Advice on progesterone after miscarriage

[Willow11981]

I’ve had two miscarriages in the first half of last year, I’ve finally fallen pregnant again (5 weeks) and I’m desperate to try progesterone this time to try and give me the best chance of keeping this one.
I’ve rung around a few fertility clinics but they will only prescribe to existing paitients and I’m waiting to hear back from my GP who said they would have to write to someone else to ask advice as it’s not something they would normally offer.
My friend has given me a spare box of Lutigest leftover from an IVF cycle but it’s a box of 21 which would be a weeks supply if I tried the recommended dose of 3 a day. (Although I thought I could take 1 or 2 a day to make it last longer??)
Has anyone got any experience in trying it without say so from the doctor as part of me wants to try and part of me is reluctant to use something that hasn’t been prescribed for me.
I’m also thinking if I do somehow manage to get a prescription it may be cyclogest or a different brand so not sure if they are interchangeable??
Any advice work experience would be great fully received
Xxx

Personally I wouldn't try something that hasn't been found to be a problem. I've had 4 mc in total and still no one has suggested progesterone to me. I think without a real need for it after testing, or recommended by a doctor you should wait and maybe ask your epu? Mc could be down to so many problems. Hope it works out for you x

I'm fortunate in that after 2 early miscarriages I just asked my gynaecologist if I could try progesterone and she happily wrote a prescription because it can't harm anything at all, but it might help.

Same with baby aspirin which I bought myself and took from the beginning of the cycle. Can't harm, might help.

So I don't think there's a problem with taking it anyway, but if I'm right Lutigest is only 100mg? I was on 200mg twice daily, so I'm not sure if the Lutigest would be too low a dose.....it would of course run out quickly and that's what I would be more worried about

Forgot to say I'm now 23 weeks and everything looks good.

You could speak to your GP again because the updated NICE guidelines from end of 2021 state that they do now recommend a progesterone prescription for those who've had previous miscarriage and vaginal bleeding.

www.miscarriageassociation.org.uk/2021/11/upated-guidance-on-progesterone-in-pregnancy/

Your option otherwise is becoming a registered patient with a private clinic (this is what I did) and they prescribed progesterone but they also monitored me throughout the first 12 weeks of my pregnancy. I had 2 losses before my third successful pregnancy.

As another poster also said, you can also take baby aspiring (now recommended to take a 150mcg) dose a day.

Wishing you all the best! It's a stressful time. I

Please don’t take prescription medication without a doctor’s say so. There are still downsides to taking any medication during pregnancy (I have had to take progesterone with all three). If you don’t need it, that is the better way.

Just a thought, you can also get progesterone creams without prescription, even off Amazon. The dose might be super low, I've no idea, but I read about someone using that on the Conception forum.

Thank you everyone for your replies!

@Kaw10 ….. ah that’s such great news your pregnancy is going well, it gives me some hope. I am taking aspirin as that’s another thing I kept reading so I thought I may as well try, though I’ve just taken it from BFP.
Yes your prob right about it being too low a dose as they are 100mg, and that was exactly my thoughts about them running out.
I think I’m going to have to try contacting more private docs to see if I can get someone to prescribe to me.

@LASandOtto…… I saw that about the NICE guidelines but I thought because I haven’t had any bleeding I wouldn’t fit the criteria?
I think your right and I might be better off just seeing if I can find someone to see me privately!

It’s so hard to know what to do, I’m scared to take it and I’m scared to not take it…… I’m 40 so time is not on my side, xx

@Willow11981 I think it's worth going private if you want additional monitoring. It is good to get blood tests done to check your HCG levels are rising, what your progesterone levels are, etc. I recommend it.

@LASandOtto …… thank you, I think that might be a good idea! X

Hi, I have 4 unused progesterone pills packs that I bought in another country (Eastern Europe). It was prescribed by private doctor but actually you do not need prescription to buy it. I used only part during my pregnancy and really think it helped me. Not sure how but I want to give it to someone who needs it for the same price.

Ah thank you @Tushka9 but I managed to get an appointment with a private doctor who prescribed me progesterone. Fingers crossed it helps somewhat! X

@Willow11981 Ask for a referral to Tommys.

Or show your doctor their research www.tommys.org/our-research/our-research-projects/miscarriage-research/can-progesterone-really-prevent-miscarriage

On our 7th pregnancy due to recurrent miscarriages (no live births yet) due in 5 weeks time. No-where else helped us at all. The NHS just left us without treatment and let us miscarry over and over. This time had luteal phase progesterone, 1st trimester pregnancy progesterone and blood thinners… and all seems to have done the trick.

Ask your GP for a referral to your nearest Tommys clinic!

Best of luck in your current pregnancy! Pregnancy following loss is not easy but you do start to enjoy every second of it eventually

Ahh thank you for your message @RainbowTime:

I managed to get a private prescription from a gynaecologist for progesterone in the end.
My GP said they would to the obs and gynaecology team but that was 2 weeks ago and have heard nothing so I’m glad I didn’t wait around for them.

