Progesterone / luteal phase defect

[Wildwaterfalls]

Hi all

I have posted before... I have had two mmcs this year, both discovered at a scan, both ended with an ERPC. The baby died around 5-6 weeks in both cases.

Anyway, I have been reading up on possible causes, and have come across hormonal issues around low progesterone / luteal phase defects. I have some of the symptoms, but have a question about all this.

From my reading, it sounds like low progesterone might result in the uterus linking breaking down, which causes the miscarriage. Does this mean that it cannot be the explanation in my case, as neither of my miscarriages were 'natural', and no bleeding or anything like that occurred?

Sorry, I feel I have rambled on a bit. I hope that question makes sense.

Thank you for reading.

[farfallarocks]

I have had 2 at 5 weeks now but unlike you, have had spotting and then a complete MC.
I am fairly sure low progesterone are the issue as my test 7 DPO confirmed as such.

Can you ask your GP for a progesterone test to be taken 7 days after you ovulate (often called day 21 test but this assumes a 28 day cycle and ovulation on day 14!).
Do you have any other symptoms of low progesterone such as spotting before AF or a short luteal phase?

I would also ask your GP to check your TSH levels and T4 levels as the thyroid can cause other hormonal problems.

Good luck!

[57bluebells]

re miscarriages. I am an elderly lady now; however I had 4 miscarriages and now have three children. It was discovered that I had a lack of Progesterone, which increases when one is pregnant and remains high until the end of the pregnancy. A low level indicates to the body to "give birth"--- hence miscarrying occurs. I had hormone injections throughout ALL successful three ( 5,6,7,) pregnancies. I do hope that the young ladies trying to have a baby will heed my experience and ask for a hormone balance test. Good Luck to all.

[Joycep]

wildwater - so sorry about you mmcs. From what i have learnt and been told, if you have low progesterone or a LP defect then you tend to m/c earlier because there isn't enough progesterone to support the pregnancy. However, it sounds like your body kept producing it. You should still get it tested just to rule it out though. I was told by my gyane levels should be above 40 although above 30 is considered 'normal'.

[Wildwaterfalls]

Thanks all for responding. joycep thanks so much for your advice - that is exactly what I was thinking: that maybe because my body 'hangs on' to the pregnancies progesterone isn't the issue. Having said that I do have symptoms like pre-period spotting and a short-ish luteal phase, and can't find any clarity in the literature around progesterone and mmcs.

farfalla I am so sorry for your losses. I really hope you will have successful treatment for the issue. Fingers crossed for you. I will ask my GP to do these hormone tests - thank you for the tips. I am 'lucky' enough to have had chromosome tests done following each mmc. The result of the first was normal, still waiting for the second. If that is also normal, then I expect there must be some specific issue (hormones or blood clotting or something like that) that is causing all this.

bluebells very sorry for your mcs and thank you very much for your advice.

[farfallarocks]

bluebell thank you for that, at what stage were your MC if you don't mind me asking?

I am now seeing a consultant who is a famous miscarriage specialist. He used to be very anti progesterone but has no changed his mind and there are lots of studies going on at the moment which seem to support the use of progesterone in early preg.

water I would also ask for the thyroid profile as hypo thyroid and low progesrteone sometimes go hand in hand. Best of luck!

[Glitterybits]

I'm so very sorry for your losses and the losses of anyone else who has been in the same boat. Not sure I can be overly helpful as my lack of progesterone and very short luteal phase (I ovulated around the 3rd week, if at all) resulted in me being infertile rather than causing miscarriage. Having said that, it was an initial miscarriage which caused my cycle to mess up in the first place.

If I ever did have a fertilised egg, it didn't have enough time to implant before my wonky cycle started again. As you mentioned, the uterine lining started to break down before 2 weeks had passed, meaning I never had a nice thick lining to be hospitable to an egg. Some months the follicles just grew and grew, but never released an egg before they were reabsorbed. I learned this after several tests and lots of appts with the dreaded dildo cam! It's definitely worth getting a day 1-3 blood test done to check FSH and LH levels, as well as getting a progesterone blood test done. Your GP can refer you for these at the hospital and it may give you the answers you're looking for. Eventually, I got pregnant with Clomid (first cycle) which kick started my hormones back into normality. I now have a happy, healthy 2 month old after waiting for a very long time. Good luck! x

[Racheljane4]

Hi. I'm sorry to hear of everyone's pain and heartache above. I have had 2 mc this year, the latest one being last week. With all the tests above is it true that you have to wait until the third mc for them to be done or would I be able to ask for them to be done now? After my first mc, after a lot of blaming myself and eventually coming to terms with it not being my fault I thought that it was just a blip. Now, after my second mc I feel like, what the hell is going on, surely something is wrong and causing this to happen? I can't understand or comprehend why we have to experience a further mc before anything is done?

