Progesterone Therapy in Early Pregnancy

Hi A.,
I had 2 miscarriages, and then tried progesterone suppositories and baby aspirin each day. The pregnancy was uneventful and my little boy, Kenny (who will be 4 next week) was 8 lbs. 3 oz. I wish you the best A..
C.

Hey A., I didn't know you were on here too! I hope you can find some good advice from other women who have been there!

C.

I had two previous miscarriages early in my pregnancies. The third pregnancy, I was prescribed progesterone pills, steroids and baby aspirin. I took all of these pills throughout the first trimester. The combination of all three worked. I now have a 16 month old son. Best of luck to you.

Hi A.. I feel your fear. When I was pregnant with my first daughter, my progesterone level was dangerously low - only registering at 5.6. The doctor told me my chance of miscarriage was greater than 90%. I went on progesterone supplements (vaginal suppositories), 100 mg 2x per day. Within a week, my progesterone level was up to 19.5! And my pregnancy was saved. My daughter will be 3 in February.

I am currently 21 weeks pregnant with my second daughter and was put on progesterone supplements (vaginal again) immediately as a precaution. I haven't had any problems with this pregnancy whatsoever.

A few things to note about progesterone. First, it is released in your body in pulses or waves, so it is not necessarily a bad thing that your level dropped from 19 to 15. When it was measured at 18, it could have been because your blood was taken at the high end of a wave, when it was 15 perhaps it was at the low end. Remember - a blood test is only a snapshot in time. It isn't necessarily indicative of the total picture. Also, anything above 11 is generally considered to be "normal". Finally, at 10 weeks, the placenta takes over production of all your pregnancy hormones. This is when I was taken off the progesterone supplements each time. Prior to 10 weeks, the ovaries are producing the hormones, and sometimes they need a little help in women who have naturally low progesterone (like me).

Hopefully that puts your mind at ease somewhat. Hang in there! And please, don't be afraid to ask your doctor any and all questions. If you are wondering why you've been given tablets instead of vaginal suppositories, ask about them. There may be a good reason. My guess is that vaginal are stronger, and possibly you don't need that much of a boost.

Best of luck! And congrats on your pregnancy!!

Hello A.,

I also had extremely low levels with my first pregnancy and petitioned my doctor to put me on progesterone supplements. (She did stress to me there there is no proof that supplementatin helps to maintain a pregancy, however I pressed her on it. In fact, she told me that the levels were so low that it was probably indicative of a "genetically unhealthy baby.") 2 years later I see that there is absolutely nothing genetically wrong with my son.

My mother had 3 back-to-back miscarriages and after the 3rd miscarriage they checked her levels and told her she had progesterone deficiencies. Her next 2 pregnancies were successful, and she attributes it solely to the supplementation.

If I were you, I would press the doctor to allow you to take the progesterone.

Hi A.
I had two miscarriages last year due to low progesterone levels. I began taking Crinone suppositories after ovulation to ensure implantation and I was on it for 3 months and I have to say it didn't work for me as well as some others testify. I did not conceive during this time. I would like to add that they made me twice as tired as any normal pregnancy fatigue, and extremely irritable and not nice to be around. I also read that the side affects from the suppositiories is cleft palate which made me throw the whole box away and look into a natural form. I felt like I was on a permanent PMS trip and was glad to rid my self of the synthetic form and decided at that time to look into natural forms of progesterone. After much research and testimonials, and finding a reputable company, I decided to start taking this natural cream. Needless to say I was extremely pleased with what I found online about natural hormones. After starting a regimen of applying the cream ( I will add is also much cheaper than Crinone) I was able to conceive after my second shot at it. I am now 12 weeks and still applying the cream and my progesterone levels are at a steady 23!!! I was as hopeless and thought I couldn't go through another day on the synthetic stuff. Some women take it and have no problems, but I thought it wasn't worth it and needed to give my body a big old break if I was going to continue on that route. Sorry for the enormous email, but I wanted to share my story with you and to consider the natural forms of progesterone. It is something you can take your entire pregnancy and is recommended to take even after pregnancy for baby blues. The best thing about it is that there are NO side affects. If you would like to ask me anything feel free to message me! You can find plenty of testimonials on natural progesterone for infertility if you google it. If you would like recommendations on where and how to purchase, just email. Best of Luck!!

