How to find a doctor who will prescribe progesterone?

[sunflower2015]

Dear all,

Newbie here. After 2 MC my doctor back home said next time I should start progesterone asap. Moved to UK & finally got pregnant after 2 years of no luck. Went to see GP but can't get anyone to prescribe.

I know there is no conclusive proof that this works but am desperate to do the little I can to make this successful.

Anyone know of doctor (don't mind private) open to this line of treatment? Saw several mention Coventry. I'm in Oxfordshire (OX16 area).

Many thanks!

Stats
Me 41, DP 42
MC1 - Dec 12 (7-8 weeks)
MC2 - Jul 13 (5 weeks)

Standard scans all clear.

I had to cry and beg my doctor for Cyclogest after 3 miscarriages. He initially refused, then spoke to a consultant at the hospital who was in the 'can't hurt, might help' camp and agreed to prescribe it for me. My DD is 16 weeks old, im convinced it helped. I took it from 3 DPO until 20 weeks.

Are you being referred for testing given your history? Your consultant may prescribe it if so. Otherwise, kick up a fuss and change doctors if necessary.

Thanks BifsWif! I'll keep doing that .
Tests while not pregnant always turn out fine. But here they won't even do basic blood work once you are pregnant to establish your baseline hormones. V. frustrating.
Anyway, thanks again for taking the time to answer!

I would suggest approaching some IVF clinics to see if you can get a private prescription got it. Another way is to get an appointment privately with a doctor/ consultant and get a private prescription that way.

Lastly have a look on eBay. Sometimes people who have completed an IVF cycle sell off their medicines and there are sometimes progesterone pessaries available for sale.

It took three miscarriages for me to get referred to the Recurrent Miscarriage Clinic and get a Consultant assigned to me during this pregnancy. Then I was allowed to have Cyclogest and Fragmin and I am now nearly 20 weeks.

Before that my GP would not prescribe me anything at all even though I begged and begged. Now because I have a letter from my Consultant they will prescribe me my medication on repeat prescription.

I had to go to a private consultant at the Nuffield hospital. Bloody marvellous man. We are in Staffs though, so maybe a bit far for you.

Good luck

Go back to your doctor (it may have to be a fertility / gynae consultant, GPs in my experience say they are not able to prescribe progesterone) and show them the research by the Cochrane Collaboration that states that 'for some women with recurrent early miscarriages there is some evidence that it may help'

There is an article about the Cochrane research here:

www.myinformedlife.co.uk/does-supplemental-progesterone-prevent-early-miscarriage/

The Cochrane research is referenced at the bottom of that article. Good luck! It worked for me - my consultant was reluctant to prescribe it but when I showed him the research he couldn't really argue!

I would like to add to this thread, if it's not too late. I am having my first MC after conceiving naturally for the first time. Previously have had 3 rounds of IVF, the last of which was in Jan this year and didn't work. Second round gave us our DD seven years ago. After all rounds of IVF progesterone was issued under a three-line whip that it MUST be used (can be gel or pessaries). This pregnancy, which I only found about 2 weeks ago, was a total surprise as I am 44.

I have just got off the phone to my previously lovely GP who flat out refused to consider a private prescription, and I am raging. She also asked a colleague, who is more than happy to spend her time throwing chemical kosh pills to husks in the old folks home up the road (for a private consultant's fee) but as those patients don't know what day it is that's ok. But do a private prescription for a woman who's had 12 years of infertility and who, if doing IVF again, would not only would get progesterone but would be ordered to take it? No chance. My GP just came back after asking if her colleague, who's happy to prescribe willy nilly for the granny farm, would do it. Flat no from both, and no other avenue suggested, uncomfortable silence, before I actually said 'ok thank you', then she dropped the phone. IABU to think this is a bit unhelpful?

Can I go to any private doctor and ask for it? So sorry for the rant, I am sick of GPs picking and choosing what they can do for patients.

Sorry for the typo I meant AIBU. In my annoyance at my GP's unhelpfulness I neglected to say that I am wondering about progesterone for the same reasons as the OP. I started spotting last weekend and had a scan on Tuesday at an earlier pregnancy unit. To mine and DH's surprise they said there was a sac and a strong heartbeat, and that it looked under six weeks, which they were surprised at given my LMP was on Aug 14. They said that should suggest a date of 7-8 weeks, which I don't understand as everyone knows the first two weeks don't count as real conception. I know I will have OV'd at the start of Sept, which makes 5-6 weeks bang on.

