Progesterone The Culprit Waiting To Try Again

12 Replies
Jen - November 9

I was wondering if anybody else out there had a m/c due to low progesterone. I had a m/c a month ago and now I'm waiting to have my levels checked so I can ttc again. I toke prometrium at 4 weeks but lost the baby at 8 when I discovered no hb and quit the supplements. Just wondering if I was the only one. The waiting is hard, along with everything else.

 

Kim - November 9

Jenn - I am so sorry for your loss. I have heard from many sources that low progesterone is usually a symptom of impending miscarriage, not the cause. Often times taking progesterone just lengthens the time it takes to miscarry and does not fix the problem. But then again, other women I've talked to have said that being on progesterone totally made a difference in their being able to carry a baby. I hope your doctor can give you some more answers.

 

Kara - November 10

Progesterone is controversial. For most people, it is the symptom of a non viable pregnancy, not the problem, like Kim said. But as woman get heavier, their fat produces estrogen that dominates over their progesterone. My mother has had problems with fibroids since her 20's. Then a few years ago they thought she had endometrial cancer, but the caught it before it changed over which was all related to too much estrogen. My sister, 39, who is very heavy but has never had fibroids, is now struggling to prevent a hystorectomy because they cannot contol her endometial lining because of too much estogen and not enough progesterone. But it can also lead to polycystic ovary syndrom which can cause lots of fertility issues. I am 28yrs old, 5 ft, 140 lbs and displaying several of the symptoms of too much estrogen. Such as fibrocystic b___st, water retention, gallbladder problems, hyperglycemia, and remarkably worse PMS. So far, my ovaries still look good, but I have been advised that I should try to loose weight. I took progesterone with my last pregancy at ovulation, but I still miscarried. I have just started taking it again last week after my ovulation,and I dropped 4 lbs in water weight. My feeling on progesterone is, if it may be benefitial and the risks are minimal, why not try it? And I think that's why doctors prescribe it - because what if you are that 20% it might make the difference for.

 

Jen - November 10

Thanks for sharing the info. I'm thinking that my prog. is low on a monthly basis. I have read that if you spot before you start then you could have low prog. I started spotting this month the day when your prog. is supposed to peak and I cont'd spotting 6 days until my period started. This is my normal monthly cycle. Supposedly the prog isn't keeping the lining intact.

 

Erin - November 10

Spotting before a period is also a strong sign of an endometrial polyp. Progestone is only successful for women who have a diagnosed LUTEAL PHASE DEFECT. You must have a blood test on day 21 of your cycle to determine this (when you aren't pregnant...). If it is low then, it is chronically low and therefore can be the cause of mc. If it is normal but low during pregnance and then you mc, pregnancy is probably no good. I took supplements and miscarried at 8 weeks... I am having my luteal phase tested this week to see if I do have low progesterone or not.

 

Kara - November 11

My doctor said the gold standard in diagosing LPD is to do an endometrial biopsy close to the end of your cycle then send the sample off to a reproductive pathologist (the one she recommends is in NY, but consults and reports findings by phone.) Since all womens' cycles are different they want you to chart your cycle to help them pick a date. For me it would be day 22 since my normal cycle is 24 days. Some doctors still use the blood test Erin was talking about, but if you are not on a 28 day cycle, your results may be skewed so they are not that accurate. The Dr and I opted not to do the biopsy due to the fact it would require waiting an additional 1-2 months to start trying again. She said we would treat as if I did have LPD by taking progesterone at ovulation then blood test to confirm pregnancy on day 24. If negative, I stop taking the progesterone and expect my period in 3-5 days. If positive, continue taking progesterone while monitoring hcg every 48 hours until week 6, then ultrasounds every two weeks until 20 weeks, since I lost one of my pregnancies at 15 weeks. If it appears the pregnancy is not progressing during the hcg tests or ultrasounds, then we will discontinue progesterone and allow nature to take its course. I was taking progesterone with the last pregnancy that ended in m/c, but his little heart was still beating despite the blood that was pouring out of me, so I questioned her about using the progesterone with our next try. She said just because I m/c doesn't mean that it didn't do its job and that she would still recommend using the progesterone. I should also note that I am seeing a Doctor that has experienced a miscarriage herself, so I find that I get slightly more proactive care than most. So Jen, if your Doctor recommends it, and if you feel good about it. I you don't feel good about it, don't take it. Because at the end of day you have to be able to look yourself in the mirror and know you did what you believe is right for you. Best wishes.

 

Erin - November 11

Kara is right - endometrial biopsy is the gold standard, but it is expensive and most insurance won't cover. If your cycle is normal, they can get a pretty good idea if you have LPD by taking blood on day 21 of your cycle for two months in a row... If you have a low number both times, it's pretty likely that you DO have low progesterone. Just a note of caution: I took progesterone for a borderline number (11) while pregnant this summer. I was convinced I had low progesterone. I had a missed miscarriage at ten weeks. Baby stopped developing at 8. If progesterone wasn't the culprit, and since the sac kept growing it may not have been, then taking progesterone without really knowing if that was the problem probobly made me hang onto a pregnancy for at least a few extra week, and if not for the ultrasound, it could have been many more. Progesterone does help some women but it it not a Band Aid for everyone. I have had 4 mc's and one little girl.. Three mc's this year.

 

Erin - November 11

Also if you are spotting before your period you may have an endometrial polyp, which is harmless except for the fact it can cause miscarriages. It has to be removed in a procedure like a D*&C but with a tiny camera inserted so the doctor can see it and excise it fully. Get an ultrasound or maybe even a hystosonogram.

 

Jen - November 11

would the ultrasounds I had before getting pregnant, 2 during, and 1 after have been able to detect a polyp? Surely they would've looked for something like that when they were in there.

 

Erin - November 13

If it is large enough, yes. In fact, most likely, yes. But if it wasn't that big and they weren't looking for it they could miss it. Especially as polyps grow and sometimes grow faster when your hormone levels are higher, like during pregnancy. I'd have another scan just to check for sure. Also there are other causes that are structural that can only be discovered through a hysostonogram.

 

Kara - November 14

The HSG is a little bit awkard to have done but well worth the piece of mind. I'm glad I had it done, even though they didn't find anything thing. I personlly know two women who had a tiny septum at the top of there uterus that either the embryo attached to and could not get enough blood supply, or the septum interfered with the growth of the embryo that did inplant proberly.

 

Jen - November 21

I have a question about taking prog. for LPD. When do you start taking it? How much?

 

Kara - November 21

I take 100mg Prometrium 2x a day. I start taking it 1 day after ovulation per basal temp spike. I continue taking it until the day my period is due. At which time if I get a negative result with First Response I discontinue and wait for my period which may come late. If I get a postive w/First Response the doc will test my level and possibly up my dose.

 

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