Congratulations on your pregnancy, A.! I had spotting with my first pregnancy, and when I started bleeding around 5 weeks, the doctor gave me a shot of progesterone and put me on the pills until 12 weeks. Our son was born healthy and huge (10 pounds!) I was with a different doctor with my 2nd pregnancy, and I mentioned that I bled with my first baby. They immediately put me on progesterone tablets before I even had the chance to bleed, and I gave birth to a baby girl. So my experience is that it raised my progesterone levels to the level where they needed to be to carry my babies to term, so I would definately recommend taking the pills.

I have PCOS and required progesterone supplementation during early pregnancy. I took both the oral (prometrium) and vaginal (crinone) forms of progesterone and was under close supervision from a reproductive endocrinologist. I now have a perfectly healthy son. I beg to differ with the people who claim there is no evidence that the progesterone works. My progesterone levels were frequently monitored during my pregnancy and had it not been for the supplements I would have miscarried a perfectly healthy baby. Here is a good website to check out for more info on the role of progesterone: http://en.wikipedia.org/wiki/Progesterone

I needed progesterone supplements with my second child and my doctor went straight to suppositories. It isn't really fun to do and makes you really nauseous but it is absorbed directly where it needs to go and works well. They kept doing blood tests to see if it was working. We had to double the amount at one point before my numbers went back up. I would NOT mess around with pills if your numbers aren't changing. Low progesterone can definitely lead to miscarriage. I have heard of some shots too but I don't know much about that. I hope this works for you. I will be praying!

Hi A.. After my first miscarriage I wanted to know why since we were trying to get pregnant. Because I was charting I noticed that I ovulated later in the cycle than I thought which gave me a shorter Luteal Phase. I read about progesterone levels possibly being too low. Well, the cycle I got tested to see if my progesterone levels were low, I found out I was pregnant the same day I got my results back. So immediately they put me on progesterone supplements (by mouth). I took those my entire 1st trimester. I have a beautiful boy who will be turning 3 next month becuase of it. I would take them and hope that this one sticks. I didn't need them for my second son though. So each pregnancy was diffirent. All I can say is that I was happy they found my levels were low so that I could have my first son.

Hi A.,
You need to see an OB that deals with high risk pregnancy. Midwifes are great, but in your situation you need some additional care. I'm sure there are some Moms out there that could give you some excellent advice on Dr.'s. Good luck.

I used progesterone with my daughter, and most of my friends (all over 35, I'm 40) needed it as well. It's very common as you get older to make less (one reason why cycles get shorter). Even though I was already on progesterone, at about week 7 I had some bleeding, and a blood test showed my progesterone had dropped very low. They doubled my Prometrium (like an egg shaped gel cap rather than a tablet) and it did the trick. I had an extremely healthy daughter and pregnancy, my first child (I had one miscarriage before her). I've never heard about it not working--in fact, I've heard the opposite; that it's very effective. I think the pills are much less messy than the disgusting suppository some docs prescribe. Good luck with your baby!
EDIT: I just wanted to add that I started taking my progesterone pills 3 days after ovulation due to short luteal phase. My progesterone had been at 14 with progesterone, dropped to 9 during week 7 which caused the bleed and required the higher dose which brought me back up to 17 or so. Also, I had no fatigue or side effects, even with the doubled dose.

I used a progesterone cream years ago to make sure I held onto my babies. I took it for about 8 weeks or so. The only other choice then was a painful shot everyday.

Are they sure it is spotting and not a blood clot? I had two healthy children and then out of the blue I had two miscarriages. The first at six weeks and the second at 12 weeks. The second pregnancy were twins. They thought I had a mole as well, but the tissue came back negative....so they did lots of blood work on me. Nineteen vials of blood later they discovered I have a gene mutation that causes blood clots in my uterus when I'm pregnant. It is called PAI 1. I had to inject Lovenox during my pregnancy this last time but I have a healthy son now. It was well worth the effort.

