Progesterone Treatment in Pregnancy to Prevent Miscarriage

Progesterone is a hormone that naturally occurs in the human body. During the menstrual cycle, progesterone levels rise after ovulation to help build and sustain a lining in the uterus. This lining is where the fertilized egg will implant.

The lining will then nourish the growing baby for the early part of the pregnancy. The ovaries will produce progesterone during the first trimester until the placenta takes over this function around the ninth or tenth week of pregnancy.

Overview

When looking at miscarriage, we know that some women have a lower progesterone level and then miscarry. The question is, did the low progesterone levels cause a miscarriage or did the impending miscarriage cause the low progesterone levels? This is a question that is not always easy to answer.

Though researchers are trying to figure this out. In trying to help prevent miscarriages, some doctors began prescribing progesterone supplements in pregnancy to many of their patients in order to prevent miscarriage. This drastic approach is probably not the best method either. 

Progesterone

Studies show that progesterone supplements do not really help prevent miscarriage in the average pregnancy, even when there is a threatened miscarriage.

There is evidence that progesterone supplementation is imperative in pregnancies that have resulted from certain assisted reproductive technologies (ART), like in vitro fertilization (IVF). There may also be a benefit for a woman who has suffered from three or more miscarriages.

Doctors and women who choose to use progesterone supplements say that this is simply helping the body with a hormone it's already producing. They believe that there is little risk and only potential benefit of using the progesterone supplements.

Those who are concerned and decide not to use the supplements point to the fact that there is no proof that they work. Some doctors are concerned that using progesterone may simply delay a miscarriage that will happen anyway.

"My progesterone was low when I had my blood work done. Because I'd had a previous miscarriage, the doctor suggested that we try the progesterone suppositories," explains Carol.

"I started spotting at ten weeks, but my cervix was closed. We didn't find the heartbeat and once I stopped taking the suppositories, I started bleeding outright. I didn't do the suppositories in my next pregnancies because I felt like it was just false hope."

How Is Progesterone Given

The most common form of progesterone treatment is via vaginal suppositories. These are usually a once a day treatment. You simply wash your hands and unwrap the suppository. Then insert the suppository into the vagina. Some practitioners recommend lying down for thirty to sixty minutes, others say to put it in just before bed.

Sometimes, this medication will require special storage to prevent it from degrading. Be sure to ask the pharmacist how to best store the medication to ensure that it maintains its potency. Some providers suggest refrigerating them, while others say a dark, dry environment away from heat is fine. (Think about this as a cabinet not near a stove, or in a drawer.)

Research

There is a call for more research to be done as both women and those that care for them look to help prevent miscarriage from happening in pregnancy. In the end, you need to have a frank discussion with your doctor or midwife as to what is right for your pregnancy. Together, you can make a decision that is appropriate for you and your care.