Low Progesterone Levels in Pregnancy

Question

I am 20+3 pregnant and was given cyclogest 400mg daily from 5 weeks pregnant, due to 3 previous miscarriages (all at 8 weeks). My doctor has suggested it may be time to stop taking the cyclogest but doesn’t seem very sure. I asked if stopping could cause early contractions and my doctor said this was possible. I also asked if there was any harm in continuing, my doctor said that there may be a chance of genital defects in the baby. I am really scared. I don’t want to harm my baby, but having made it this far I don’t want to risk losing the baby. My doctor suggested keeping some in stock so that I could take one if I start to feel contractions or start to panic. If I stop taking the cyclogest and then started having contractions next day, how quickly would the contractions stop if I then took cyclogest?
What is the harm in stopping taking it or continuing until 30 weeks when the baby stands a good chance of survival?

I really don’t know what to do for the best and I am getting really upset and worked up about making the decision. My doctor doesn’t seem too committed either way and it’s a very difficult decision to make.

Answer

Last Updated: July 24, 2013
Cyclogest contains progesterone, the hormone normally occurring in large amounts in women after ovulation and during pregnancy. Progesterone is vital in developing the lining of the uterus so a child at the embryo stage can implant, receive nourishment, and develop. Some women have low progesterone states manifested many times with difficulty becoming pregnant, polycystic ovaries, miscarriages, etc.

It sounds as if you are a person who doesn’t produce enough progesterone in the early stages of pregnancy and progesterone support is needed. Fortunately, there has been a lot of work in this area at Pope Paul VI Institute by Tom Hilgers, MD (Ob/Gyn). He has found that some physicians’ hesitation to use progesterone is based on one study that I believe was on lab rats. The doses used were astronomical. In his 30 years of using progesterone guided by laboratory levels, he has had no problems with birth defects.

Why? Because he did the research and set up normals on women who had normal pregnancies and so standardized what are normal progesterone levels throughout a pregnancy. Women who have low progesterone levels take progesterone and get their blood levels drawn and are followed. Some women need progesterone throughout the pregnancy, some women do not. They are followed and if the progesterone levels start to fall off, then they restart.

This standardized level of progesterone can be used through the laboratory at Pope Paul VI Institute in Omaha, NE. Your local lab would draw the levels and have them sent to Omaha. Your doctor would get an email or overnight fax so he would know immediately where to keep you on the progesterone.

There are many physicians trained by Dr. Hilgers in the world, myself included. Go to American Academy of Fertility Care Practitioners and perhaps there is one near you who could answer more of your concerns and some questions for your doctor.

To really answer your question, I’d probably stay on the cyclogest until I’d gotten some concrete laboratory analysis. I hope that this helps!

Gretchen V. Marsh, D.O.

Answered By:

Gretchen Marsh, D.O.
Dr. Marsh graduated from Western University of Health Sciences in 1987 in Pomona, CA and is board certified in Family Medicine by the American Osteopathic Board of Family Physicians. She has been certified as a NaProTechnology® Medical Consultant (NaPro) and Creighton model Fertility Care System (CrMS) teacher since 2001. She and her husband, Jon, have 5 sons and live in the Reno region, where she sees patients in person, in addition to her telehealth services offered via MyCatholicDoctor.com

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