Recurrent blighted ova and progesterone?

[majord]

I have had diagnoses of a blighted ovum within the past four months.  I have had successful pregnancies in the past (youngest child is now 2.5).  Could these be due to low levels of progesterone?  I am almost 38 and dh is 38.  Is there anything I can do to increase my chances for a successful pregnancy next time?
THANKS!

[lovinmom]

My doctor said to take an ovulation test.  On the bingo day, be sure to come into the office immediately for a progesterone test to make sure the body has enough.  If the test shows low progesterone, he recommend Clomid over the standard progesterone treatment.  He believes this is best because it lasts throughout the whole cycle.  If conception was formed during the time of the first ovulation test, a normal progesterone treatment could be used if the test showed low progesterone.  If there was no conception, but the test showed low progesterone, then Clomid would be used throughout the whole cycle rather than using it after ovulation.  I haven't actually done this myself yet.  I was so busy this month that I never did the ovulation test.  Maybe next month.  I hope that this helps.  The doctor who gave me this information is a top fertility specialist who teaches at USC in Calfornia and has a fertility practice.  If you you do conceive, be sure to visit http://home.earthlink.net/misdiagnosed

to get some additional info that might help your pregnancy.

[Maggie8]

Hi Lovinmom,

I have a question about progesterone level for you. You mentioned about progesterone monitoring in your post. Do you know the normal progesterone level during a natural pregnancy (not induced by any drug or medical intervention)? Say between 4-6 wks? I lost 4 pregnancies. All happened in early 1st trimester. Thinking back, I suspect that 3 of them might be due to low progesterone level. But only during my 4th pregnancy, did the doctor test my progesterone levels. The 1st one was 13.8 ng/ml at 4wk3d. The 2nd one was 12.9 at 4w6d. My doctor is an IVF specialist. He was not sure if my levels were low or not, considering that progesterone fluctuates. Thank you very much for any information or suggestions you can provide. I am on recovery now from my 4th m/c and will try again. So I would like to collect as much information as I could to increase my chance of having a successful pregnancy.

Happy holiday.

Maggie8

[lovinmom]

Maggie,

Here is a good chart that has the levels that you should be at.  I hope that this helps.  I wish you the best with this pregnancy.  Let us know how this goes.

  
http://www.bobrow.net/kimberly/birth/hcglevels.html

PREGNANCY STATUS SERUM hCG LEVELS

from conception  from LMP  (mIU/ML or IU/L)  
7 days  3 weeks  0 to 5  
14 days  28 days  3 to 426  
21 days  35 days  18 to 7,340  
28 days  42 days  1080 to 56,500  
35 - 42 days  49 - 56 days  7,650 to 229,000  
43 - 64 days  57 - 78 days  25,700 to 288,000  
57 - 78 days  79 - 100 days  13,300 to 253,000  
17 - 24 weeks  2nd trimester  4060 to 65,400  
25 wks to term  3rd trimester  3640 to 117,000  
After several days postpartum   nonpregnant levels (<5)"  

[majord]

Oops, I just reread my post and realized that I left off that I've had TWO blighted ovums in the past four months.  Both diagnoses were made when I was around 9 weeks pregnant.
I just saw my doctor yesterday for the two-week follow-up from my D&C.  My doctor doesn't think progesterone has anything to do with a blighted ovum - I'm not sure if I agree based on what I've read.  I'm considering changing doctors since I also didn't like that he didn't take a culture to make sure I didn't have any infection.  I appreciate your response lovinmom - it seems to make sense to me.  I have checked out that misdiagnosed website before.  I'm glad there is that website, but it just makes me feel more guilty that maybe there was a baby that I killed - even though I'm fairly positive that there wasn't any baby either time.  But I'm still just worried that somehow I did something to affect this.  My doc says he thinks it is mainly because of my age (almost 38) which is just SUCH an injustice because I never would have even been this old if I could have gotten pregnant when we wanted to in the past, but we had to deal with a few years worth of infertility. Anyway, THANKS for the information!

[cfd]

Hi there,

I am in the same boat as you.  I just had a D&C on Monday at 8 weeks for my second blighted ovum.  I have two healthy kids,  but since last August I have had 2 blighted ovums and a chemical pregnancy.  My progesterone level at 5.5 weeks this time was only 10.3.  My doctor said it is hard tell whether the low progesterone caused the miscarriage, or if the miscarriage was already impending and caused the low progesterone.  I guess it is a "what came first the chicken or the egg" type problem.  I have a huge list of questions for my doctor at my 2 week follow up appointment and I'll let you know if I find out any more info about the recurrent blighted ovums.  So far, the doctors have just said it was bad luck.  I don't buy it.  I think there is either a hormonal problem, immune issue, or something.  And, like you, I don't want to miss out on any preventitive measures I can take the next time we try!

[majord]

Let me know what you hear.  I talked to my OB about progesterone and he told me that he did not think it was a contributing factor for a blighted ovum, but I have read opposing thoughts elsewhere.  My doctor called on Friday and said he had some test results from my previous doctor (I fired a doctor and switched to this doctor because my first doctor didn't show for an appointment and I had to track him down for test results - never got some of them).  My previous doctor had a progestrone level test done when we found out it was a blighted ovum this last time.  He thought that it could be a contributing factor.  So I'll see what the new doctor says tomorrow when I call him.  I also bought some natural progesterone cream that I am going to use if he doesn't prescribe any progesterone.  We are going to wait a couple of months to TTC again though just because I need to lose some weight I gained on these miscarriages and I need a small break.

[cfd]

Hello,
I had my follow up appointment.  Turns out it was a normal baby girl, so that rules out any chromosomal problem.  My doctor took blood tests for a Thyroid disorder, Lupus and anticartinoids.  All came back negative for me.  So, he suggested taking progesterone supplements starting 3 days after ovulation.  I guess that' s what I'll do.  I wish I knew what went wrong!  But, anyway, thought you might want to compare this with whatever your doctor told you.  Best of luck.