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Forum Name: Obstetrics

Question: What to do when Progesterone supplements don't work?


 JustBreathe09 - Sat Mar 28, 2009 9:40 pm

I have had three miscarriages in the past year. I have PCOS, and low progesterone. I have been on suppositories, the progestra cream, and proetrium. Nothing had helped. I have never seen a heartbeat, and this last pregnancy was the first time we saw a yolk sac. I had my first miscarriage with two empty sacs at 11 weeks and had to have an emergency DNC. I had my second miscarriage at 7 weeks, and it was like a heavy period. I am currently waiting to miscarry again. I am 9 weeks, and although they have seen a yolk sac, there is no heatbeat and no fetal pole. My progesterone has never gone above 9.5 and I am feeling very hopeless. What do you do when you can't get your progesterone high enough to support a baby? I am seeing an RE, and he pushes IVF. But I don't understand IVF, and we can't afford it either. Even with IVF, if your body does not produce enough progesterone, won't it result in miscarriage also? At this point I feel like I may never be able to have children. I have metabloic symdrome, I am on metformin, and I feel like a complete failure.
 Debbie Miller, RN - Sun Mar 29, 2009 11:03 am

User avatar Hello,
Have you had a work up for clotting factors or are you confident that low progesterone is the problem? Most miscarriages are actually never explained. It is nice when we find something that works like progesterone or low dose apirin but these are less frequently the answer than we would like.

Patience can be very hard to sustain under these circumstances and the hearbreak of repeated miscarriage is hard to bear but you could still sustain a pregnancy at some point. Chromosomal problems are considered a common cause of miscarriage and there is little to be done about that. You are correct that IVF is expensive and not necessarily the answer anyway. I would discuss with your doctor all other options available first.

Best wishes.
 JustBreathe09 - Tue Mar 31, 2009 10:20 pm

Thank you so much for responding. I saw my RE again, and he said that he doesn't think I am miscarrying JUST because of the low progesterone. I have to wait to miscarry this time, and then go back in a few months to do some more testing. He hasn't done the clotting testing or anything yet, but he said something like 85% of the time, they find nothing wrong. That seems so depressing. I just want them to find something so they can fix it, and I can carry a baby to term. What do you think my chances are of having a normal pregnancy after 3 miscarriages & low progesterone?
Thank you so much Dr!!
 Debbie Miller, RN - Sat Apr 04, 2009 10:06 am

User avatar Hello,
It would be impossible to predict the chances but it does happen. I know of several women who carried to term after several miscarriages. In many cases they took low dose aspirin and progestrone supplementation at the beginning just to be safe, even when no clotting problem was actually diagnosed. Your doctor is correct that most miscarriages do not result in a diagnosis that can lead to active prevention. In most cases it is out of our control completely but if you do miscarry again I would get the evaluation just to be sure it is not a factor. Human reproduction is very complicated, even though it seems to happen easily for most couples. It's something of a miracle that everything comes together as it does and when things go smoothly - a miracle we often take for granted.

Good luck.

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