Lowish progesterone at 4weeks pregnant

[aprilshower]

(I'm not sure if this is the right place to post.  Sorry if it is not.  Mods, please move to the correct area if needed :))

At 3 weeks, 5 days pregnant (from LMP), my progesterone was 17.5.  hcg was 665.

At 4 weeks, 1 day pregnant - my progesterone dropped to 9.5.  hcg was 1263

At 4 weeks, 3 days pregnant - my hcg was 1747.  Progesterone level not checked.

At 4 weeks, 5 days pregnant - my hcg was 2799.  Progesterone level not checked.

All the levels prior to 3week/5day were good.  I'm shocked/shattered by the drop to 9.5.  I've been using natural progesterone cream 1/4 t 2x/day since 11dpo (BFP).  I'm doubling the dose as of today.

Also, I was not as tired as previously last week.  Probably due to the decreased progesterone level :(

I took another pregnancy test today, and I am still pregnant :)  with a strong and quickly developing line.

This is my 4th pregnancy/baby.  I've never miscarried.  With my 3rd, I used natural progesterone cream 3dpo - shortly before birth.  I never tested progesterone or hcg with him - so I don't know the levels then.

I'm terrified that I am going to miscarry with the progesterone of 9.5. 

I'd so appreciate all advice, thoughts, and suggestions :)

Should I get on a prescription progesterone?  I have a family practice doc who would prescribe, but I don't think he knows what to prescribe.  I'd have to tell him.  I won't have my 1st mw appt til later in Dec. 

Thanks so much!

Julie

Edited by aprilshower - 11/21/11 at 10:24am

[mamaforever]

I'm sorry you are going through this - I can see how scary that would be.  I don't know much about progesterone levels, but I'm just wondering if you're able to call your midwife ASAP for some advice?  Your hCG levels seem really good, so that's a good sign.  Sending hugs to you and lots of sticky vibes!!!

[Jaimee]

((HUGS)) mama!  Your hCG levels look pretty good for every 48 hours.  Typically you want a progesterone level over 11, right?  But I imagine there is some variation involved woman to woman.  I'm not sure if 9.5 is a glaring red flag or not.  I would absolutely get another medical opinion, however!  There is no reason you cannot be seen earlier than your appointment date when you suspect an issue.  If you can't get into your mw practice then call around to OB's and just get an appointment and a prescription, if necessary, and then switch back to your mw.  I would also suggest cross posting this in the I'm Pregnant forum and maybe the Infertility forum (a lot of those mamas know a lot about medications) for addition responses.

[gozal]

aprilshower, I'm sorry you're going through this. Everyone is different, but I can tell you that I did not miscarry with a progesterone as low as 5. (I was actually waiting to miscarry because we knew it was a nonviable pregnancy.) My RE usually prescribes 100mg 2x/day natural progesterone taken as a vaginal suppository. Endometrin (proprietary) and prometrium (generic) are the two types I've been prescribed. IME they work equally well. Personally, I would also ask for early monitoring. Otherwise the progesterone supplements might disguise potential issues. Your betas are beyond the threshold of descrimination so you could be reassured within the week! Hang in there! I hope the rest of your pregnancy is blissfully uneventful! 

[Jaimee]

Originally Posted by gozal 

Your betas are beyond the threshold of descrimination so you could be reassured within the week! Hang in there! I hope the rest of your pregnancy is blissfully uneventful! 

Gozal, can you explain this a little further?  The threshold of discrimination for an intrauterine pregnancy is around 3000, right?  So if the hCG level is above 3000 and they cannot see an intrauterine sac in a high resolution u/s then that is presumptive of an ectopic pregnancy?  Is that the idea?
 

[gozal]

Sure! From what I know (what my doctor told me) the threshold actually varies: for some pregnancies/women you might see a gestational sac with a beta of 1000, for others not until 2000. If you don't see anything at 2000, that's not good (short version!). What I meant, though, is that by OP's betas and dates, she should be able to confirm hb within around a week. I just added that because I would not want to be on progesterone without knowing that my pregnancy is progressing normally. Absent other issues, low progesterone could be a sign that there is something wrong with the pregnancy, and taking supplements will only prolong that - which is heartbreaking (personal experience talking, unfortunately...)

[Jaimee]

Ah, thanks for explaining gozal!