Anyway the point is it had a heartbeat. Then I started cramping and bleeding, and am sure I will have now miscarried. Have to go back for scan next week but in the meantime I have reasoned that a miscarriage must have been because of something deficient in my body, not the baby's. My research confirms that low progesterone is likely given other symptoms (spotting before AF due, raging PMT, light AF, and failure to conceive naturally for 12 years). At my age, I am willing to give progesterone a go every month to see if it makes a difference.

Go easy on me here, I'm a GP

I get why you'd want anything that just might improve chances of success but as a GP I would only be permitted to prescribe progesterone as "shared care" after a consultant obstetrician had advised it and usually on nhs progesterone is not recommended. So your gp probably isn't being unhelpful they are following evidence based national guidelines

Naysayer can you get a NHS go to contact your hospital and if a consultant agrees to it then your GP could prescribe it? Or contact your IVF clinic and see if they would prescribe?

You can take vit b6 in quite large quantities for short periods which will help. I can't link at mo but maybe you can search on Fertility Friends for more info. Good luck!

I really think that the overall outlook of GPs / NHS on the benefits of progesterone is massively flawed. I have been told by many that 'I think you'll find it doesn't make a difference' however I've read the research myself and for recurrent miscarriage the research shows that it MIGHT make a difference, reducing the risk of miscarriage by up to 50%

www.myinformedlife.co.uk/does-supplemental-progesterone-prevent-early-miscarriage/

It really annoys me that Doctors won't prescribe it if they don't believe in it just because the research is structured a certain way. Could the GP not have called / faxed their colleague who does have the expertise and asked them to write the prescription? There are no serious side effects to supplemental progesterone, just prescribe it!!!

I think that once new research comes out on the use of progesterone in cases of recurrent miscarriage then many nay-sayers will have to eat their words.

Sorry, I'm posting again as this subject is something I feel incredibly strongly about. Here is what I would do:

Read and print out this research article:

www.myinformedlife.co.uk/does-supplemental-progesterone-prevent-early-miscarriage/

Within the article, read about the research by the Cochrane Collaboration. This was a systematic review on progesterone supplementation for recurrent miscarriage. Locate the Cochrane research and print it out.

Take both articles to your doctor and tell them that the evidence-base at the moment suggests that progesterone might well help for recurrent miscarriage.

If they are unable to prescribe progesterone / Cyclogest then ask them to refer you urgently to someone who can, or ask them to call their colleague who can, and that colleague can write a prescription and fax it to your local chemist THAT DAY.

Always sunny, your own post is disgraceful, talk about making it personal. To use your own phrase, how on earth do you think I know anything about the GPs' prescribing? Because I had a relative in there for three years and our practice is well known locally for all the private medicine sidelines the GPs have. And why have you assumed I ranted at my doctor? I have already said I was taken by surprise and could say nothing when she refused, before I eventually said thank you and SHE hung up. Seems an extremely harsh response from you about something that is not the subject of the post. This website is about getting practical advice and information from each other. If you have a problem with the way people express themselves when going through things, stay off it.

Thanks Chudders for your article, I have read it and will print it out. It did occur to me today I should have said I would like to insist on it and if she or the other GP were not able to do it I would like to be referred on to someone who could. It was the finality of no, I'm not doing it and neither's my colleague that caught me by surprise. It was a very straightforward request of a few words, could I have progesterone on a private prescription. I didn't say anything else other than telling her that I'd attended an early pregnancy unit after spotting and bleeding and the outlook wasn't good. So to be hit with such a sudden end to the conversation was a surprise when GPs will usually offer further avenues. It was as if I'd offended by asking.

Thanks luciole for the vit tip, I will look that up too. Thanks Rooibos I am going to call a private clinic on Monday and a scrip from there. My GP was three hours late in calling me at 5pm yesterday afternoon. So she didn't leave me able to phone anyone else up at that time, or with the feeling that she'd done her best for this particular patient that afternoon. Sleepless in Derbyshire, haven't meant to offend you but did feel my GP was leaving me with no options at the time when any other clinic I could have called was closing for the weekend, she herself had been very, very late in calling me and appeared to want to close matters there and then.... 5pm on a Friday, miscarrying the first natural conception you've managed in 17 years is a lonely place to have a medical professional tell you they can't help and can't suggest anyone who can. Close of business in every sense.

