Progesterone is a really debatable issue and one that often gets firey debate amongst professionals.
Progesterone is produced by our bodies after an egg has been released from a follie. This progesterone is necessary in maintaining a pregnancy - this is true. When we look at a HCG result we also look at progesterone. For a lowish progesterone and a lowish HCG often (but not always) do not augur well for a pregnancy. High progesterone creates an environment that is favourable for pregnancy - low progesterone makes it less favourable. If women have a short luteal phase (11 days or less) it can mean that the progesterone is low and thus it makes it more difficult to maintain a pregnancy - basically the progesterone is the glue that helps that embie to stick. Often clomid will be used for this issue as the multiple follies that it often stimulates creates a higher level of progesterone. B6 and vitex are used for this reason to good affect by some women. If low progesterone is the cause of a pregnancy loss it will be a very early loss and usually manifests in "chemical pregnancies" - where the pregnancy is chemically confirmed (by b/t or urine test) but the levels are low and the pregnancy is lost soon after.
When a woman has a pregnancy loss of a normally growing embryo with "normal" range ratios of hormones it is usually put down to a chromosomal or developmental issue with the baby. When a woman has multiple chemical losses it is often thought to be either lp issue or autoimmune. Autoimmune issues often manifest with later losses - this is not because "all of a sudden" an issue arises.
The placenta begis to develop from conception. It doesn't magically have a switch at 12 weeks. So the groundwork for that development (of the placenta) begins at the beginning! A bit like when you build a house - all the pipes etc have to have places for them in the house - the holes need to be big enough - the position needs to be correct.
It is theorised that this isn't occuring well in some pregnancies - so once the baby is reliant solely on the placenta if that placenta isn't tip top we run into trouble.
In failing pregnancies (early ones) the progesterone drops prior to seeing changes in the HCG. This is an early indicator of a pregnancy that is not going well. Yes, there are anecdotal stories of women with dropping progesterone who go on to have healthy babies - these are enigmas and miracles and wonderful! However, "usually" it does not augur well.
So, if you have low progesterone, sometimes that can be helped by pessaries - used sometimes for the first trimester. This can help maintain a pregnancy that will fail because of the mothers low hormone levels. The debate is that it can maintain a pregnancy that just won't survive.
Many fertility specialists use P4 pessaries as a par for course - especially in cases of recurrent early loss.
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