Ah that’s such wonderful news your due soon after what sounds like a long painful journey! I wish you all the happiness!!!

X

Hello, I've been wondering about this too. Currently having my second early miscarriage - I'm still breastfeeding my first baby, she's 19 months, and I know this can lower progesterone so wondering if this is why I have had the miscarriages 😞

Do you have private health care Op or did you just go private for this? I imagine it's hard to get it via the NHS...

I'm on progesterone suppositories as part of my fertility treatment but if you read up on it you will see that there is very little supporting evidence that shows they have any effect of maintaining a pregnancy some literature says they merely delay miscarriage (which can be even more distressing).
80% of miscarriages are caused by chromosome issues with the embryo itself so no amount of progesterone would help.

@Skylark1990 ….. so sorry to hear about your loses, it really is heartbreaking. I haven’t got private healthcare so I just paid for a zoom consult with a gynaecologist ( was £250) who was happy to prescribe it for me.
@Purplecuppa …. Yes I know it may or may not make a difference but it’s all I can do at the moment so just hoping it helps! X

@Purplecuppa you need to check your evidence base. Following the PRISM randomised controlled trial that Tommys UK conducted they found progesterone does make a difference for women with recurrent miscarriages. In addition NICE UK guidelines have now been amended to reflect this research and they have changed their recommendations for clinicians.

More info here: www.tommys.org/tommys-research-helps-inform-national-guidance-around-progesterone-treatment-prevent-early

www.nice.org.uk/guidance/ng126

www.miscarriageassociation.org.uk/2021/11/upated-guidance-on-progesterone-in-pregnancy/

www.tommys.org/about-us/charity-news/prism-trial-bleeding-early-pregnancy-and-miscarriage

Also your comment on 80% of miscarriages being caused by chromosomal abnormalities is also not fact. Having had multiple losses analysed in labs none of ours had any chromosomal abnormalities. It’s an old fashioned way of making women feel like their loss is acceptable because it wasn’t viable or whatever the reason it’s not evidence based. They don’t actually know all the reasons why women miscarry. They are predominantly looking at the womb lining at the moment at Tommys in the CERM trial and have some evidence that suggests inflammation is to blame. Until they have an actual reason and full scientific evidence base,
stop normalising miscarriages.

Research is ongoing. Before you spread all this old school hear say and speculation. Please check the evidence.

Anyone looking for progesterone in recurrent miscarriages. See the links I’ve posted or speak with Tommys UK - don’t listen to the hear say and don’t give up hope.

See CERM trial - www.tommys.org/our-research/our-research-projects/miscarriage-research/cerm-can-doxycycline-prevent-miscarriage

I meant no offence it's just the literature that I have read like this study from Harvard University.

www.health.harvard.edu/blog/9829-201606229829#:~:text=It's%20disappointing%20that%20progesterone%20doesn,they%20have%20a%20healthy%20pregnancy.

This study www.nejm.org/doi/full/10.1056/NEJMoa1504927

But anyway apologies if this was offensive.

@purplecuppa Both not UK based. And both older than the current research that current clinical guidelines are based on. Look to current UK research that is used in clinical settings - as above.

Hi,
Can I ask which private service you used for your progesterone prescription?
i have just suffered my first miscarriage after only 5 days. I know progesterone can’t harm if taken, and would like to try this next time. However my GP and fertility clinic aren’t interested as it’s not a recurrent miscarriage?

@Willow11981 how are things going?

I'm a similar story to you I'm 5 weeks.

@Niko2525 ….. very sorry to hear about your loss……. I used a private gynaecologist called dr Mahantesh Karoshi …….. he’s based in London but I did a zoom consult anyway. He was on a website called top doctors.

@dreamyunicorn ……. So far all seems to be going ok! I am 11.5 weeks and have had a couple of scans so far which have been positive!! have my 12 week scan in a week! 🤞🏻

Thanks for your reply Willow. I am looking in to that doctor and it looks like a good option. Can I ask what the following steps where after the consultation with him? You said he prescribed progesterone, how much was the private prescription? How much did he prescribe you? Was it enough for the first 12 weeks? Does he want to monitor you during the first 12 weeks, or are you going back to your normal GP for that?
Sorry for all the questions, I just want to make sure it’s the right decision before paying the consultation fee. I am also worried he won’t be able to do anything if it’s my first miscarriage? I don’t know if he mentioned to you that you need to have a recurrent miscarriage to be given progesterone or not? Thanks again for your time. X

@Willow11981 that's amazing! You must be so pleased but still so wary!

How did you get your scans, private? I've looked and there are very few places by me and all seem to need to be 8 weeks onwards.

@Niko2525 I had one mmc and have been prescribed progesterone and aspirin for that one as I was spotting for about 2-3 weeks on/ off, so it is possible. Good luck.