I'm finding myself in this position today. Spotting started today and cramping at 3w 6d. Had a mc in August at 4w 6d. Had a progesterone test on day 21 which came back low 27.1 but we still managed to conceive. I was about to go back for the results in Tuesday when I had my bfp. Booked an appointment to go to the gp in the hope to get some progesterone prescribed. She said it is not within "nice" guidelines and reassured me that it would all be ok and it's unlikely to happen again and last time was probably just bad luck. I'm so cross I listened and didn't make a private appointment. If my progesterone was low on day 21 then I'm pretty sure it will still be low and this is the reason for my spotting. I also have incredibly light af, a day or a day and a half at most which i also read is a sign of low progesterone. It's so sad that you have to go through this hell 3 times before they will help in any way. I'm now scouring the web looking for local clinics where I can get an appointment for Monday as I hear that the private dr's will hand out whatever is necessary rather than what they are budgeted to prescribe. So many ladies on mn have been given progesterone privately and they have had successful pregnancies. I'm sorry to say I think it is too late for this pregnancy as my tiredness has disappeared. My only symptom from both pregnancies and it disappeared the day my spotting started with my last.

After 27 months ttc #1 I thought this was our time. Sadly not! I should have stuck to my guns and gone privately

Not sure how to find the clinics myself. Is there a website like a directory of private clinics? Really wishing it wasn't the weekend!

Hi, I was prescribed progesterone in my last pregnancy by my NHS consultant (not for recurrent early miscarriage but because of incompetent cervix). However, after giving me the prescription he did a U turn and would not give me a follow on prescription (because he'd attended a conference where a speaker cast doubt on use of progesterone in pregnancy) and I had to space out taking the progesterone I had from the first one to last through the pregnancy. I had seen a private consultant before this for an operation and he was prepared to prescribe the progesterone. I know my circumstances are different but at the time (2013) it did seem that the NHS guidelines were not to prescribe it (at least they were for my local hospital).

Just read this by fluke but wanted to say when I started spotting and went to the early preg unit, I was offered to join a trial on this very matter. Only thing is that it's double blinded study which means you don't know if your prescribed the placebo or progesterone. I understand they are running this study all over the country. Personally didn't go for it.

Dear all,

First of all, apologies for starting this thread and then disappearing off the face of the earth.

I had a 3rd MC and it hit me really bad.

Now I'm ready to pick up the fight again and just wanted to share a little info I've gained along the way for any who might stumble upon this thread.

1. If GPs (& consultants) were reticent to prescribe progesterone before now it's even worse as the results of the long awaited PROMISE trial are finally out and the result is "Progesterone supplements in the first trimester of pregnancy do NOT improve outcomes in women with a history of unexplained recurrent miscarriages" www.miscarriageassociation.org.uk/information/research/the-promise-trial/

2. Several suggested private appointments - I had trouble even finding a doctor who would prescribe privately! Finally I came across Dr Impey who was open to it - I had an appointment but didn't get to see him because of MC. Here are his contact details: www.oxfordfetalmedicine.com/

3. The reason why the "but they give you progesterone during IVF" line doesn't work is that because, when you're doing IVF conception is outside the body, so your body doesn't know it's pregnant and, thus, does not increase progesterone levels.

Good luck to all

Are you taking a low dose daily aspirin op. Unless you have a medical condition that makes it unsafe I would strongly advise you take it.

I am sorry sorry for you losses op

• so sorry

Hi there, seeking some advice please . I'm in London and wondering if anyone can recommend a GP /consultant who is happy to prescribe progesterone . I have have been trying for a baby for 8 months , I'm turning 37 soon . I have a son 18 months now, but for the last 8 months I've had 1 miscarriage and notice that when we tried I get my period less than 1 week after ovulating . Spoke to my NHS Gynae , hair asked to keep trying . I checked my Progesterone when I had the miscarriage at 7 weeks- was only 7 nmol/L. And when I had the early period it was 2. I desperately want some Progestetone as I know other countries do prescribe them. UK doesn't do much saying there is no evidence . I've heard stories of mothers who have responded to Progesterone and I want to try it . Who can I get to prescribe it please ? Without having to pay a bomb ? Thanks !

Sorry for your loss Blessing21. You might want to try a consultant at a fertility clinic.... The high cost would be in the consultation itself, the prescription shouldn't be too bad. Maybe call around and see what they say?

Sorry I can't be of more help but we encountered the same problem. GP would not prescribe without a consultant's recommendation. It was only when I "qualified" to see a recurrent miscarriage specialist that they even considered it, but they still think it makes no difference.
Good luck!