I would ask about PAI 1 and if you were tested for it. My doctor said they typically test for it after two miscarriages. You can google it and find out more about it. Just google PAI 1.

I think the progesterone can work if the pregnancy is a viable one but often when things aren't quite right early on, it is a sign of chromosomal abnormalities and they can't fix that. There isn't a downside to taking it. Good luck.

I did vaginal progesterone suppositories. I carried to 37 weeks with twins. The suppositories put the progesterone right where it needs to be, in the uterus. Like other women said on here, I would see a high-risk Dr. just to be sure. Or maybe even an OB who has experience with high risk pregnancies. I am in the Schaumburg area and can give you a number to an OB and high risk Dr. if you are interested.

I too took the vaginal suppositories to help ensure my pregnancy. My numbers weren't doubling like they should either and so my Doc recommended them. He told me that the research isn't solid but that it was worth trying. I am happy to report that I have a healthy and active 22 month old baby today and so "something" worked. Given your history, I would take it and hope for the best.

Good luck. I hope that things work out for your family.
N.

I took progesterone last year with my last pregnancy. It was taken by mouth and I used it for the entire first trimester. I know that there is also a cream option which you can insert but the pills worked for me. I began taking it VERY early on also and I believe that is what worked for me. Maybe ask about the cream option as well?? I hope all goes well for you. Take care.

I had to use progesterone suppositories (Sorry - TMI) as my numbers were around the same as yours... but those didn't work too well for me. So I had to do the progesterone shots. I had to give them to myself --in between my rear and my lower back -- I think I had to do that for 2-2 1/2 months. It wasn't fun at all (I am scared of needles) but it got my numbers where they needed to be!
Good luck!

Hi! I am sorry you have to go through this difficult time. I almost lost my daughter and was prescribed the pills. They called it a "threatened miscarriage" and I had heavy bleeding for the first three months of the pregnancy. But I took those little pills faithfully and after the first trimester the bleeding stopped. I'm not sure I can credit the pills with that, but it was the only thing I felt I could do. Do talk to your doctor about when to stop them though, because mine never told me I could stop taking them and I got really really depressed. Until I asked and he wondered why I was still taking them. IMO if it's a chance to help my baby, I'll do it! Good luck to you!

A.,
I don't know too much about progesterone therapy, but it sounds like your history would put you in a 'high' or 'higher' risk category of patient. My advice would be to find the best ob specialist to help you and advise you through this pregnancy.

Personally, I wouldn't take any medication without better evidence of effectiveness.

Just my two cents,
C. C

I am not an expert on progesterone but I have heard of many people taking it to support early pregnancy. You could always get a second opinion if you are unsure. Best wishes for a healthy pregnancy.

In a typical menstrual cycle, there are hormones that rise and fall. After ovulation, progesterone surges through the body in case the egg is fertilized in an attempt to sustain a pregnancy. If someone gets pregnant, usually progesterone continues to surge. However, if progesterone levels start to drop then the brain starts to think "okay, no baby" which triggers menses (menstruation, which as you know means that the lining of the uterus detaches and you have your period).

If you've ever had irregular periods and your doctor has you take progesterone to start a period, you get the period because of a 'withdrawl bleed' - the brain recognizes the drop in progesterone which triggers the period. Most hormonal birth control methods work similarly (although not exactly the same); take active birth control pills for 21 days, take a break - get your period, wear a patch for 3 weeks, take a break - get your period, use the NuvaRing, it is inside for 3 weeks, out it comes - get your period. Estrogen and FSH are for ovulation and conception; progesterone is for implantation and not conception.

I was under the care of a Reproductive Endocrinologist for fertility treatments and each and every time I took progesterone after ovulation. Once I did get pregnant, I continued to take progesterone throughout the first trimester.

Good luck and hope everything works out well!

A.,

I used the suppositories with both of my pregnancies - after two miscarriages.

They were messy and a pain because only certain pharmacies carry them (they are made overnight and put in the fridge). But, to me, more than worth it.

I read that the suppositories are the most effective.

