Progesterone & HCG

My wife and I ( married two years) are trying to have a baby.  She's 38 years old and got pregnant for the first time last year.  At eight weeks she miscarried.  We were getting blood levels twice a week and her progesterone never went above nine.  Her HCG went up for a while but once the progesterone fell twice in a row the HCG followed.

We're pregnant again.  This time the numbers look better. At five weeks her progesterone was 16.5 and her HCG was 85 at 5 1/2 weeks the progesterone fell to 12 and the HCG went up to 255.  We're both worried because everything we've read leads us to beleive that even though there is a wide range the progesterone is headded in the wrong direction.

I told her not to worry and lets wait and see what the next levels are.  But afoter the first miscarriage shes very worried.  Our doctor says its OK and the progestorone will vary up and down as long as it stays above ten things are OK.

Last time there was some light bleeding all along this time there is none.

I guess I'm just looking for reassurance on that.  Please let me know what you think.

Thanks

[RunningL8]

I've been pregnant twice in the past 6 months and miscarried both times.  (But I'm 46, so the odds of miscarrying at 46 due to chromosomal abnormalities are very high, so keep that in mind here....)  I read and asked my RE a lot about progesterone, as both times I watched mine fall as the pregnancies progressed.  My Reproductive Endorinologist (who was overseeing the pregnancies) wanted the level consistenly above 20, got worried at 17, and thought it was really bad when it dropped to 14.  He did not say I would necessarily miscarry, however; you really have to go by an ultrasound, and your wife could have one in another week to see if the pregnancy is developing normally.  (BTW, in reading around online while I was pregnant, I found a lot of cases in which people with progesterone way below 10 went on to have healthy babies.)  One option in the meantime is for your wife to use progesterone vaginal suppositories (which are by prescription); that way, more progesterone goes directly into the uterus even if the blood levels are falling.  It is best to start progesterone earlier in a pregnancy, but even so, progesterone supplements won't save a pregnancy that is going to fail.  Does your wife have a good Reproductive Endocrinologist?  If not and this pregnancy doesn't work out, I think you should go see one, rather than deal with a general doctor or ob-gyn.  I wish you the best!

[Tanker Chic]

At 4wk2d pg my progesterone was 20.  Dr told me they like it to be at least 21 but since it was close he wasn't worried.  Tested again 48 hours later and it went down to 16.  Tested 48 after that and it went down to 11.  Dr had me leave work and go pick up a script of Crinone progesterone suppositories.  The next blood test my progesterone was up to 39.  I stayed on the progesterone till I was 12wks pg and I'm now 27wks pg.  My advice to you is to call the Dr ASAP and insist on a progesterone supplement.  There are three kinds shots, suppositories and oral.  From what I've read, oral is the least effective and  have the most side effects.  

Good luck to you and your wife and your peanut!!  

[MelzieWelzie]

As women age, our ovaries don't always produce progesterone as well as they should.  That's why most dr's will prescribe progesterone to pregnant women in their mid 30's and 40's if their progesterone is low or drops during the the 1st 8 or 9 weeks of pregnancy.  Somewhere around 9 weeks the placenta takes over production of progesterone--so you typically only have to take it for the 1st trimester.

I'm 43 and my progesterone was 21 at 4 weeks pregnant, a week later it was 16 (still in the normal range but dropping).  The doc put me on 200mg progesterone vaginal suppositories once a day.   I quit using the suppositories at 12 weeks and I'm currently 13w2d and everything appears to be normal.  Supplementing with progesterone is definitely worth it if it helps to save the pregnancy.  If your dr won't prescribe it, maybe you should talk to another OB.

I hope you and your wife have a happy healthy pregnancy!
Melanie

[housingmama]

you should ask your doctor for some progesterone suppositories. if her are low and take them for up to three months that should work. good luck

[melimeli]

the suppositories are vaginal.. and she should get them immediately.. please don't wait..