY CYCLE????   THANKS! INFERTILE 8 YRS, 1IVF,HAD CANCER,TRYING AGAIN….

Response:

I HAVE A QUICK QUESTION…DID YOUR DR TELL YOU TO TAKE CRINONE 2 TIMES A DAY? WHEN WE DID OUR LAST CYCLE I DID IT ONLY AT NIGHT, MAYBE THATS WHAT WENT WRONG WITH MY CYCLE????

Yes, my RE told me to take it twice a day.  However, from talking to other women on Crinone and from talking to my Pharmacist, I believe most women only take it once a day.  Pharmacist told me he had only seen a few women on it twice a day and they all were "high risk" as he put it for miscarriage. (I don’t know how he knew that unless he asked them why they were taking it twice a day). Package insert says to take it once a day for progesterone supplementation and twice a day if you have partial or complete ovarian failure and thus require progesterone replacement. I think my RE telling me to take it twice a day was more precautionary than anything – I’ve had 3 miscarriages.  I’ve never been told I have ovarian failure – only PCO as far as I know.   If Crinone does enter the bloodstream (even partially) I guess I can’t have my progesterone level checked this morning and assume that is what my body is producing, not the Crinone.  I’ve never had my progesterone level checked 7dpo and told it was too low.  I was just given Crinone to take after second pregnancy failed to implant properly.  Ever since then, I’ve been told to take it after ovulating.   I’m going to RE this morning for blood draw.  I know I’m having HCG level checked and I’ll ask about progesterone level.  I’ll let all of you know what they have to say about Crinone and my progesterone level. Thanks for all of your help! Nicole

Response:

Just an update.  I just got back from having blood drawn.  Me and the nurse were debating as to what kind of test I should have done today – HCG or progesterone.  After a doctor overheard our conversation, I won out.  (I won’t know results of HCG test until this afternoon, but am expecting a -). According to doctor Crinone DOES enter the bloodstream. I didn’t ask to what extent, but enough so that once you start taking it a progesterone test is not accurate to tell whether in fact you did ovulate or if your body on it’s own makes enough progesterone to support a pregnancy.  Doctor suggested next cycle when I detect the LH surge to come in for ultrasound to make sure that there is activity in ovaries. Apparently it’s possible for a woman to have an LH surge without ovarian activity.  (And I know there’s some fellow PCOers who can get ++OPK test any day of cycle, but my LH has never been that high that I couldn’t use OPK’s as I know some PCOers can’t).   Thanks for everybody’s responses!!!!!! Nicole

Response:

Filed under: PCO

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