Best of luck to you.

T.

My doctor perscribed the progesterone vaginal suppositories because they believe that's where the progesterone is absorbed best and needed most. I'd ask your doctor asap.

I do have insurance, and paid $35 for a three-month supply. I think it was like $145.00 per box (and I got three boxes)!

I would not wait, your numbers should be going up, not down.

The very best of luck!!!
M.

I cannot address the progesterone treatments but just wanted to send my hugs and love for a safe, smooth and easy pregnancy. May your son be granted a healthy little baby soon.

I have used it in both tablet and injectable form. You are correct--there is scant evidence that there is any benefit to the oral form, particularly in women who become pregnant naturally. The reason for this is that progesterone is produced by the corpus luteum, which is the "pod" (for lack of a better word) that the egg emerges from. If you have ovulated normally, the remaining cells of the c.l. produce the progesterone in early pregnancy.

If you have not ovulated naturally, as in an IVF, progesterone supplements are given. The theory is that in extracting the eggs in IVF, cells from the corpus luteum may be taken as well, damaging your ability to produce progesterone. This is only a theory, and the progesterone therapy is given as a precaution, not because there is proof that it is valuable. It's probably MORE valuable in secondary IVF, where frozen embryos are used, since in that case the woman would not have any production herself (the growing embryo eventually takes over this job as the corpus luteum peters out).

There have been studies that show greater effectiveness from the injectable form (it's intramuscular, given in muscle of the hip and while the injection itself isn't painful--sharp needles and inert liquid--it causes muscle soreness that takes quite a while to resolve).

When it's given in your situation, it's unlikely to have any effect. There is no proof that it's effective at all, and your levels are high enough on their own (anything above 12 is very good). Doctors prescribe it because it's a benign therapy, and they are covering all bases. In other words, it won't hurt you, but there is no evidence that it prevents miscarriage.

If it gives you a more positive outlook to take it, then by all means continue. It cannot be harmful in the low doses prescribed. Best of luck to you.

After several attempts at carrying a baby, I was told that my body was not producing the amount of progesterone that the baby needs to feed off of the first 10-11 weeks of pregnancy (before it begins to eat from the placenta). This is why I continued to miscarry over and over for the past 10 years. My doctor told me that as soon as I find out I am pregnant, call him and get in for blood tests.

Within 2 weeks of conception I had a positive pregnancy test. I called my doctor and went in the next day for a blood test. They asked me to come back in two days for another. Within that 48 hour period, your hormone levels should double...mine did not. So, I was prescribed progesterone. It was a little ball of a pill that I had to take I believe twice a day (100 mg sounds about right).

So at barely 3 weeks pregnant, I started taking the medication. I was extremely nauseous 24 hours per day, 7 days per week for almost 3 months. I had to go in for blood tests every other day for weeks to be sure that my levels were increasing, which they were.

It is now 2 1/2 years later and I have a beautiful, healthy little girl! The only thing that I was concerned about during the pregnancy was that I did get toxemia in the last month of my pregnancy, and I gained 32 pounds in 4 weeks. My daughter was only 5 pounds at birth, but was on time. I don't know if the progesterone had anything to do with these issues or if they were just a coincidence.

To be honest, at this point in your pregnancy, I don't know much about how effective the medication will be. My doctor made it very clear to me that I needed to be vigilant in taking pregnancy tests, and as soon as one was positive I needed to get on this medication. So I was on it at less than 3 weeks from conception and carried a beautiful baby.

I wish you the best!

I have heard that the pills are not as effective as they go through your digestive track and much of the progesterone doesn't make it into your blood. Creams (you rub on your abdomen), suppositories and now sublingual progesterone - you put it under your tongue and it goes directly into blood system - are usually recommended above pills. But check with your doctor and see why he/she chooses pills. Maybe they have a good reason and will answer you intelligently when you come armed with some knowledge. Google "progesterone pills vs. suppositories," "progesterone pills+effectiveness" etc. to get some more info. Best of luck to you. I hope you have an uneventful pregnancy. I did after 2 miscarriages and have a beautiful daughter, so it can happen!