Progesterone supplements, do they work?!

[brokenbarrenbrook]

Hello all,

I'm currently under the care of St Mary's in Paddington after having 4 mc all around 5-6 weeks. All the tests I've had done both at GP level and at St Marys have come back showing nothing is wrong. I've been asked to take part in the PROMISE study which is a double blind trial involving 900 women in the UK and The Netherlands who have had 3 or more mc with no identified cause. The trial involves half of the women taking 4x400mg pessaries of Progesterone (2 am, 2 pm) from BFP to 12 weeks. The other half will be given a placebo but no one knows which you will get or are taking during the trial.

I've decided against taking part purely because if the trial is taking place there is obviously some train of thought that it does work, and previous studies have shown it could help recurrent mc patients. I obviously don't want to take the risk of getting the placebo and mc again so am going armed with as much pro evidence as I can to GP to ask to prescribe it for me.

Does anyone have any experience of taking Progesterone and if it works? Be grateful to hear any experiences.

Hello, I don't know if this helps but DH and I are about to start IVF and the clinic said that even if my progesterone levels at CD21 are normal, they still recommend progesterone supplements as they don't do any harm and the Drs believe it helps support the development of the placenta in the first trimester.

So sorry about your mc and I hope you get a sticky BFP very soon

Hi there bbb and sorry to hear about your experiences - I have just been prescribed 1 x 400mg following 2 mcs (one mc approx 7 weeks and one mmc approx 9 weeks) although I've had no tests done other than clotting. I'm currently 4+3. My ob/gyn says that it seems foolish not to take it as it can't do any harm and they routinely prescribe it for IVF patients, so why not non-IVF patients. She has also prescribed me 1 x 75mg asprin which I know there is some debate about but I have decided to take it anyway.

From what I have read from this document from the MHRA, the practice of prescribing progesterone seems to have
been based on theoretical considerations rather than robust evidence of efficacy. So it will be interesting to see the results of the PROMISE trial as it seems they have a decent number and are working with only recurrent mc cases. On the same document on page 13, they say :
"4.3 Conclusions on efficacy
There is no good evidence that administration of progesterone or dydrogesterone effectively reduces the frequency of miscarriage in women with threatened miscarriage. Compared with the standard of evidence that is required to support an application to market a new medicine, evidence for the efficacy of progestogens in recurrent
miscarriage is extremely limited. However, the data suggest that progesterone and dydrogesterone may have a beneficial effect in women who have had three
consecutive, unexplained, spontaneous miscarriages. Further work in this area is necessary"

So, perhaps this could be useful to take along as evidence. I can understand your reluctance to take part in the trial. Good luck and let us know how you get on.

Hi

You may have difficulty getting your gp to prescribe it, many gp's will not prescribe it without the say so of a consultant.

I have taken it with 4 out of 10 of my miscarriages and it had no effect........ so I am very happy that they are finally doing a proper double-blind trial.

It did however lengthen the time to miscarry, so rather than miscarrying at 4 or 5 weeks I miscarried at between 6 and 12 weeks on the times that I took progesterone.

I took 400mg suppositories twice daily.

I think the general concensus amongst doctors is that it does no harm but it is unclear if it actually does any good. It would appear some women do have low progesterone levels prior to getting pregnant and it is in those women that it might help. I think that the trial is more about trying to establish if it helps at all, rather than trying to prove that it does, as there has been debate on it for years. Most doctors I have been to have prescribed it on the basis that it does no harm!

I have no known cause for my miscarriages (I already have 3 healthy children). But I am now taking heperin, asprin and progesterone before and during pregnancy.

I hope that you get the support you need and that you get a take-home baby soon.

I had/have low progesterone and my clinic (Argc) thought I produce antibodies to it so I was on 800mg of prog via pessaries and 100mg IM daily for the first 12 weeks, plus aspirin, heparin and steroids. It worked for me. I have 3 boys now.
All of the use of drugs in this patient group is off label so you're unlikely to find any robust trial data supporting it. In your position, I'd take them, and also consider taking the other drugs I mentioned. PM me if you think I could help, and very best of luck. X

Ladies, thank you so much for your responses. It's good to hear some positive reports from "real people" IYSWIM.

babyfour so sorry to hear you have had to endure 10 mc, that is truly horrible and I hope you get your much longed for baby soon.

wombat thanks for the link, I will certainly print it off and take it to GP, if not successful with her I will try the consultant. We are also toying with the idea of paying privately to see Mr Shehata at the miscarriage clinic but that is an expense we could do without so will be a last ditch thing I think.

Holly good to see it worked for you and you've got your 3 boys.

Thanks all again x