Progesterone in Pregnancy With History of Miscarriage
Question
I lost my first baby at four weeks, three days. When I became pregnant again, I advocated for checking my progesterone levels. At four weeks, the prog. level was 18, then at four weeks, six days it was about 17. Still worried, I asked for one more test. At five weeks, two days, the level had fallen to 14. At five weeks, four days, when we got the last results back, my doctor put me on 200 mg pellets of progesterone suppositories twice a day. I was not tested any time after starting the suppositories. I am eleven weeks tomorrow and all has gone well so far.
My doctor has said that I should go off of the progesterone suppositories at twelve weeks. But, since I really had to push for testing in the first place, I don’t feel like I can trust what he says about this issue. I would like to know whether or not you agree with his opinion and if not, what you would suggest I do.
Thank you in advance for your help!
Amber
Answer
Last Updated: November 13, 2021
Many obstetricians will only supplement progesterone for the first 12 weeks and they will often recommend a standard dose of progesterone. NaProTechnology, developed by Dr. Hilgers, takes a different approach, checking levels about every two weeks, and adjusting the dose of progesterone depending on the lab values to bring the level up to the normal range. Many women will make enough progesterone so that they don’t need supplementation after 12 weeks, but others will still have lower progesterone than normal pregnancies so still benefit from supplementation. At 12 weeks (counting from the time of conception) the average progesterone level is about 33, and the average will increase fairly steadily over the next 12 weeks to about 70-75.
Your physician is practicing standard of care, but medicine is always changing, and there are many opinions. It sounds like your doctor does listen to your concerns, and I would recommend talking with him about further testing, at least a baseline a day after you stop the progesterone.
I wish you a successful pregnancy,
Dr. Lynn Keenan
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