Progesterone to Prevent Miscarriage
Question
I am 40 years old and am trying to conceive. I had a healthy pregnancy when I was 37 and have a beautiful 2 1/2 year old daughter. I conceived again in January 2003 but miscarried in April at almost 11 weeks.
I have spoken to my doctor about progesterone and how low levels in older women can cause early miscarriage. This is something they have not heard of before and have never prescribed progesterone for this.
On Friday I will be on CD21/33 and have asked my doctor to do a blood test to check for low progesterone , which she has agreed to do. She has also asked me to bring in any information I can find on progesterone in early pregnancy. Could you give me some information or lead to a website where we can obtain the answers we are looking for. I would like to try all means possible to prevent a m/c from occuring again.
Thank you,
Gillian
PS. I have been using an OPK since cd13 and had a positive this morning on cd19.
Answer
Last Updated: June 14, 2013
Inadequate progesterone can be a factor in miscarriage. The key to evaluating progesterone levels is the timing of the test. You are evaluating the luteal levels, and so you want to time the test to be conducted in the luteal phase of the cycle. And since the levels can fluctuate, it is helpful when a profile can be done over the span of the luteal phase. Some physicians check levels on Peak +3, 5, 7, 9 and 11 (Peak being identified by the woman’s observations of the biological markers in her cycle which indicate to her when she enters the luteal phase of the cycle). Other physicians have simplified the test to one draw on Peak + 7, which will give a good indication of general levels at the mid luteal phase, but may not identify a low level of progesterone in the early or late luteal phase.
If I understand you correctly, you indicate you will be conducting a test on cycle day 21, in a 33 day cycle. Since you have not completed that cycle yet, I am unclear how you determined it is a 33 day cycle, except by past history. This is not a very accurate way to predict cycle length, or determine the best day to measure the progesterone. The results of this particular evaluation are only as good as the timing. And if you are indeed correct in anticipating a 33 day cycle, then day 21 is not the optimum time to measure the levels, as you may not even be in the luteal phase at that time. And as mentioned earlier, if only one draw is taken it should be taken mid-luteal phase.
You can eliminate much of the guesswork by learning to chart your cycles. Not only will this allow you to accurately identify your peak and time a progesterone profile, it will also provide valuable information into the actual length of the luteal phase, and provide you and your physician much needed information to evaluate your fertility. The quality of the mucus and the nature of your menstrual flow, for instance, in addition to the length of your luteal phase, provides valuable insights into understanding your fertility, in addition to timing Intercourse to achieve a pregnancy or hormonal tests.
If you are in California, you can consult our website for an NFP Professional — teacher or physician — in your area. A great source of information for you and your physician, on the use of cooperative progesterone therapy is the Pope Paul VI Institute in Omaha Nebraska. There is a link to their website http://www.popepaulvi.com on the links page of the CANFP website at www.canfp.org.
Hope this is helpful and you are soon welcoming a little sister or brother for your daughter!
Answered By:
