Progesterone in Pregnancy—History of Miscarriage and Pre-Term Delivery
Question
We are seven weeks pregnant after trying for over a year. We miscarried last year after being on Prometrium for low progesterone and infertilty (infertile for five years). Since my local Ob/Gyn is not trained under Dr. Hilgers he neglected to check my levels even after I asked him to. I switched doctors needless to say, one that is pro-life and open to Dr. Hilger’s research. I am having my progesterone levels drawn every two weeks. I am on 400mg of Prometrium (that is how we conceived since he had me on 200mg and I felt that I was still having low progesterone symptoms.)
But now I am worried that they will want to take me off since today I found out my progesterone levels are 31.5 at seven weeks. He really doesn’t know Dr. Hilgers’ protocols, etc. My son who is five years old came five weeks early and I am wondering now if my progesterone levels dropped? I was on 50mg back then until 13 weeks.
Should I stay on the prometrium the whole time? When do I stop monitoring my levels? I am scared! I really don’t want to lose my baby we have tried for 12 years to have a family!!!
God Bless you and the work you do.
Corinne
Answer
Last Updated: May 8, 2022
There are several issues to consider here. First of all, it is reassuring that your progesterone level was greater than 30 at seven weeks. However, with your history of miscarriage, I would be inclined to keep you on progesterone at least for the first trimester. The level should be a “trough” so you should have skipped your Prometrium dose the night before the blood draw.
The other issue is that you had a premature birth. The standard Ob/Gyn literature supports the use of a progestational agent in women who have had a history of premature delivery. Some would argue that you should be on progesterone the entire pregnancy to prevent another preterm birth.
Whichever strategy you choose to follow, know that progesterone achieves the highest levels with injections, the second highest with vaginal suppositories and the least with oral pills.
In health,
George Delgado, M.D., F.A.A.F.
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