Low Progesterone and Miscarriage

Posted by Cari on May 21, 1999 at 11:50:38
Hello,
My husband and I (we're both 33) had been trying to conceive for 8 months. I was told that I wasn't ovulating, based on the fact that my basal body temperature charts showed a temp rise, but my luteal phase was only 6-8 days. I also had my progesterone level checked at 6dpo and it was low--4.5.  My doctor prescribed Clomid for the next cycle, but somehow I got pregnant that cycle anyway (with a 6 dpo level of 4.5).  My doctor prescribed progesterone suppositories, though they aren't proven to help. My questions are: is there a high risk of miscarriage in my case? What symptoms should I be aware of as danger signs? SO far, my doctor has not done any blood tests (except to confirm pregnancy). Should I insist on quantitative Hcg and progesterone tests to make sure everything's okay? She doesn't want to see me until 8 weeks.  I'm 6 weeks now and this worries me so much that I have a hard time sleeping at night. By the way, this is my first pregnancy.

Posted by hfhs.md.rcs on May 21, 1999 at 13:15:26
Dear Cari:
Luteal phase defect does not prevent pregnancy: it makes the process less likely to happen and makes the likelihood of miscarriage higher. The addition of progesterone, as a catch up therapy, is unproven, but is very safe. There are physicians and programs that do not believe luteal phase defect is real: the strongest argument is a patient studies in Texas who had a biochemical inability to make "normal levels of progesterone" and who successfull carried her pregnancy without therapy.
Quantitated hCG levels give a measure of trophoblast (the early placenta) development and well-being. It does not tell one if fetal development will occur normally. In someone who is on progesterone, measuring this hormone assures only that the medication has been absorbed into the body.
The definitive test is an ultrasound study 6 weeks from last menstrual flow or 4 weeks from conception (if known).
Miscarriage is signalled by bleeding and cramping. These are often late symptoms and the poor health of the pregnancy is already known from the ultrasound or hCG measures.
Keywords: luteal phase defect; miscarriage.
This information is provided for education purposes and is not a medical consutlation. If you have specific questions, please speak with your healthcare provider.