Another progesterone question(losses mentioned)

[doodler]

Ok guys, bear with me here.  I just want to run something by you.  In September I had a mmc.  Then in November I had a CP.  In December I switched OB practices and when I showed up for my annual exam I had just gotten another positive pregnancy test.  The doctor that I saw cancelled the exam and did a "consult".  We basically talked about my history and she discussed a few additional things.  One of the things we talked about is progesterone.   She said that the newest research shows that progesterone supplementation does not decrease the number of miscarriages.  (I'm summarizing but this was the general idea of what she said to me).  She basically said  "I know that people are going to say that they had a miscarriage and the next time they used progesterone and had a healthy baby, but that doesn't mean that it was the progesterone that made it happen." She wasn't being snarky, she was just explaining things to me.

With that being said, she did not test my progesterone when I had my betas tested and I ended up miscarrying again at 7 weeks.  I have had several people tell me their anecdotal stories about how they supplemented with progesterone and finally had a successful pregnancy.  I understand the doctor's point that it wasn't necessarily the progesterone that helped them, but it is hard not to second guess EVERYTHING at this point after another loss.  So my question for you is:  Should I insist on some kind of testing?  Has anyone heard this same information from their OB or have any firsthand knowledge of it?  If I am reaching here, please feel free to let me know that too.  I will be speaking to one of the OB's(not sure which one because a different doctor handled my actual miscarriage) about other RPL testing and I want to have all of my thoughts sorted out before I go.

Thanks for reading my novel!

[jags8]

**graduate lurking, loss and BFP mentioned**

Are you having any other signs of low progesterone? After more than a year of temping, I saw a consistent pattern of starting to bleed (spotting) within just a few days of ovulating, until I would get my actual period. Because of my low progesterone, I couldn't even get pregnant because I was shedding my lining before a possible zygote could even implant. Low progesterone may or may not have been the cause of my miscarriage August '14. My OB listened to me, we ran some tests, and decided to try progesterone.

While I did still have some spotting 7-10DPO, it was nothing like the spotting I had been experiencing in the previous year, which would start as early as 2DPO. And I did get a BFP that cycle. I had to stay on the progesterone through week 14. If there would have been anything wrong with the baby, I would have miscarried regardless of being on progesterone.

So I guess I would suggest you talk to your doctor about being tested. It can't hurt.

[Deleted]

I read that study several months ago. They're still working on a study to see if it makes a difference when there is significant spotting/bleeding, but my perinatologist agrees with your ob. Supplementing hasn't shown to be effective. It never was for me.

I know I shared a story on it in my g+feed at one point if you'd like I can hunt it down for you.

[doodler]

Feb 4, 2016 10:14:45 GMT -5 jags8 said:

**graduate lurking, loss and BFP mentioned**

Are you having any other signs of low progesterone? After more than a year of temping, I saw a consistent pattern of starting to bleed (spotting) within just a few days of ovulating, until I would get my actual period. Because of my low progesterone, I couldn't even get pregnant because I was shedding my lining before a possible zygote could even implant. Low progesterone may or may not have been the cause of my miscarriage August '14. My OB listened to me, we ran some tests, and decided to try progesterone.

While I did still have some spotting 7-10DPO, it was nothing like the spotting I had been experiencing in the previous year, which would start as early as 2DPO. And I did get a BFP that cycle. I had to stay on the progesterone through week 14. If there would have been anything wrong with the baby, I would have miscarried regardless of being on progesterone.

So I guess I would suggest you talk to your doctor about being tested. It can't hurt.

I don't have a consistent pattern of spotting that I can identify. However, I did see my old OB in June about random spotting and bleeding after sex. Off of the top of my head I don't know when the spotting was happening in my cycle. I was on Nuvaring, then came off, sat on the bench for two cycles, then got pregnant on the first shot in July. It was during those first few cycles after nuvaring I had the spotting. She did some blood tests and a pap smear that came back normal and then I got pregnant and we dropped it. Since that loss, I have spotted for 2-3 days before getting my period every cycle. Very lightly.

[JustJudy]

Have you been tested for the MTHFR defect? I know of few of my friends who had repeat losses were finally tested and treated and now have take home babies.

[doodler]

Feb 4, 2016 10:48:19 GMT -5 JustJudy said:

Have you been tested for the MTHFR defect? I know of few of my friends who had repeat losses were finally tested and treated and now have take home babies.

