Progesterone to Support Very Early Pregnancy

Caitie81490

I just had a second chemical pregnancy on 12/20 after having one on 11/6.  My doctor put me on progesterone after I thought I miscarried again because my levels went up so he thought I could still be pregnant.  However after getting a third test on 12/26, my levels went from 44 on 12/21 to 5 on 12/26 meaning I really did have a miscarriage.  He said to stop the progesterone but start it again as soon as I get another positive hpt and to schedule an ultrasound at 6 weeks as opposed to the traditional 8 weeks so he can see how things are progressing.  I am planning on waiting for a period or two before trying to conceive again.  The second pregnancy was unplanned and extremely stressful since I had just gone through a miscarriage and was terrified of another.  I am typically pretty good about tracking my ovulation and so I am wondering if I should just start the progesterone after I ovulate (after a cycle( to be sure my body has enough progesterone before it is too late and I lose a 3rd pregnancy.  Has anyone else done that? Has it helped them?  

PeggyOlsonFTW

I haven't used progesterone, but I met with my OB today to discuss my losses and next steps. I asked her if my losses could have been due to a hormonal problem and she flat out told me no. She said when you have a viable pregnancy, your body automatically produces the appropriate hormones. If you're not producing the appropriate hormones, the pregnancy is likely not viable and hormone supplements aren't going to help.

Obviously, I can't speak for everyone and my OB's advice could just be because I've had a successful pregnancy and have no other obvious symptoms of a hormonal problem, but in any case, that was her advice.

MrsDho11

I'm sorry for your loss. It seems like you just talked to your doctor, so did you not ask this? I know nothing about this medicine, but it sounds like your doctor gave you specific instructions on when to take it, so if follow that advice.

Edited for spelling.

PrimRoseMama

I've read that you start P4 supplement as soon as you get a +HPT. Give your doctor a call and ask him/her to clarify?

Caitie81490

It was a question that popped in my head this evening after talking with him this morning.  It was just a thought and so I was just curious to see if any other women have had success using progesterone that way.  More than likely I'm going to follow his advice and take it once I get another positive hpt.

Itsnotyourturn

OP my doctor had me wait until a specific date of my first post loss cycle to have a blood test for progesterone levels to be sure I actually have low progesterone versus low levels from a pregnancy that would not have been viable.  It sounds like your doctor didn't do that?  
Since your doctor told you to start taking it after you get a positive HPT I would suggest either following their orders, or ask them if it's appropiate to take as soon as ovulation is over.  Since, you know, they spent all that time and money on medical school they would probably know better than internet strangers.

Sorry for odd formatting, accidently quoted someone and couldn't get rid of the grey box.

_darth

I am sorry for your loss. Progesterone supplementation is very effective in helping with the various issues caused by progesterone deficiency, which is diagnosed via blood test. It will not help if your pregnancy is not viable for other reasons. While supplementation is generally started at 3dpo, and continued to cd1 or into early pregnancy, no, you should definitely not just start taking medication in a different way than it was prescribed.  

That said, may I ask what kind of doctor you are seeing? From what you are describing, he seems out of his depth in handling your case, and it feels like his cavalier attitude has made an already stressful situation worse. If I were in your position, I would ask for a referral elsewhere.

FiancB

KDHB13 said:

I haven't used progesterone, but I met with my OB today to discuss my losses and next steps. I asked her if my losses could have been due to a hormonal problem and she flat out told me no. She said when you have a viable pregnancy, your body automatically produces the appropriate hormones. If you're not producing the appropriate hormones, the pregnancy is likely not viable and hormone supplements aren't going to help.

Obviously, I can't speak for everyone and my OB's advice could just be because I've had a successful pregnancy and have no other obvious symptoms of a hormonal problem, but in any case, that was her advice.

This isn't necessarily the case. My sister had two successful pregnancies, then two miscarriages that were found to be due to low progesterone, and her two youngest wouldn't be here if it weren't for progesterone supplementation. But it's true that it's rarely the case- it's almost always a chromosomal issue and all the P4 in the world won't help with that. 

I did ask my doctor about it, and he said because of my concerns he's willing to check my levels for me, but that I should absolutely not expect that to be the problem. A lot of docs wouldn't even do that, especially since I've only had one loss and it was a MMC so also not likely to be P4.  You test it after ovulation and you start supplementation when you get a BFP if needed. They won't put you on it just in case without the testing. 

PeggyOlsonFTW

@FiancB I agree that it's not always the case. Just that my OB thinks that it's not my case because I have no other signs of low progesterone. We'll see what happens if I have another loss.

LadyMillil

Please follow the advice of your doctor on the use of progesterone. It can cause many problems when not used appropriately. I use progesterone at work to induce a favourable experimental condition for my research. When handling the progesterone I need to wear full safety gear because inadvertent exposure can cause reproductive toxicity, germ cell (ovum) mutagenicity, and is carcinogenic. 

NamelessAria

For what it's worth, I asked my doctor about the possibility of my last MC being caused by low progesterone and she said it was possible but that because of when it happened (6w3d) it was far more likely to have been a chromosomal abnormality. However, she did agree that because it was my second loss (first since TTC and 1 when I was in college) combined with the fact that I've never had a successful pregnancy and I've had some other issues that could point toward a hormone imbalance that she'd be willing to have me come in for a blood draw once I get another +HPT. I was told to call the office as soon as I get a +HPT and if my progesterone comes back low on the blood draw my doctor said she'd start me on progesterone. She did say that there isn't a lot of evidence to support the effectiveness of progesterone supplementation and it's still more of a theoretical benefit. Basically it was a "don't get your hope up on progesterone being a miracle cure" type speech. She also said that she doesn't expect me to have another loss either way and checking progesterone would be more for my peace of mind than anything else.

