NEED advice please- Progesterone and Pregnancy

[mamaforever]

I have suspected I have low progesterone because I have had a short LP (8 days) except it increased to 11 days with Vitamin B6.  I had a m/c at 6 weeks in Nov. with lots of spotting prior to the miscarriage and this makes me wonder if it was progesterone related.  I am pregnant again and should be about 4 weeks 3 days.

My tests this week:

Tuesday (4 weeks 0 days) - hCG 297 and progesterone 24

Friday (4 weeks 3 days) -  hCG 1482 and progesterone 19

First of all, the hCG level went through the roof and I have heard that hCG rising too quickly can be a sign of a problem, but I'm trying my best not to worry about this since it's out of my control.  But what I'm concerned about is my progesterone dropping.  My dr. wasn't concerned because it's still above 10 and she says that it is expected to go down when my hCG level goes up (NEVER heard this- actually have heard the opposite that it should increase as hCG increases!).  She doesn't seem to think that progesterone supplements would do anything and she thinks I'm worrying too much.  So I have taken matters into my own hands and started natural progesterone cream today.  I feel better about it and I really don't care what my dr. says anymore.  I think I will try and find a new doctor.

I am planning on using 40 mg/day (20 mg twice a day) of natural progesterone cream.  I'm hoping this will be plenty to keep my level up.  I need some opinions on this decision I've made... I feel like I had no other choice but to go behind my doctor's back and start taking the cream.  Or should I try and find a doctor who will prescribe suppositories?  Thanks in advance for your help!

[MaryLang]

I don't know a lot about it. But I had been on progesterone this pregnancy for the first time (9th pregnancy- 6th baby that made it this far). My numbers around wk 6 were something like 17 and my doc put me on 200 mg of prometrium suppositories until wk13. I think more so that it was a little low, and that I have a history of m/c, and had spotting with this one.

After further research, I'm not sure how much they did for baby, it did relieve my worry a bit though. I now hear that progesterone is not a steady number, it fluctuates throughout the day.

I think that what your doing sounds good. Maybe you could ask to have it checked again now that your on the cream? You don't have to tell her your on it, but just try and get another draw?

[mamaforever]

Thanks so much for replying.  I have increased my dose to 60 mg/day of the cream.  I feel good about what I'm doing but I definitely want to get one more progesterone test now that I'm taking the cream (just to make sure I'm doing enough and that I don't need a stronger dose of progesterone).  I am crossing my fingers that I can get in soon with a new provider.... I called today but they were closed so I'm calling tomorrow.  I really don't want to call my current provider again as I know she will say again that I'm worrying too much and that there is no need for another blood draw (she basically said this the first time I requested my progesterone test and beta test when I had spotting a week ago and again on Friday when I got the second results back).

Thanks again for your reply.

[LilyTiger]

I had a low prog test that my doctor said indicated that I probably hadn't ovulated.  I had in fact ovulated and became pregnant that month.  Her response was that progesterone spikes and falls throughout the day and so you can get very low readings that are still not a problem.  I read into it and found that there is absolutely no medical evidence that progesterone supplements help keep a pregnancy.  Keep in mind that most early miscarriages are the result of chromosomal abnormalities... So, your hormone levels fall because the baby is not healthy and not the other way around.

I would do more research before you start taking supplements without your doctor's knowledge.  It's also important that she knows what you're taking so she can adequately assess your test results.  If you aren't comfortable with her or really want the suppositories, switch doctors by all means, but just realize that the supplements are probably having no physical effect.  I know how hard it is.  I had to wait out the early weeks with one low progresterone reading and I was completely paranoid, but the baby stuck there.  I would focus more on your HcG readings than progesterone, because as others have indicated, that fluctuates wildly.

[mamaforever]

I appreciate your post giving another view on the issue.  I planned on telling my dr. but I haven't even seen her yet - it's impossible to be seen until at least 8 weeks.  I only had a short conversation with her about my blood test results and that was before I made the decision about natural progesterone cream.  But I have decided to change providers.  I have now made an appt. with a different office with a midwife in a couple weeks and I plan to tell her my supplements.  It's certainly possible that the cream is not doing anything for maintaining the pregnancy - but it's also not doing any harm.  I will ease off of it after the first trimester.  Thanks again for the replies.

[LilyTiger]

Any updates on your numbers?  I hope everything is going well.

Sorry if I sounded a little bossy.  The most important thing is feeling comfortable with your provider.  I'm switching OBs right now for similar reasons, and it is stressful but worth it (I hope!).

[mamaforever]

No, you weren't bossy. :)  I know a lot of doctors say that progesterone supplements don't do anything, but I know there are others (especially infertility specialists) who say they do.  It's hard to know what to believe.  I am getting terrible nausea now and so this is a great indiciation that the hCG levels are rising fine (I was extremely sick when pg with DS and not on prog, so I know the natural prog cream is not causing the nausea).  I'm not going to request my prog to be checked again unless I have spotting.  My appt. is on Feb 3rd for my first prenatal appt with my new midwife and will tell her about the natural progesterone cream.  Good luck finding a new provider!