To progesterone or not to progesterone?

[AiRoo]

Hi all,

im 5+1 today after 2 losses (5+3 and 6+5) in 7 months.

this time around my hcg seems to be rising much better and at 20DPO got 3+ on a clear blue.

I am very aware that doesnt mean anything and a lot can still happen, but seeing that 3+ did make me happy.

my GP sought advice from obs and gynae and they did prescribe 400mg progesterone pessaries twice a day.

when I went for scans with my two losses my lining measured 15mm each time, and from trusty google, I’ve read that’s ok?

so…. I have no bleeding, very few symptoms at all actually, bar sweating very easily (sorry if that gave you the ick).

do I take the pessaries as a precaution or do I not try to fix what is (currently) seeming to not be broken.

the gp gave no advice, guidance, nothing. I don’t even know what my progesterone levels are as she refused a blood test. She just heard my anxiety from two losses and next day I got an email saying “pessaries sent to pharmacy”.

any lived or prior experience with this is welcome! Thank you all!

Why not? It won't do any harm and could help. I think that's generally the thinking behind much of the progesterone prescribing/taking.

@Flederjo the only reason I’m thinking not is I’ve read it can cause irritation and bleeding which would just make me panic.

I took it in 3 successful pregnancies. No irritation or bleeding. Just a bit messy but wore pads.

I took progesterone in my 3rd pregnancy (after 2 MCs) and have a healthy 1 year old. I didn't feel irritation or bleeding. I did feel nauseous and exhausted throughout the 1st trimester. I will never know what would have happened if I hadn't taken the progesterone but I never considered not taking it. That would have been doing the same as 1st and 2nd pregnancies but expecting a different result.

I had been prescribed it in 2nd pregnancy after a bleed. Spoke to my GP who said she would prescribe as soon as I got a positive pregnancy test.

@Mulledjuice thank you for your insight.

sorry about your losses and pleased you had a rainbow baby!

ive just been reading the NICE guidelines that state it is only really advised if you bleed after previous losses not if the pregnancy seems to be progressing well, and it’s recommended to make sure the baby is in the right place first too.

I have an early private scan next sat when I’ll be just over 6 weeks, so once I know the baby is hopefully in the right location, I think I’ll just go for it regardless.

as you quite rightly alluded to, making no changes but expecting a different outcome is daft really isn’t it! I’m just an over thinker!

thank you again.

Doing nothing and having different outcome is exactly how mine worked out!
If you've been given them and feel comfortable taking them, do it.
But I was never allowed them, in any of the pregnancies, after back to back mcs I ended up with my 6yo
And even though I bled with her, and spotted with this current pregnancy (with another mc prior to it) still wasn't allowed any. But all is well with current little one.
Fingers crossed with your outcome whatever you decide to do with the progesterone!

@LaTable thank you for your reply.

im sorry you’ve experienced so much loss but glad you’ve had successful pregnancy in between.

yes, ill see how the scan goes and make a decision next sat.

thanks again

I’ve had progesterone in 3 pregnancies
The first two were already measuring behind when I was given the progesterone but this time I’m measuring on time so I’m hopeful it will help..
I haven’t experienced any bleeding with it at all. Mainly it’s made my boobs hurt like hell, maybe a bit of bloating/cramping.

Best of luck whatever you decide🤞🏼

I’m in a different situation doing IVF, but for IVF you can take the progesterone pessaries rectally, which might work for you if you’re worried about irritating your cervix.
It’s less grim than it sounds and there’s no mess unlike taking them vaginally- plenty of people prefer it!
Something to ask about at your scan anyway if you think it might help, wishing you all the best.

If you have a progesterone deficiency they will help, if you don’t then they won’t do any harm. I think bleeding is very rare. They’re usually prescribed in late pregnancy to support the cervix in women with incompetent cervix. They helped me loads to stop the bleeding I had while oral progesterone did nothing.

I think the NICE guidelines are to reduce it being over prescribed (to save money). It’s not proved to reduce miscarriages in people without a history of miscarriage so why bother giving it to them, but it does help those who have a history. It doesn’t cause any harm. I’ve taken it in my successful pregnancies and would definitely take it in future ones.

@Blueskycat @Confusedmermaid1

thank you both for the advice and guidance.

and the bum tip!!

3 losses and 4th pregnancy - only one I took progesterone for and I’m 16weeks now.

there is no harm in taking it and everything to possibly gain from doing so.

it won’t stop a miscarriage or of course and embryo with genetic issues but it can certainly support your pregnancy in those fragile first few weeks.

bleeding in pregnant is NOT rare it’s actually really common, I think 1in4? I’ve actually bled the most in this one due to a SCH - It won’t stop bleeding from other things but it will support your lining.

ps I took a couple vaginally but was messy and same, I didn’t want cervix irritation it so I’ve taken rectally for 16w, been hassle free and becomes really easy to do.

@Xwx1010 sorry about your losses and so pleased this pregnancy is going well!

team progesterone all the way.

pleads could I ask what week you started taking it?

