Progesterone to Improve Fertility
Question
Hi,
I have been prescribed Cyclogest as a precautionary measure after miscarrying at 11 wks earlier this year. I didn’t start to bleed, but at my scan the baby had no heartbeat. I went on to have a D&C. I’m a bit worried that I’ll be using something that may not be necessary and could even do harm. I haven’t had a blood test to check my progesterone levels. I’m due to use the first suppository this evening, please can you advise?
Many thanks,
Theresa
Answer
Last Updated: December 28, 2014
Dear Theresa,
Cyclogest is bioidentical progesterone. If you have low progesterone levels, progesterone can be helpful in the first (and sometimes the second and third) trimesters in preventing miscarriage or premature labor. Low progesterone is a treatable cause of miscarriage. I follow the protocols of the Pope Paul VI Institute for progesterone therapy, which are excellent. Obtaining progesterone levels – what we would call trough levels that reflect your body’s production of progesterone rather than what you are getting from the Cyclogest – are helpful in guiding therapy. It is hard to get too much progesterone in the first trimester. Later in pregnancy, a few studies have linked excessive progesterone to the very rare occurrence of urinary tract anomalies such as hypospadias in males to excessive progesterone levels. So using the blood levels for guidance is a good idea. In general, the loss of pregnancy and premature labor due to to low progesterone is very common, whereas hypospadias is relatively rare.
In your situation, it could also be helpful to obtain tests for treatable causes of miscarriage such as low thyroid, blood sugar abnormalities, ureaplasma/mycoplasma, and thrombophilas (production of antibodies causing clots in the placenta) such as anti-cardiolpin antibody and lupus anti-coagulant. And as you probably know, many miscarriages are not preventable because they are due to chromosome problems in the embryo. Best wishes with this pregnancy.
Mary L. Davenport, M.D
Cyclogest is bioidentical progesterone. If you have low progesterone levels, progesterone can be helpful in the first (and sometimes the second and third) trimesters in preventing miscarriage or premature labor. Low progesterone is a treatable cause of miscarriage. I follow the protocols of the Pope Paul VI Institute for progesterone therapy, which are excellent. Obtaining progesterone levels – what we would call trough levels that reflect your body’s production of progesterone rather than what you are getting from the Cyclogest – are helpful in guiding therapy. It is hard to get too much progesterone in the first trimester. Later in pregnancy, a few studies have linked excessive progesterone to the very rare occurrence of urinary tract anomalies such as hypospadias in males to excessive progesterone levels. So using the blood levels for guidance is a good idea. In general, the loss of pregnancy and premature labor due to to low progesterone is very common, whereas hypospadias is relatively rare.
In your situation, it could also be helpful to obtain tests for treatable causes of miscarriage such as low thyroid, blood sugar abnormalities, ureaplasma/mycoplasma, and thrombophilas (production of antibodies causing clots in the placenta) such as anti-cardiolpin antibody and lupus anti-coagulant. And as you probably know, many miscarriages are not preventable because they are due to chromosome problems in the embryo. Best wishes with this pregnancy.
Mary L. Davenport, M.D
Answered By:
Mary Davenport, MD, MS
Mary Davenport, MD, FACOG, an obstetrician/gynecologist from the Oakland Region of California, offers telehealth services over MyCatholicDoctor.com She graduated from Tufts University School of Medicine and completed her residency at UC San Diego. Dr. Davenport is a Fellow of the American College of Obstetrics and Gynecology, and serves on the Advisory Board of the California Association of Natural Family Planning.
