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!

bridie i'm a bit confused with what Dr Rai said about the benefits of progesterone. So he said it can help when you are bleeding as its anti-inflammatory, but it was the other use i'm curious about. He said then if you take it from ovulation it can help prevent a mc? I was under impression there was no proof hence the current PROMISE study to look into that in more detail - although as you say its being given to them at a later stage . I know women who have IVF are often given progesterone but their pregancies are quite different at the start.
Has anyone else heard this?

Hi there. I'm new to mumsnet so bear with me. Just wanted to share my own experience. My first pregnancy was textbook. Beautiful baby girl. Second pregnancy I didn't miss a period and spotted on and off for weeks. Bleeding became heavier at 17 weeks and I sadly lost a baby girl at 23 weeks. Absolutely devastating. There was no real explanation other than placenta planted low and tore as pregnancy went on. When I fell pregnant again and spotted again I went to a private consultant who ran all recurrent miscarriage bloods and found no reason. My mum told me that she had been prescribed progesterone when she bled with my brothers pregnancy and it stopped the bleeding. I had v supportive consultant at Kingston hospital who listened when I asked was there any benefit to progesterone. By now I was 8 weeks and still bleeding. She gave me progesterone because heartbeat and all bloods were positive. She did caution that no evidence to support progesterone helping prevent recurrent miscarriage and that it would not save a failing pregnancy. I took it for a week and my bleeding stopped. I carried a beautiful boy to term. Then a surprise pregnancy and again, bled on and off. She prescribed progesterone and bleeding stopped again. This time though progesterone only prescribed for 10 weeks. At My 20 week scanned it was discovered I had vasa praevia and placenta was a mess. Miraculously for me and baby I carried him to term.
I appreciate this is all anecdotal but I am fairly sure progesterone helped me carry my third and fourth children successfully.
Anyway, just hope this helps x

Hi All

Unfortunately I ended up going for a scan at 9 wks and there was no longer a heartbeat and embryo had stopped developing. Am just waiting for appointment at St Marys and results from karyotyping.

Blackcat - sorry for confusing explanation - I'm not very clear at the best of times. To try to clarify - Dr Rai (who I saw) is a colleague of Prof Regan at St Marys and it's actually him who is running the PROMISE study. As he explained to me they have to have enough of a professional feeling (anecdotal evidence, other studies that are too small to show statistical significance etc) that progesterone is effective in reducing miscarriage to get funding (in the case of the PROMISE study 1.4 million pounds). They couldn't get funding to see if any old thing has any effect on miscarriage rate (e.g. pineapples - his example!). If there was definate sound proof already that progesterone reduces miscarriage rate, on the other hand, they would not get ethics approval for the study as they would be withholding a proven treatment from half the women in the study (those receiving placebo).

In summary - There have been no scientific studies to date that meet the statistical criteria for proving that progesterone is effective in reducing miscarriage rate. St Marys have been able to make a strong enough argument for the likelihood that progesterone could be effective to secure 1.4 million pounds in funding. I really don't know what Prof Regan's (I'm also a big fan of her book) take on this study is and whether she's changed her mind since writing her book (which she wrote some time ago now).

The study hypothesis is as follows:

1. In women with unexplained recurrent miscarriages, progesterone (400 mg pessaries, twice daily), started soon as possible after a positive pregnancy test (and no later than 6 weeks gestation) and continued to 12 weeks of gestation, compared to placebo, increases live births beyond 24 completed weeks by at least 10% (principal objective)
2. Progesterone improves secondary outcomes such as gestation at delivery, on-going pregnancy at 12 weeks, survival at 28 days of neonatal life
3. Progesterone, compared to placebo, does not incur substantial adverse effects to the mother or the neonate

4 Explore differential or subgroup effects of progesterone in prognostic subgroups

1. Perform an economic evaluation for cost-effectiveness

I've just found this page - the 'plain English summary' section is v. interesting (and probably alot clearer than what I've said!):
www.hta.ac.uk/project/1764.asp

Oops - sorry - posted that before I'd finished (sorry - despite essay above I still have more)!!

During the appointment Dr Rai said that he wouldn't prescribe progesterone for me because he felt that it was too late and the fate of my pregnancy had already been decided either way. I imagine that heading up the PROMISE study probably has an effect on this as prescribing something to some patients while trialling it on the grounds that there is not yet any research to say it works could be ethically dicey maybe. He did say that if I continued to bleed he would consider progesterone as bleeding can irritate the womb lining which can then start to spasm which could lead to miscarriage in an otherwise ok pregnancy. I did start to bleed again the following week and he did prescribe me progesterone as an anti irritant (at a much lower dose than the PROMISE study) as I'd had a scan the day before showing heartbeat and appropriate growth. My bleeding stopped but I guess the pregnancy wasn't going to work out anyway for other reasons and I suspect that the progesterone stopped me from miscarrying spontaniously (rather than missed miscarriage) as it stops the womb from shedding it's lining

This maybe ties in with what Mumbot says. Mumbot - I'm sorry for your losses and it's really lovely to hear your positive stories!

Lolalee - how did you get on with your RM clinic?

Link above doesn't seem to have worked so I'm trying it again here:

www.hta.ac.uk/project/1764.asp

B

Sorry I know this is an old thread but I've had the exact same experience and have just been put on progesterone. Did it help at all? I've had two m/c and going out of my mind