I think what I'm trying to say here is: follow your doctor's instructions. If you don't trust your doctor to have given you good instructions then you need to find another doctor that you trust.

I'm so sorry for your losses.

kcolly32

*****Lurking & TW BFP******

First off I'm sorry for both of your losses @Caitie81490. I currently take progesterone supplements although my RE said its mainly for a precaution because I had a corpus luteum cyst rupture. I learned that this cyst is what provides the baby with the correct amount of hormones at the beginning of the pregnancy, like estrogen and progesterone, until the placenta takes over. My RE has told me he gives it for ppl that start spotting early on in their pregnancy too as low P4 could be the cause, but blood work is usually drawn to confirm. I wouldn't start taking progesterone til a positive HPT.

Caitie81490

Thanks ladies I was just curious to see what other women's experiences with progesterone was like.  Most of what I had read pointed to taking it after ovulation, there wasn't much about taking it after a BFP, leading me to question what the doctor instructed me to do. A nurse at my doctor's office calling me this morning, to make sure my doctor spoke with me yesterday morning, which gave me a chance to double check with the doctor's instructions and she reassured me that taking it after a BFP should be just fine.

Because of timing of my pregnancies, miscarriages, and my primary doctor leaving her practice, my first appointment with an actual OB doctor was after my second miscarriage, the day before I was supposed to meet with an OB for an OB History exam.  Because I had the heavy bleeding last Sunday I called the office Monday morning and they were able to get me in with a doctor that day to go over what had happened and start a plan for my next pregnancy.  

I am actually choosing to stay with the OB I met with that day after the miscarriage because of how well he was able to take over getting my situation under control as opposed to meeting with the doctor my primary doctor originally wanted me to meet with.  I've always been someone against the idea of a male OB but his management of my awkward situation really impressed me and made me feel comfortable trusting his judgement.  I was also comforted by the fact that he called me to talk with me about my results the two times he sent me for blood work as well as informing me of what the action plan was going to be for future pregnancies.  Each time I have had blood work and other tests done in the past it was always an MA or nurse that called to speak with me.  I am hoping taking the progesterone and folic acid the day of a BFP will prevent me from having a 3rd miscarriage.

Itsnotyourturn

@Caitie81490

I am so sorry for your losses.  

I think that got cut off with the formatting issue I was having.

Caitie81490

Thank you @Itsnotyourturn The first one was tough because we had been NTNP for 6 months or so and so I was starting to wonder if I had fertility issues (because of somewhat irregular periods) and I felt so blessed to know I was going to be able to get pregnant.  I think I'm having a tougher time with this one because there was a little glimmer of hope that I didn't have a miscarriage at first and because I had gotten pregnant the cycle immediately  following the first miscarriage.  Again we went back to NTNP thinking it wouldn't happen so quickly but we were wrong.  When I met with the OB last Monday he reassured me that it is a good thing that I was able to get pregnant so quickly following the miscarriage and so he thinks 3rd time is going to be the charm.  Especially with the progesterone, folic acid, and baby aspirin.

As much as I want to try again, I really feel like we should prevent pregnancy the next month or two to give my body a chance to have a period or two and then go back to NTNP.  This way we can start fresh and have a chance to relax and reconnect a bit.

Sorry for the babbling, thank you again

chaine1

I'm a recurrent pregnancy loser (4 losses) and am seeing a specialist in recurrent pregnancy loss. You really need a new doctor.

Most recurrent pregnancy loss specialists recognize the fact that progesterone given after a positive pregnancy test is too late to impact the lining and any hormonal issues associated with it. Progesterone started after a BFP has been shown to have no effect on pregnancy outcomes.

Here's a New York Times article describing some of what I said. (Sorry I'm mobile and can't figure out how to imbed the link).

https://mobile.nytimes.com/2015/11/26/health/progesterone-may-not-help-women-with-history-of-miscarriages-study-finds.html?referer=&_r=0

Again, you really need to see a different doctor.

kickassi78

I have had 4 losses, 3 being chemical. My fertility specialist has me on progesterone 3 days after ovulation until I get a BFP. If that doesn't happen and my period starts, I stop progesterone until the next cycle. I currently just got my BFP on sunday so I am continuing the progesterone until hopefully I make it to 12 wks. Fingers and toes crossed for me....

 Sorry for your losses, and I hope that everything works out for you in the near future - but I would definitely talk to your doctor about starting the pills 3 days after ovulation so you can be well prepared by the time baby gets there. Better sooner than later with this especially if you have had early losses. Good luck!

cjt121413

I'm sorry for your losses.

******T/W loss mentioned *********

Just my experience:

I recently had an m/c. Early on, I got my HCG and progesterone tested and progesterone was low. I begged for supplements because I wanted to know I tried everything I could. Turns out, my doc was right, the low progesterone was a symptom of a problem with the pregnancy, not the cause. Unfortunately (probably in part due to the progesterone) I had to take cytotec three times before my m/c even started, and then it lasted for almost 40 days. The progesterone also hit our back account hard - probably $800.

My doc will check my progesterone after O to see if it's actually low and we'll go from there. My research (and my doc) indicate low progesterone is not that common and most often supplements won't prevent M/C (unless you're doing IVF, totally different story).

I'd request further testing before just using progesterone. It sucks in a million ways I haven't even described, and may not help at all. It can even delay the inevitable and make it worse (like it did for me).