Progesterone withdrawl could have caused my 2nd trimester miscarriage
I have posted this same question on another page but found this and thought it was more appropriate so apologies for posting twice!
Last year, I was pregnant with twins following IVF and was put on progesterone pessaries (2x400mg per day) by my private IVF consultant. This is the clinic's normal procedure up to 12 weeks but he told me that since my pregnancy was very high risk, my antenatal consultant would leave me on it for the duration of my pregnancy. My risk factors were twins, IVF, severe OHSS from IVF procedure with 27 eggs retrieved, 2 previous LOOP excisions of the cervix and my age being 40. The antenatal consultants did not see that this was necessary as there is little evidence to support the use of progesterone after 12 weeks and took me off it at 13 weeks (I suspect this is a cost issue on the NHS - I am in UK). I weaned myself off it taking 1 a day for the last 2 weeks as I had read a lot about withdrawal bleeding. Within 2 days of going to 1 a day, I started spotting with brown discharge. This got heavier when I stopped the progesterone completely and within 5 days of stopping, I went into pre-term labour and lost my twins at 17 weeks. I have since found out that I had Chorioamnionitis in one of the placentas which had ascended through my cervix. My question is could the drop in progesterone have allowed my cervix to open and allow this infection through or would it have happened anyway? Would the fact that I had 27 follicles producing progesterone for the first 12 weeks have also impacted on the sudden withdrawal?
I am now pregnant again at 13 weeks with a single baby and I have struggled to convince my consultant to allow me to stay on it. He says they do not believe my miscarriage was connected to the progesterone but I didn't fight for the progesterone last time and have regretted it ever since as I am convinced it is connected. I don't want history to repeat itself which it feels like is happening. What is your view on progesterone to strengthen the cervix and prevent infections ascending?
They are also concerned at the dose my IVF consultant has put me on - 2x400mg a day. I want to stay on this as it is when I reduced it that I miscarried last time but they want me to go to just 200mg a day. Is 800mg too much and can that dose do any harm?