progesterone to help stop m/c

[satya]

I've just had m/c number 3. All have been before 6 weeks.

I'm waiting for a lap in the public system and my gyno doesn't want to see me until that's occurred.

If I do conceive again I'm worried I will m/c again and want to know how to proceed if I do get lucky again.

I have read that some women are given progesterone to try and help sustain an early pregnancy. I've not had a doctor suggest this to me, nor test my progesterone levels whilst pregnant so I have no idea if my levels were low.

If I do get pg again should I be asking for my progesterone levels to be checked as well as my HCG levels? My GP only ordered the second test for my recent pg after I showed concern at a level of 20 on the day my AF was due. She thought it was fine at 20. It had gone down to 11 4 days later and then the m/c followed the next day.

I guess my questions are:
In future should I get my progesterone levels checked?
Can a GP give a script for progesterone or can only OB/GYN or FS give you such a script in Australia?
If I get pg again before the lap should I be going straight to my gyno or back to the GP?

[BekZ]

Hi Satya,

You may find it difficult for a GP to recommend progesterone. I was using natural progesterone recommended by my GP after my first m/c. I only used the cream after Ovulation and up until I got AF or a positive preg test. The natural progesteron cream is not strong enough to sustain a pregnancy but it can give your egg extra time to implant thus lengthing your luteal phase.

After my second m/c I kept asking my GP about using progesterone injections to help sustain a pregnancy. She looked at me with a funny look on her face and told me that this type of therapy is not widely used and she did not believe in it. From there I called Fertility Specialist who I knew used this therapy, fortunately I feel pregnant and this one stuck. My suggestion would be to do some research into seeing a FS. Tell them your history and definately get your hormone levels checked out.

In the meantime I have you ever used Vitex and vitamin B? This combo is excellent for regulating your cycles and promoting a long luetal phase.

Hope this helps.

[Inanna]

Satya I really feel your pain... :hugs: Again, I am so sorry for the loss of your baby.

Okay, are you in SEQld? Or Sydney?

Gavin Sacks is coming to SEQLd to speak on miscarriage and immunological reasons for it on the 17th of August. He is an obstetric immunologist.

You would have had progesterone levels done with your hcg - or at least you should have. They are usually done together. A Bhcg of 20 at 14 days post ovulation is very low. Now, there are women who have a low level like that and go on to have healthy babies but it is lower than what we like to see to breed confidence iykwim. You need to ask what your prog level is but with a hcg of 20 I would suspect your prog. would have been on the low side too.

Women are given progesterone support to help maintain pregnancy and this is one of those contentious areas. Some obs disagree some agree. Progesterone levels begin to fall prior to hcg falling so it's difficult sometimes to know what comes first the chicken or the egg iykwim?

3 consecutive miscarriages are termed recurrent miscarriage. So, you do need to have further testing. Sometimes a woman can have too high level of NK cells. NK cells will fight off the pregnancy resulting in a miscarriage - usually in the first trimester or early second trimester. Again, this is one of those areas of great debate. Many obs poo pooing it and others not. The drug that is often used to treat this is prednisolone/prednisone/ a steroidal drug. This halts the bodies autoimmune response, halting those nk cells and allowing the pregnancy to continue.

Have you been tested for clotting disorders? There are a number that cause early miscarriage.

Do you have a luteal phase greater than 12 days? A shortened LP will sometimes cause early miscarriage. Simply ivf docs tell us that implantaion generally occurs 5-8days post ovulation but either side of that it acan also occur. If implantation occurs say on cd9-10 and you have an 11 day lp your progesterone level has begun to dip and this confuses the implantation process causing an early loss. Progesterone support in the LP is sometimes given for this and clomid is given also to increase the hormonal levels.

I had a short LP and I suffered 3 very early losses due to a short Luteal Phase(well that was the assumption).

Have you had chromosomal studies on both you and your partner? This is necessary to rule out any issue that could be causing your losses.

I so very well understand your confusion, sadness and need for answers. What I need to say is to leave no stone unturned. Seek seek seek. There is always an answer. Sometimes that answer isn't clear and sometimes it is.

If you need any more help you know where I am...

[rufalina]

Satya - Sorry for your loss... It is not an easy thing to deal with, and I know how you feel, having experienced a similar situation at least twice (is not three times) myself...
I am going to see my fs tomorrow regarding this. I will let you know how I get on, but I am definately going to be seeking testing for the things metioned here and others.

Deb - your knowledge in this area is invaluable. Thanks again for sharing this with us...