[farfallarocks]

So sorry Rachel :(

You do have to wait until 3 generally. That is because statistically 2 is bad luck and 3 indicates a problem. I did not want to go through a third so I had some of these tests done privately. At how many weeks did you miscarry? Some clinics will see you after one MC if it is after 8 weeks. If you have a sympathietic Gp they might at least test your hormones and thyroid for you?

[Racheljane4]

Thanks farfalla, I haven't posted before but in some way I find it has helped. My first MC was at 12 weeks, I'm not sure though exactly how old the baby was as it was all natural and relatively quick. I didn't want any tests doing on the baby because we thought it had been through enough already. My second MC died at 8 weeks and 3 days. I had a D&C for this one as I didn't want to see the baby again or experience what I did for the first one.

Maybe it's just a case of finding the strength from somewhere to start again. I'm more than aware that there are people far worst off than me. I do have a healthy 2 1/2 girl. I will talk to my GP and see what they say. Thanks once again and my fingers are also crossed for you.

[Wildwaterfalls]

Thanks again everyone for your advice. Glitterybits I am so pleased your story has such a happy ending. It really gives me hope!

Rachel I am so sorry for your losses. I completely understand how you feel, looking for answers, it is so frustrating. Please look after yourself over the coming days and weeks.

For my part, today I received a letter confirming my second mmc was indeed due to a chromosome abnormality. Not quite sure where that leaves us as I suppose it doesn't rule out any of the other problems. But perhaps it is simply a case of trying again. I may try and get some of the tests done anyway.

Good luck to everyone, and thanks very much for posting.

[Glitterybits]

It really is barbaric to have to go through mc three times before something can be done. I suppose I was almost lucky to be rendered infertile by the mc. I was so deflated because I couldn't conceive, but somewhat comforted by the fact that I was too broken to get pg and lose my baby again. I did see one doctor who was unwilling to do anything for 6 months, but I sought a 2nd op from a slightly more sympathetic GP who could see how distressed I was getting about the ever increasing gap between my DS and a potential sibling.

Not that anyone should have to bend the truth, but you may find it easier to get help if you tell any doctor you have been TTC for 18 months or more. At that point, regardless of mc, they should investigate your hormones from a medical point of view, as there could be underlying health issues which need to be addressed. I really feel for everyone in this situation. There was a time not so long ago that I would have weed on anything if it gave me any indication of ovulation, I was obsessively charting my temps everyday and was completely unable to deal with RL pregnancies. Then I finally got pg and panicked through most of it, but the end result is so worth all of it. I hope you all get the assistance you need and that you are holding your beautiful babies very soon. X

[Joycep]

Wildwater - i think the trouble with m/c's are that you just can't help wondering why it all went wrong. We want a answer to these things. I spent many a sleepless night after my m/c overthinking things and researching my short LP etc etc. I've had just the one m/c but if I had have had 2, I would have gone in to complete overdrive and meltdown at the same time. 19 cycles on and i still haven't conceived again and so i'm just in meltdown instead!
I am hoping that you have just been incredibly unlucky and actually the chromosome abnormality points to that. You have a clear reason as to why it didn't work out last time. It's probably a good idea to get other things tested whilst you continue to ttc just for peace of mind if anything else. Really best of luck.

[Wildwaterfalls]

Thanks both for your lovely posts.

Joycep - I am so sorry that you are having such a difficult time conceiving. I really hope you are getting good advice and support. I really understand the 'overdrive/meltdown' thing... Today following these results I have been researching chromosomal issues and finding lots of new things to worry about. But I have now made a decision (and will stay strong!) to stop doing this. A bit of knowledge is a good thing, but in the end no amount of research is going to make a difference to my chances, and in fact relaxing a bit is probably better.

Fingers crossed for you.

[farfallarocks]

I am just going to post this link as I think its the best explanation of luteal phase defect and its various causes and also the treatments (which vary depending on the cause)

www.inciid.org/printpage.php?cat=infertility101&id=7