2 miscarriages, pregnant again - bleeding. Progesterone?

[Bridie321]

Hi all

I'm pregnant again after two miscarriages. I've started spotting again, at pretty much the same time as with the two miscarriages so have a horrible ground hog day feeling.

I'm just wondering if anyone has had a similar pattern of miscarriage and if they got to the bottom of it...

My two miscarriages:

• Started spotting (brown and pink) at 5wks 4/5 days
• Heavier bleeding at 6wks 2 days. Scan showed hearbeat and closed cervix. Told not to worry (despite having v. strong period pains and heavy bleeding with scecond m/c - before scan had been sure I'd already miscarried).

• Miscarried at 7wks first time and 6wks 2 days with second (the evening of the scan.

I was sent to recurrent m/c clinic as am over 35. Was told no reason was found and I had 75% chance of normal pregnancy next time.

This pregnancy I started spotting at 5wks 3 days. Have had brown, pink and a couple of red flashes (sorry if tmi). Had a scan yesterday where they estimated that I was between 4-5 wks pregnant (I was 5wks 6days yesterday). Gestational sac mean 9.7mm, gestational sac volume 0.4ml, yolk sac mean 2.7mm.

Has anyone had similar experience. Did anyone get to the bottom of it? Has anyone been prescribed progesterone? If so - who by (we live in London)?

Thanks!

No advice but just wanted to wish u luck.
I'm possibly also having my 3rd mc today, lets hope neither of us are tho.
xx

I've been prescribed it by the recurrent mc clinic but my GP wrote the script. I'm to take it as soon as I get a BFP

Hope all goes well in the end

Thanks for your responses.

Lola4lee - I'm keeping my fingers crossed for you. Do you have access to a walk in scanning unit?

Hebiegebies - was your clinic nhs? I'm in London (Kings, NHS) but I know they are involved in the PROMISE study so don't think they'll prescribe it to me if I'm not involved in the study (I don't yet qualify). Best of luck with a BFP.

B

Just to say I really hope it works out for you. I was given progesterone by a private clinic in St Johns' Wood (Viveka) as I saw a consultant there - so you'd need to pay for consultant appointment and the private prescription for the progesterone as I'm not sure they'd give it to you without seeing a consultant first. Technically your GP could write the prescription but whether they will or not is a different matter. I took it for my one successful pregnancy and think its something that it doesn't hurt to try although I have no idea whether it was the progesterone that worked. You can have your hormone levels checked to see if they're low during the luteal phase but the doctor I saw seemed to say it was worth taking as a precautionary measure anyway. good luck, hope you have good news.

Yes, it is an NHS clinic in East Anglia

Thanks Tea - can you tell me who your saw at Viveka and did you have to wait for long?

Many thanks

B

I saw Talha Shawaf - I'd ask to see him or Yehudi Gordon. No didn't wait long at all -if you tell them its a urgent they should be able to fit you in. They sometimes also do private clinics at other hospitals so could check if that's quicker.

Thanku for ur post birdie.
Also wishing u lots of luck and keeping everything crossed for u xx

Sorry BRIDIE just realised my typing error xxx

Thanks Lola - I'm so sorry to hear your news.
I'm not sure what's happening here. Bleeding stopped last week but I won't know how everything is till next week when I have another scan.
B

Also thanks Teaandchocolate - I went to see Dr Raj Rai in the end (but didn't get progesterone!).

B

Hi Bridie
What date have u got ur scan? I really hope it is good news.

Yeah I have been referred now for my mc's actually got my appt on Friday was very shocked (but pleased) to get it so quick.

xx

No worries, apparently Dr Rai is brilliant. Just out of interest does he not think there's any point in taking progesterone? (I'm debating whether I should take it if I get another bfp at some point...)

best of luck with it all - I really hope you get good news at your scan xx

taking progesterone will not save a failing pregnancy. If the placenta has not implanted properly then unfortunately it will inevitably fail. I've been reading Prof Regan's book on MC and progesterone has no effect in most situations. My understanding of science is poor and reading the whole book means there is a lot of ground to cover and as i don't know what my problem is I'm skimming over the lot. She does say that in a study on women with Polycystic ovaries there was no difference in the number of MC amongst women who took placebo progesterone suppositories and those who took real progesterone . She also goes on to say how powerless doctors feel at not being able to help women who have mc and how they will often agree to treatments which have no known benefits as long as they cause on harm. NB the book is 2001 so there have obviously been advances since then but if anything major had come along i suspect they'd release an new edition.

