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Progesterone Injections to Carry to Term

by Jessica
(PA)

My first pregnancy ended at 24 weeks gestation after my cervix dilated to 5 centimeters. Doctors pushed for a cesarean delivery as if my son's feet were to slip through my cervix, his head could be caught up and that would result in his death. Long story short, despite being born at such a gestation, he is thriving with minimal issues due to being premature. I was diagnosed with an "Incompetent Cervix" and sent on my way.

Fast forward to our second pregnancy, at 17 weeks, our doctor and I argued about the best options that would aid in my carrying that pregnancy to term. He wanted a cerclage, I didn't want the miscarriage that comes along with the risks of such a procedure, so we settled on 17P injections. I carried my daughter to 35 weeks. I do credit the huge accomplishment to progesterone therapy.

Being a more natural minded person, I'd like to skip the injections all together this time and try a different method which has placed me on this page. I may lose my doctor over the decision, but providing that I carry to term, I have a midwife who will assist in this babe's delivery. It's not an ideal situation, that's for sure, either way this is cut.

My main concern is the effectiveness of the cream vs. the injections, just on the chance that I don't have the access to ultrasounds to measure my cervix throughout this pregnancy. I'd like to be able to go to sleep at night and not have the nagging fear that I am dilating without any knowledge due to my ignorance on the difference between the injections vs. cream and making the "wrong" decision. Are there any studies that show a comparison between all of the options? Perhaps even individual insights would be enough to put my mind at ease...

Thank you so much for any and all assistance, this is a wonderful page!

Comments for Progesterone Injections to Carry to Term

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Jan 19, 2012
 Progesterone Injections to Carry to Term
by: Wray

Hi Jessica There are studies on vaginal progesterone, see here, here and here. They don't do a comparison, but do show it's effective. I've also helped a number of women with the cream, who've had previous miscarriages/pre-term births all successful. No one with a short cervix though. But I don't doubt it's efficacy, as it's absorbed well via a cream, see here and here. These are more comparisons, see here, here, here, here and here. We also have more info on our Delivery systems page. I always recommend using the cream in the vagina too, best at night, as it can leak out. It's pleasanter than the gels, which have a bio-adhesive combined. The amounts used in the studies varied from 90mg/day to 200mg and more. I would suggest using 200mg/day, divided into a minimum of two applications. Progesterone levels begin dropping after about 13 hours. If you wish to accurately measure the cream, a syringe is best. Although a kitchen teaspoon set is good. I'm relieved you were given 17 OHP injections, as often 17 OHP caproate is used. This is a synthetic progestin, and unfortunately the term 'progesterone' is applied to each! We also have a page on Pregnancy which explains more, and has more studies. Thanks for the kind words! Take care Wray

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