At this point the only testing I have had is a clotting panel.  It was done during my first pregnancy because my mother has a significant history of blood disorders.  It came back normal.  We are going to be discussing additional testing with the OB after the results of the genetic tests on the baby come back next week.

[daystardreams]

If I were you (and I was technically in the same position several months ago) I would demand progesterone supplements. I did after my third loss. Every time my progesterone was checked it was low whether it was after ovulation or during pregnancy. I've took it the last three cycles with no happy results yet but I figured it definitely can't hurt. I'm not sure if it is helping anything but I'm willing to pay the $25 a month and insert a pill into my hoohaa twice a day for two weeks of the month, just in case it might help even the tiniest degree.

[joy]

My RE sits strongly in the "progesterone supplementation isn't helpful" camp.

You've now had three losses? I seems that you could do repeat loss testing now, right? I actually don't know what that entails.

I'm so sorry for all you've been through.

[JustJudy]

Feb 4, 2016 10:57:22 GMT -5 doodler said:

Feb 4, 2016 10:48:19 GMT -5 JustJudy said:

Have you been tested for the MTHFR defect? I know of few of my friends who had repeat losses were finally tested and treated and now have take home babies.

At this point the only testing I have had is a clotting panel.  It was done during my first pregnancy because my mother has a significant history of blood disorders.  It came back normal.  We are going to be discussing additional testing with the OB after the results of the genetic tests on the baby come back next week.

I hope you get it figured out. Hugs.

[littlelion]

doodler I agree with daystardreams, it won't hurt to test or even take progesterone. I can say that I've had a MC while taking supplements and on Lovenox (for MTHFR). The 1 successful pregnancy I had the RE threw all the meds she thought could help incl progesterone. So I'm a bad example since I support both sides. But I'm willing to try everything.

Also I think the clotting panel includes testing for MTHFR.

[hoopoe]

doodler, I have a history of early losses and see a recurrent loss specialist. As all of my losses have been early, she suspects a progesterone issue with me. She explained to me that even if progesterone levels are adequate, some individuals do not respond to progesterone appropriately and the lining can be out of phase with implantation, which can cause earlier losses. For me, we have done several endometrial biopsies that support her hypothesis (these biopsies are controversial, but she claims to have had a lot of success with them).

I asked her about the PROMISE trial results when they came out. She stated that, in the study, progesterone was started AFTER a positive pregnancy test, which she said was too late to impact the lining for implantation. She pointed me to this New York Times article, where she made a statement (Stephen.son).

While I know most docs will read the results and draw the conclusion that progesterone is worthless for RPL, I am choosing to trust my doc, who only treats RPL and is heavily involved in the research side of it.

We have an RPL check-in over on 3T, come join us if you want!

[smallllmin]

Feb 4, 2016 12:13:36 GMT -5 littlelion said:

doodler I agree with daystardreams, it won't hurt to test or even take progesterone. I can say that I've had a MC while taking supplements and on Lovenox (for MTHFR). The 1 successful pregnancy I had the RE threw all the meds she thought could help incl progesterone. So I'm a bad example since I support both sides. But I'm willing to try everything.

Also I think the clotting panel includes testing for MTHFR.

Lurking from the other low progesterone thread...

So would it be harmful to take progesterone supplements if you're not actually low in progesterone? I have been tested before (though never on any particular day), and it has always come back "normal." I'm concerned that they will oblige and test me again, and tell me I'm normal-- and then I'll be SOL. I'm in the "testing progesterone is a crapshoot" camp.
I guess I'm just wondering if it would be worth it to insist on trying supplements for the next month or two to see if it helps with the pre-AF spotting (and potentially early preg. spotting). Because to me, if it helps with that, it would indicate that I need more progesterone, whether or not my tests come out normal.

[littlelion]

smallllmin I'm not one to take medicine unnecessarily much less anything not prescribed from a dr. If your dr agrees to prescribe progesterone then it must not hurt to take it. So basically I'd ask your dr about it. And I'd see a specialist if you've had more than 2 losses.

[doodler]

hoopoe thank you for that perspective. It's all rather confusing! I just talked to the doctor and scheduled my appointment to discuss RPL testing at the end of this month. The results from the karyotyping of the baby I just lost should be back by then and we can discuss next steps. Everyone has given me food for thought.

I just lurked your check in and printed the google doc. It's nice to see all of that in one place. Thanks!