I have a friend who is currently approx. 5w1d pregnant and has been spotting for the last week on and off. She had a beta on Monday (139) and on Wednesday (179), so it definitely is not going up like it should. She found out today that her progesterone is only 1.9. The OB said that it is too late to add progesterone supplements and they are having her go in for another beta tomorrow. She has already had 2 MCs and 2 CPs. Is it too late to supplement progesterone for this pregnancy? In the future, would she supplement progesterone every month of TTC or only when she gets a BFP? Her OB isn't being very helpful.
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Sorry to hear that your friend isn't getting much help. It sounds to me like it's too late for her to start taking progesterone this time. I started taking progesterone 3 days past ovulation through 10 weeks of pregnancy. You can take the progesterone every ttc month.
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It sounds late, but you never know. I'd suggest switching OBs! Sorry your friend is going through that
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I'm sorry to hear that. With my last and current pregnancies, I started progesterone at 5 weeks. Hoping for god news for your friend.
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I would agree with possibly switching OBs to someone more willing to monitor progesterone. Has she ever had it measured during her cycle? Does she have a short LP?
I was on it for several TTC cycles to help deal with excessive spotting. If she spots more than a day or two before AF, it could be a sign she should be on it while TTC.
I wasn't taking it the cycle we did conceive, but my cycles were more regular after several months on it. I found out I was pregnant toward the tail end of my third week and my doctor put me on P right away because of my history.
If her betas are already slow to rise, I would think it's probably too late.
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It sounds too late, but I'd still take the progesterone bc I would want to know I did "everything I could."
I'd also find a new OB.
My doctor wanted me on progesterone every cycle after ovulation.
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I think that it is probably too late/progesterone would not really help if her betas are not going up appropriately. I know my doctor is of the mindset that progesterone is generally low if it is not a viable pregnancy anyway. If she is concerned about her progesterone generally, she would have it tested during her next cycle.
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@Eko: @Mrs.Someone: Thanks, I figured it might be too late - I feel so bad for her. Just doesn't seem like the OB is really helping her very much.
@fancyfunction: Thanks for the info on when you started progesterone. I guess if her betas were looking better maybe the OB would have recommended it
@MaryM: I think she may go see another doctor pending the outcome of this. She did have a repeat loss blood panel after the last MC and her progesterone was fine (so would that be at like CD 21?). I don't think she has any other cycle irregularities, but has had the same thing happen with her previous MCs/CPs where the spotting starts and then the pregnancy doesn't continue.
@DesertDreams88: @hilsy85: Thanks for the info - I'll pass it along. She isn't really sure that it is even a progesterone issue, I guess since her bloodwork was fine before. I suppose the progesterone naturally falls if a pregnancy is non-viable (just like a regular cycle) so maybe this latest level doesn't really indicate low progesterone right after ovulation, just that this pregnancy isn't viable so it is dropping like it would in a normal (BFN) cycle.
Thanks ladies!
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@GreenThumb: progesterone should progress during pregnancy, so the CD 21 baseline would be different from a during pregnancy baseline. I'll see if I can find a chart...
Does she only have it tested when she has a loss? When looking for a new doctor, it would be good to find one willing to check her levels as soon as she knows she's pregnant, and even possibly bi-weekly after that.
This chart is pretty basic, but pretty much she should want to be near the mean, or if lower, supplementing.
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@MaryM: Thanks - this is great! What I'm wondering is sort of chicken and egg… is her current progesterone low because the pregnancy isn't viable or is the pregnancy not viable because her progesterone low? I agree that monitoring through a cycle would be helpful. I think she is going to see a new doctor because her current practice isn't really taking her losses very seriously. I think they were suggesting she just take progesterone from now on while TTC, but they don't really know if that is the problem conclusively.
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@GreenThumb: Yeah, it is a hard thing to pinpoint.
A lot of doctors will agree with @hilsy85: 's that supplementing with progesterone is a waste because most times the pregnancy wasn't viable anyway (not that I think that's the truth, but that's what some think).
But for women like me, who may have low progestone to begin with, if that's the only underlying problem, it can be a relatively easy fix to infertility.
1.9 seems extremely low though. After ovulation it's usually around 10, and that's before you're even pregnant and supposed to be producing more.
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@MaryM: Right, I thought they were looking for it to be over 10 early on. I'm hopeful that she will find a good doctor who can help her figure things out! Thanks for some good info that I can pass along.
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My doctor will supplement anything below 20 at the first visit.
I hope your friend heals soon and is able to find someone to help her out more.
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