Low Progesterone

karin512 - 06:57pm May 18, 2007 EST

Hi There> I wanted to share my story so that it will hopefully help others realize the importance of monitoring your progesterone levels when you have had a miscarriage and the importance of not always believing that your doctors know everything. 11 days ago I had my 3rd miscarriage. It was my 2nd 2nd trimester miscarriage (16 weeks) in 8 1/2 months.

My story starts with the fact that I have two healthy children (thank the lord) ages 10 and 7. I had no problem getting pregnant with them.

About 4 years ago I was having a lot of hormonal issues (acne at age 31, mood swings, weird menstrual cycles, etc.. ) I was also having difficulty getting pregnant with baby #3. I was diagnosed with PCOS (Poly-Cystic Ovarian Syndrome) and just sort of gave up on the whole baby thing.

To my surprise, I ended up getting pregnant with baby #3 two years later. I went to my 8 week appointment and found out there was no heartbeat (a "missed" miscarriage). The doctor's just ruled it out as an "unknown" reason.

One year later I got pregnant with baby #4. I called my doctor immediately and asked to be seen. Since I had done a lot of reading on progesterone levels as being a cause for miscarriage, I requested that I get my progesterone levels checked. My doctor said this wasn't a usual test that was done, but that she would do it since I had a miscarriage before. Two days later I got a call that my progesterone was low (I forgot the number!), and I was put on Prometrium (Progesterone) suppositories. At week 8 there was a heartbeat. At week 12 there was a heartbeat and the ultrasound looked great. I was told to stop the Prometrium at week 13, since the placenta was supposed to take over the production of the Progesterone. I noticed an increase in mood swings, headaches (migranes) and acne almost immediately. I also noticed reduced fetal movement around week 15. I went in for my 16 week ultrasound and was told there was no heartbeat. I gave birth to my son and was utterly devastated. I was determined to find out what went wrong.

Since this was my 2nd miscarriage and a "rare" one since I was in my 2nd trimester, the doctor's requested that I have a full blood workup. Everything was fine on my blood, except that I had the Anticardiolipin Antibody (which was low). I was referred to a Hematologist who said that he didn't think the Anticaridolipin was the cause of my miscarriage because my levels were low and it wasn't the "IGG" kind of Anticaridolipin, which they worry about in pregnancy. Later my son's autopsy results came back and said that a "twisted cord" was the reason. He had no chromosomal or physical abnormalities. I still had an unsettled feeling that this was not the reason.

5 months later, what I considered a miracle, I got pregnant again. Of course you can imagine how scared I was. I was instantly seen and put on Prometrium again. I changed my doctor to one who I felt was more qualified and had my file reviewed by two Fetal/Maternal Specialists who all told me to "gestate" and relax because my bloodwork looked great and that my last loss was a "fluke" accident. I had ultrasounds at weeks 8 and 12. Everything looked great. My new doctor even let me come every week to do a doppler (to check the heartbeat) so to put my nerves at ease. My doctor instructed me to go off the Prometrium at week 14. I was nervous about it, but trusted what she and my other doctor's were saying, that the placenta takes over by week 12 and that I will be fine. Plus, I thought the reason for my former miscarriage was a "twisted cord". Again, I instantly started having migraines, headaches and was moody. I noticed decreased fetal movement about 4 days after going off (week 14, 3 days) and panicked. I went in for a doppler and heartbeat was fine and strong so I was relieved. I went in for another doppler the next week (15 weeks,3 days) and again there was a heartbeat. However, I was still not feeling fetal movement like I was at week 13-14. Feeling really nervous because my "16th Week" ultrasound was coming up in four days, I decided to just think positive and that this time it was going to be different. 4 days later I went in for my ultrasound at the Fetal/Maternal Specialists office and there was no heartbeat.

Instantly I had a revelation about the Progesterone ( a little too late obviously). I immediately asked the Specialist, " Could this be related to me going off the Progesterone, since this is exactly the same gestational age and story as my last baby". He said he didn't think so and that the placenta would have already taken over the production of the Progesterone. The same story that all the doctor's had been telling me.

That same day I was referred to another doctor (an associate of my new OBGYN) who I had never seen before. He was to perform a "D&E" on me (I just couldn't do the birthing of a dead baby again). I told him my same theory about the Progesterone and he told me that I could be right. He said that he keeps some of his patients on Progesterone for longer than the first trimester, because their placenta's take longer to make the Progesterone on their own. He said unfortunately we don't find this out until a woman has had multiple miscarriages! He agreed to do a Progesterone draw on me, but said that the results would be anectodotal.

I have no results on anything yet, but will in the next few weeks.

I am convinced that all my losses are related to going off of Progesterone too early. Both of my last two losses had almost the identical story: Going off of Progesterone at 14 weeks, Fetal Growth Retardation at 15 weeks and death on or about the 16th week. The ultrasounds at 16 weeks said they stopped growing around 15 weeks, 3 days. Even my new OBGYN said that she thinks there has to be a correlation between these, since they are almost identical in gestational age. She also told me that she wasn't sure that the son I lost was really due to a twisted cord, since often babies cords twist in-utero after they die.

My problem with the medical field is why do they wait until a woman has had multiple miscarriages before they check Progesterone levels? Why isn't this a standard test? Progesterone is vital to the pregnancy, yet I was cleared because all of my other blood work was normal. Progesterone was never mentioned and I was never tested on my levels after going off of it.

I've read that Progesterone is safe doing the entire pregnancy, so why I was not checked for this I don't know. I also had a gut feeling that going off the Prometrium "cold turkey" wasn't good and that I should be weaned, but again I trusted the experts.

I will update this in the next few weeks with my test results and autopsy results. If everything is the same as my last loss, I will be 100% convinced that these miscarriages were due to going off of Progesterone too early and as crazy as it sounds, I will try to have another baby again. However, this time I will not trust anyone but myself, since I should've listened to my inner voice.

I hope this information helps someone out there. I don't want my 3 children's passing to be in vain.