she also says that hormonal problems can be the cause of a sporadic Mc, in which case its just a one off. For women who have repeated mc ( especially those with poly cystic ovaries) the hormonal imbalance will be present in most pregnancies and they need treatment appropriate for their particular problem.
Basically if a poorly matured egg is released the production of progesterone from the corpus luteum may be so poor the luteal phase is too short and the uterine lining so poorly developed that an embryo cannot implant successfully- therefore giving progesterone is of no use. "Giving injections of progesterone or HCG during early pregnancy with the aim of reducing the miscarriage rate is worthless" p.285

Thanks Blackcats, thats interesting. I have actually just ordered that book & am waiting for it to arrive. The doctors Ive seen have said progesterone probably doesn't make a difference but took the approach that I might as well take it as it will do no harm. I wondered whether it could encompass the 'tender loving care' approach that I know Prof Regan researched - as monitoried pregnancies have more chance of success? I wasn't sure if taking progesterone could be part of that - a placebo effect? I really have no idea to be honest, I have pcos and sometimes feel totally panicked that there's actually nothing I can do to avoid another mc as my hormones are obviously mental. Its all like some horrible lottery.

Sorry to hijack your thread Bridie! I hope it all goes well for you - your'e definitely in the right hands with Dr Rai

teaandchcolate it could well be. I've read that tender loving care in early pregnancy can produce better outcomes and she talks about that in the book (as does Zita West) . Prof Regan is quite against giving treatments empirically (i.e to everyone with no real reason) for several reasons but probably an important one is you cannot assess how effective the treatment was when its done that way, therefore it hinders advances in understanding how Mc works and what helps and what doesn't. There's just no proof at the moment when someone takes it and has a successful pregnancy to say the progesterone helped, the pregnancy may have gone on to be successful anyway.
Women can't be blamed for wanting to try it though just in case it does work, and mc is so awful, recurrent mc really such a dreadful thing to have to go through. An earlier poster mentioned The Promise study at Kings, maybe they will have a different conclusion to previous studies, maybe not, but doing more research is clearly needed, if it works then it should get funded on the NHS, if it doesn't then research can look at other avenues.

bridie i'm so sorry for your MCs. There are many women on MN who have had 3 consecutive MC, had everything investigated to come back clear and then went on to have a live take home baby. There is so much they don't know about the causes of MC. We all want answers, its normal to want to know why and what to do to stop it, what will help. In my case its highly likely its an age issue, though my first MC was when i was 22 ! I suspect both were random chromosomal problems. There is still a very good chance you will have a successful pregnancy so try to hold onto that thought.

a group of unexplained recurrent miscarriers were encouraged to visit the early pregnancy unit weekly for scans and to have tender loving care from scanners, nurses and researchers, nearly 80% then had a live baby. Those who couldn't attend ( clinic is in London so weekly visits impossible for many) had a lower rate , 50% had a live baby, this is what she says
" i cannot give you a scientific explanation for this, but i do recognise that tender loving care in early pregnancy improves the outcome for women who have experiences repeated, unexplained miscarriages. Perhaps the supportive care has a beneficial effect on the woman's hormones, or on the way in which her immune system responds to the pregnancy in the first few crucial weeks".

she also says other workers in this field confirm this and that as many units as possible should set up EPU clinics for their miscarriage patients (this was published in 2001) . My EPU do not scan recurrent miscarriers which i feel is cruel but i don't know if there is a separate unit for women who attend the MC clinic though.

Thanks for that blackcats. I am hoping that there is something in that theory as my successful pregnancy was quite 'monitored' (had loads of scans, accupuncture and saw a specialist - although he didn't do anything really except give me progesterone) whereas my 2 mc were not at all. I think whether you can get NHS scans maybe depends on where you live - in London they seemed to be happier to scan whereas I now live in Yorkshire where they make you feel like you're trying to get one over them by daring to ask for a scan before 12 weeks...

Hi all

Lola - that's great that you got the appointment so quickly! I hope it goes well. I found that I sort of wanted everything to be fine but also sort of wanted them to find something treatable so I could be more positive for the next pregnancy.
Am I right in thinking you've had a few miscarriages in quite a short time? I asked Dr Rai about something called (something like) Unfussy Uterus syndrome where women get pregnant very quickly each time as I've got pregnant first time trying for all 4 of my pregnancies (including successful one).