"What I need to say is to leave no stone unturned. Seek seek seek. There is always an answer."

is a fantastic motto in this.

xo

[satya]

Bekz - I have been using Vitex and Vitamin B since just before my 2nd pregnancy. It has not lengthened my cycle nor seemingly changed it in anyway but I have managed to fall pregnant twice in less than 18 months compared to once in 8.5 years when I wasn't using it (was with a different partner back then too).

Flowerchild - My GP did not test my progesterone levels but seeing that I always get spotting before my AF I think I probably do have a problem with my progesterone levels but testing that's been done so far has not shown this. Mind you I've never had my progesterone level checked whilst pregnant because I just haven't stayed pregnant long enough to get it tested.

I have not been tested for clotting disorders. It is possible that I could have some hereditary thing I guess. Two aunts on my dad's side ended up adopting due to infertility & secondary infertility but I'm not sure if they had m/c's and my dad is on some kind of drug to keep his blood OK. My LP is generally 11-12 days - that's why I'm thinking progesterone may help me. I was put on clomid a decade ago but I did not conceive on it.... but did 3 months after I went off it. I tested positive on CD28 of that cycle and bled for two weeks from that day.

The gyno I saw recently is just telling me to get my lap done then head straight for IVF and I don't see why I should be doing this when I can conceive, I just can't keep them. At my age (41) I know the odds are only 50/50 but I don't want to go and have expensive testing and treatment done if something as simple as progesterone is all I need.

He has ordered the following tests which I am yet to have done:
blood group RH & antibodies
RPR
prolactin
karyotopying.
Plus the usual disease ones that they like to test you for. I don't know if he can tell much from these but I guess I will have to ask him about about clotting disorder testing and the NK thing as well. But seeing he doesn't want to see me til after the lap there's not much I can do until I get to the end of the damn queue.

[Inanna]

Satya,
Your LP could be causing the problem. Clomid is the drug of choice for this - it worked for me. Just because you are on clomid doesn't mean you will conceive but it often lengthens that LP.

Karotyping is the chromosomal tests I suggested. Your partner should also be tested.
Your gp probablywon't know what you are talking about if you discuss NK cells.

I think it would be great if you could see an obstetrician. You need a thorough workover and you won't get that from a gp. IVF won't help if you have an underlying condition. So, I think it would be wise to get a consult if you can.

Wishing you lots of luck on your journey...

[satya]

Flowerchild, I've already seen an ob/gyn and he's the one that's ordered all the testing. There was no mention of clomid at all.... just OK we have to get that fibroid dealt with - hence the lap and then after that straght in to IVF (no time to waste at your age is what he said). Do you think it's worth my while going back to him and asking about clomid now that I've had another shortlived pregnancy?

[Inanna]

I think it's worthwhile seeking out another opinion. You need more bloods done in my opinion. It may be none of the things that has been talked of but we don't know that until you are tested.
Are you in Sydney?

[satya]

No Flowerchild I'm in Melbourne. I haven't been able to find anyone who's been to the guy that I went to so I have no idea what his reputation is. He knew my old FS on a first name basis so from that I think he probably works out of Monash. I don't want to go back to the original FS as he was pushing for IVF as well and that was 10 years ago - he had done very little testing on me and was pushing for it after only trying clomid for 3 months. I think I'm just having bad luck in going to doctors that think IVF is a fix for everything.

[blackduckies]

Hi Satya, I think that your problem may well be the short LP as well. That is the reason that I am doing the artifical insem, not because I can't fall prg but because I have trouble staying that way. My cycle is regulated with the hormones and made the correct length.When I have fallen preg and carried to term my cycle has been a longer one. I have had every test done and they have shown no reason for the MC. My fertility specialist is based in Richmond but travels to my neck of the woods: Dr Mac Talbot:he believes that I am very lucky to have the children I have and the only test he sent me for were the dye test and an ultrasound,because my history told him what he needed to know. He is linked to Monash IVF, maybe he is worth looking up while you are waiting for the lap. Perhaps the AIH could be an option, you are going to get the hormones you need at the right time and it costs a lot less than IVF, if it does'nt work go the IVF route then. If you need any more information, just let me know. See you in the other threadPam.

[Sequoia]

Hey Satya

Check out my thread:

Progesterone Pessaries & HCG Levels - Need Advice Please....

I'm about to start progesterone pessaries tonight. I'll guess we'll know in the next week whether or not they work, having a BT next Thursday to check HCG and progesterone levels again. Since my MC in May, I'm all for having weekly BT''s to check my progress for peace of mind.

The nurse at my FS clinic told me to insert the progesterone, I didn't speak to my FS at all.

HTH.