@Xwx1010 I meant bleeding from taking the progesterone. I heard a lot of women who took it vaginally but none had bleeding.

@AiRoo I saw your other thread a few days ago and you really wanted some extra support from GP, you really got quite passionate about it (with good reason) and wanted to give your embryo a fighting chance this time.

So now that your GP and a specialist have prescribed you something that could help, why wouldn't you just take it?

Your other pregnancies were okay until they weren't, I suppose I'm saying, and now you have the progesterone which is what you wanted the whole time. I'd just take it!

If I were you, I’d take it if you were prescribed it! I’m another one who has been refused (2 MCs behind me, but no bleeding so far in this one yet). GP was very sympathetic but apparently gynae just said nope! I’m 5 weeks today, so early days. I’m taking 75 mg aspirin as it was something else the GP had mentioned. Luckily you can buy that over the counter, so doesn’t really matter what gynae thinks 😂 Otherwise, the GP was basically saying if I wanted further reassurance I can just get an early scan. I won’t be doing that, as I’ve read too many times when that’s given false reassurance. I’m due to go off on holiday towards the end of week 12, so if my scan doesn’t get scheduled before then, I may go for a private NIPT and scan beforehand. Do the still charge for that, even via the NHS? I remember we had to pay £300 or £400 with DD2, but that was back in 2017.

I’m so sorry of your losses and can totally understand why you want to investigate about the progesterone.
I had a previous loss so took it for my second pregnancy up until week 16, this was prescribed by going via a private fertility clinic though and I did have to pay for the prescription but had no problems on the pessaries, a little itchiness at first while my body adjusted but no bleeding or anything. I also took 75mg aspirin right from the beginning and still on it now. 23 + 5 now and all looking fine I do believe it’s completely natural to want to give the pregnancy the best chance to progress especially after a loss so I completely get it.
I wish you all positivity for your pregnancy going forwards 🩷🩷🙏sorry for the long message just wanted to share my experience as it helped me a lot to hear of others experience.

It helps some of those who had a history. It's worth looking up the study (which was a meta study - it looked at multiple) to understand when it can help and when it can't

Well this was an IVF pregnancy so from egg collection even before embryo transferred.
however previously when I have asked during natural pregnancies they have said from 6 weeks once pregnancy located as uterine (I’ve had 2 ectopics though so this makes perfect sense).

@LuxyLocket thank you so much for your message. I’m really hoping this little baby sticks 💖

@Flederjoyes I appreciate what you’re saying but I’ve done a lot of reading and the research is conflicting.

its not a case of “now I’ve got what I wanted I don’t want it anymore”

it’s more, do I mess with something that’s progressing much better than last time and the time before.
and should I wait for uterine confirmation.

I am full of anxiety and worry and I know it doesn’t always prevent miscarriage anyway.

i was just reaching out for extra lived experience. Apologies

I had two losses last year and am pregnant again. I spoke to the epu when I found out I was pregnant and asked if there was anything I could do to help this pregnancy and they said they could prescribe progesterone.
I had a referral to the reoccurring miscarriage team too due to my age and asked them the same and they said they would recommend the progesterone I had already been prescribed.

I was already 8 weeks when I started taking it as I found out later than normal due to not having a period after my last loss. This was further than the previous pregnancy managed and I think the one before that too so I think this pregnancy was already doing better than the two losses without the progesterone but i still took it until 16 weeks. I had no side effects from the progesterone and only one day where I had a spot of blood but this day I coughed as I inserted it so I think this was purely because I had to insert it twice and may have irritated or scratched myself internally. I am now nearly 23 weeks as I said I don't know if the difference is the progesterone or if this was always destined to be successful but I had no negatives from it either. I did have a scan at the epu before they prescribed it though.

Would you feel.more comfortable if you could talk it through with the epu rather than your GP?

From what EPU told me, the evidence is for those with repeated losses who are also experiencing bleeding this time round. A bit of me is thinking by then it’s too late then, innit??!

I’m also curious - and the answer is probably nobody knows - what proportion of early losses are caused by low progesterone vs chromosomal issues….what proportion of MCs can progesterone actually help prevent in any case??

@curliegirlie guessing it wouldn’t be ethical to carry out this kind of research on pregnant women no doubt so I doubt we will know.

the evidence would point to being helpful for those with RC loss and bleeding as that’s who get it, you wouldn’t give it to someone who was having no issues.
id say no it’s not to late to take it if you’re bleeding because if the bleeding is due to thin lining then it would help stop the bleeding as long as pregnancy and sac ok.

the bottom line is progesterone does not harm and it COULD attribute to supporting the pregnancy through the first trimester.

Albeit it won’t help if there are other issues such as chromosome or NK cells for example. However many women do report that their successful pregnancies coincided with the use of progesterone but of course many women will take progesterone and still miscarry.

you’ve got nothing to loose by taking it, it won’t do any harm and it’s worth a shot.