Could progesterone therapy have saved my pregnancy?

by Jeanette

I'm 41 years old and found out 2 months ago I was pregnant. It was unexpected, as I have two teenagers and was not preparing for a baby, however, my husband and I were getting more and more excited with each passing day. Once I found out I was pg (from my general practitioner) I immediately scheduled with an OB/GYN (my friend suggested him, as my former OB dr had retired).

At my first appt it was determined I was 8 wks pg. I gave my history to the dr and explained that I had two miscarriages between the birth of my two children and how I used progesterone therapy to maintain a viable pregnancy with my last child. I asked if my HCG levels could be tested to determine my progesterone level (as I did not want to miscarry.) He assured me that things would be fine and provided me with a sonogram to reassure me. The baby was fine - strong heartbeat and good size.

My next appt was scheduled for 5 weeks (this would put me at 13 wks - my first 2 miscarriages were at 11-12 wks - so I was a little nervous waiting that long. My husband and I decided to wait until my 12th week to tell people (extended family, friends, work...) since I felt everything was fine.

At my 13 wk appt (early last week), the dr. could not find a heartbeat. Although I was not spotting or showing other signs of miscarriage, he did a sonogram and it was determined that the baby quit developing at 9 1/2 to 10 1/2 weeks. (A D&C was performed.)

I asked the dr. if progesterone therapy would have saved my baby if I would have started taking progesterone at my first appt (8 wks) or would I have had to start it much sooner in the pregnancy. He said there has been some controversy with progesterone therapy and assured me that my miscarriage was more than likely my body naturally taking care of a pregnancy that had genetic abnormalities.

Although its been just a week, my husband and I now seriously considering trying for another baby and were not sure if we will have luck talking with this doctor about the importance of progesterone therapy in staying pg. Or, should we seek another OB/GYN who will take us seriously. Also, is there any way that my progesterone level can be tested throughout my monthly cycle (before I get pg) to truly determine if I suffer from a luteal insufficiency? I think this would help me convince my doctor if he could see it on paper.

Because of my age, I am interested in ttc as soon as possible (within the next 3 - 4 months), so any advice would be greatly appreciated. Thank you!

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Aug 28, 2010
Could progesterone therapy have saved my pregnancy?
by: Wray

Hi Jeanette I can't agree about there being some controversy about progesterone therapy, it's still used extensively. Besides which without progesterone we wouldn't carry any child, never mind to term. So if the body is not producing enough a miscarriage will occur. You've had two previous miscarriages and a successful pregnancy using progesterone. So it seems highly likely with this history that for some reason you don't make enough. And that a genetic abnormality is not the cause. A luteal insufficiency would mean you would have difficulty falling pregnant, which doesn't seem the case. The luteal phase should always be 12-14 days long, if yours is then there's no need for a test. If you spot a few days before bleeding then you are producing insufficient progesterone, and would need to supplement over these 14 days. The critical time is once you're pregnant. The corpus luteum continues making progesterone until about the 8th week, when production starts dropping. It's at this point the placenta is producing sufficient to maintain the pregnancy, or should produce enough. If it doesn't, the decline in corpus luteum production would mean levels drop too low for the pregnancy to continue. Most miscarriages occur within the first 8 weeks, the remainder in the next 2 months. If you should consider progesterone you should start it before falling pregnant. Often doctors give it only when pregnancy is confirmed and generally at 8 weeks. To my mind too late, as I said above most miscarriages occur in the first 8 weeks. I think it's essential to start beforehand, as oestrogen dominance can occur, not something any woman wants while pregnant. For more info please see our page on Oestrogen Dominance. This occurred to someone who wrote to me, and she wasn't happy about it, understandably! Please read our page on Pregnancy. It gives info on how to use progesterone before conception. Take care Wray

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