Progesterone and Miscarriage

I am not a medical professional. The information I share is meant to supplement the information given you by your doctor. If you feel your doctor is not doing enough for you or not willing to listen to your concerns, I strongly encourage you to take what you've learned here and get a second opinion.

After reading the stories at Saving Babies Online I am really interested in the role progesterone plays in miscarriage. I would just like to pass on a bit of what I've learned in hopes it may help somebody else.

The Importance of Progesterone:
Progesterone is important not only to keeping a pregnancy but also may determine whether or not you conceive. During your cycle, the uterine lining grows thicker in anticiption of a fertilized egg and progesterone helps ensure the endometrium (lining) is ready. Progesterone is responsible for preparing the uterus for implantation. If you have low progesterone, chances are the baby will not be able to implant which may result in a chemical pregnancy. And, low progesterone may keep you from ovulating. Keep in mind that once both estrogen and progesterone levels drop, your body prepares to break down the lining and thus your period begins. If your progesterone is dropping during pregnancy, you are in danger of losing the baby.

Some symptoms of low progesterone:
If you have short cycles (25 days or under), you may have low progesterone. As women age, progesterone may decrease as well. Other symptoms may be severe PMS and weight gain. Stress, whichs stimulates cortisol production, will also decrease progesterone production making conception more difficult and could jeopardize a pregnancy. Progesterone actually produces a more calming effect than cortisol which increases stress

Natural or Synthetic (man-made) Progesterone:
Although I'm reading alot on the benefits of both synthetic and natural progesterone in maintaining a pregnancy, there does seem to be some consensus that synthetic progesterone may cause some birth defects. I haven't really seen that those studies are reproduceable and am unsure how valid they are, but the risk of birth defects should be taken into consideration. Natural progesterone, however, looks to be much safer with no side effects as long as you don't overload yourself with it. Also topical progesterone and injected progesterone seems to be more effective than progesterone taken orally.

What it boils down to is this:
If you have short cycles, have suffered from infertility or are a bit older than the average mother, you may want to have your progesterone checked. The best time to get checked is around the time of ovulation so you can begin taking supplements if needed. Natural progesterone seems to be a safer than synthetic progesterone and can aid in both achieving and maintaining a pregnancy. Take what you've learned about progesterone to your doctor. If you have a doctor who is not open to testing for progesterone, it may be time to find a new doctor.

Hope this helps.

(taken from fertilityplus.org 's website)

Mid-Luteal Phase
5+ ng/ml -- A level of 5 indicates some kind of ovulatory activity, though most doctors want to see a level over 10 on unmedicated cycles, and over 15 with medications. There is no mid-luteal level that predicts pregnancy.

First Trimester
10-90 ng/ml -- Average is about 20 at 4 weeks LMP, and 40 at 14 weeks LMP. It is important to note that while a higher progesterone level corresponds with higher pregnancy success rates, one cannot fully predict outcome based on progesterone levels.

Second Trimester
25-90 ng/ml Average is 40 at beginning, 90 at end.

Third Trimester 49-423 ng/ml Usually peaks at about 175.

One note, FertilityPlus has some wonderful information, however, they do take the stance that beginning progesterone supplements after a positive test is unlikely to do much. I've been able to find studies online to contradict that opinion. I'll be sharing some of those studies on this page as well.

Some studies I have stumbled across in my quest for more information on progesterone in pregnancy. I'll post the conclusions of the studies. Feel free to take a look at the links and then take this information and discuss it with your healthcare provider.

more to follow...
A combination treatment of prednisone, aspirin, folate, and progesterone in women with idiopathic recurrent miscarriage: a matched-pair study.
In a nutshell, this study found that taking this combination resulted in a much higher rate of live births (77% vs. 35% in the group who were not treated) in women who have had recurrent miscarriages.

Use of synthetic progestogen in the treatment of threatened habitual miscarriage
Synthetic progestogen was begun no earlier than 7 weeks in women who were 7 to 16 weeks pregnant and experiencing a threatened miscarriage. Of those studied, approximately 8% miscarried, 9% experienced preterm birth and 82% gave birth 'normally'.

Effects of vaginal progesterone on pain and uterine contractility in patients with threatened abortion before twelve weeks of pregnancy.
This study found that the use of vaginal progesterone diminished pain and contractions in women with threatened abortion. They also found that the placebo group had twice the miscarriage rate of the supplemented group.

Estrogen Dominance: Losing the Healthy Hormonal Balance
This article discusses estrogen and progesterone imbalances. Some of the reasons given why women of childbearing age may have low progeterone: toxins, contraceptive use, stress, extremes in diet and exercise, or xenoestrogens found in foods.

My Own Misdiagnosed Blighted Ovum Story
- After turning down the D&C twice, we found my baby at nearly nine weeks!
My First Misdiagnosed Miscarriage
- During my first pregnancy, we believed I was miscarrying at 12 weeks

A collection of Misdiagnosed Miscarriage stories

When You've Been Diagnosed with a Miscarriage

Bleeding during the First Trimester

What your Doctor may not know about your pregnancy after IVF

Miscarriage News and Research

hCG levels and Pregnancy FAQ

Tilted Uterus and Early Pregnancy

16 Days Past Ovulation (DPO) and hCG levels

Infant Survival Rates during Pregnancy

Is This Really an Ectopic Pregnancy?

High hCGs and No Baby?

The First Trimester: Enlarged Yolk Sac

Progesterone and Miscarriage

Asherman's Syndrome: Why you may want to rethink your D&C

So You've Been Told You Have A Blighted Ovum

Blighted Ovum FAQ

Non-Doubling hCG Levels in the First Trimester Do Not Mean Inevitable Miscarriage!

Can Stress Lead to Miscarriage?

Getting a Second Opinion about a Miscarriage Diagnosis

Why You May Want an Ultrasound Right Before Your D&C

Intravenous Iron Infusion and Me

Coping With A Miscarriage

Remembrance Gifts After A Miscarriage