He was saying that it is not normal to get pregnant so quickly every time as usually a large percentage of fertilised eggs don't make it past your first missed period. So, some women's uterus appear to be less selective and let eggs that are not up to scratch or eggs that are outside of the normal implantation window implant and they later miscarry. He was saying that for these women he would give them progesterone from the date they ovulate to help support eggs that are not abnormal but may otherwise fail due to lack of progesterone from a old or young corpus luteum.

New Scientist:

www.thaindian.com/newsportal/health/non-fussy-uteruses-blamed-for-miscarriages_100352001.html

Anyway - I have started bleeding again today so am going to try and get a scan this afternoon (just waiting for my husband to get home).

Blackcat - I've also read Dr Regan's MC book and found it a real help. It meant I was a bit more informed re. asking questions etc. Infact - when I went to the recurrent MC clinic I mentioned something Dr R says about one of the blood tests they were doing and how you're not meant to use a cuff (they were using one). Unfortunately the Dr at the clinic didn't know what I was talking about and Dr Rai mentioned that, if I wasn't pregnant that is the one test he would repeat as he couldn't say if it was accurate or not due to most hospitals using a cuff. Not sure I've explained that very well...

Anyway - as you say, her book is quite old now and they are currently doing the PROMISE study to see whether or not progesterone is a help or not. Dr Rai is leading the study.

Teaandchocolate - Dr Rai wouldn't give me progesterone as he felt that the course of this pregnancy has probably already been decided and it's a bit too late. He said that ideally women should start taking it just after they ovulate. He's worried that the PROMISE study might not show much as they are allowing women to start a few weeks after a pos test. He said progesterone can also sometime be a help as an anti inflamatory if are actually bleeding (which I wasn't by the time I went to see him) - helps because bleeding sometimes irritates the womb lining and can cause to more bleeding causing a miscarriage in the end.

Interestingly Dr Rai also suggested that I don't go back for another scan till 8 weeks (2 wks after my first one) which is what my hospital said as well. He said that this is because they now think that early scans may actually cause more stress as they've found that women's stress levels go down for around a day after the scan and then shoot up (above the level of women who aren't being scanned) again until their next scan. However - Ive started bleeding again today so am going to check as I can't face miscarrying at work again.

Sorry for such a HUGELY long and garbled message!

Hi Bridie
So sorry that it seems to be dragging out for you :(

Yes u are right, I have also thought I must have an unfussy uterus, as whenever me and DH have tried we have got pregnant straight away, apart from maybe once (but was so down about 1st mc probably wasn't trying properly)
But didn't realise they could actually treat it in any way so thats good to know thank you, I shall make sure to ask about it.

I really hope Dr Rai can help you, sounds like they can xx

Hi bridie. Thanks for all that info - sounds like your appointment was really useful. Its all so confusing isn't it as even the experts don't have any definite answers. With my successful pregnancy I started the progesterone at about 5 wks so doesn't sound like it would have made a difference. I also don't understand how low levels could caused a missed mc as I thought low levels would make you bleed.

I'd also heard of an unfussy uterus (on another thread on here) & wondered if it could apply to me as I always get pregnant 1st time too. So much to think about!! I drive myself mad with it all....

Keep us posted on your progress.... Hope it's good news xxx

Hi ladies

Good to hear your replies. We are an unfussy lot! I'd be interested to hear what your recurrent m/c clinic says about it.

Had scan yesterday and heartbeat seen. They said all was looking fine but they think I'm 6 wks when I'm sure I'm 7 (because of LMP and date of pos. test) so I'm still really worried as a small fetus can't be good.

Just keeping everything crossed!

p.s. Tea - Dr Rai didn't say that prog. definately doesn't help if you start taking it later. He is just unsure as to whether it helps if you don't start just after mid cycle.

Bridie that's really good news, fingers crossed it stays that way. Try not to worry too much about dates- they dated me a week earlier than i though I was with DD & I worried loads but turned out fine. Have u tried accupuncture? I found it really helpful when pregnant & stressed & can definitely help regulate hormones.

Thanks so much for investigating the progesterone issue with dr rai - feel like we all shared your appointment! Definitely value for money!! Think i'll probs take progesterone if I ever get another bfp as might as well try - altho I really hated those pessaries & they cost a fortune!!

Try to stay relaxed & positive. Hope your next scan is also good news xxx