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Progesterone and Miscarriage

Updated on October 20, 2014
Blossom III
Blossom III | Source

Why is Progesterone so Important during Pregnancy?

As a result of talking to many women going through miscarriage scares. I have learned a bit about the importance of progesterone and how this hormone affects pregnancies. As a result, I believe that a number of doctors downplay the significance of supplements during the first trimester and, for some pregnancies, progesterone supplements may be needed to save that pregnancy.


I am hoping the information on this page will educate women on the importance of progesterone, whether it might be an issue in their own pregnancy and whether they should discuss this issue with their physicians.

I am not a medical professional. The information I share is meant to supplement the information given you by your doctor. If you feel your doctor is not doing enough for you or not willing to listen to your concerns, I strongly encourage you to take what you've learned here and get a second opinion.

Progesterone, Why is it so Important?

the keep-it-simple version

After reading the stories at Saving Babies Online (an older site and no longer maintained), I found myself really interested in the role progesterone plays in miscarriage. I would just like to pass on a bit of what I've learned in hopes it may help somebody else.

The Importance of Progesterone:

Progesterone is important not only to keeping a pregnancy but also may determine whether or not you conceive. During your cycle, the uterine lining grows thicker in anticiption of a fertilized egg and progesterone helps ensure the endometrium (lining) is ready. Progesterone is responsible for preparing the uterus for implantation. If you have low progesterone, chances are the baby will not be able to implant which may result in a chemical pregnancy. And, low progesterone may keep you from ovulating. Keep in mind that once both estrogen and progesterone levels drop, your body prepares to break down the lining and thus your period begins. If your progesterone is dropping during pregnancy, you are in danger of losing the baby.

Some symptoms of low progesterone:

If you have any of these symptoms of low progesterone, your doctor should check your progesterone:

  1. Short cycles (25 days or under)
  2. In your 30s or older. By age 35, I have read that up to 50% of women have low progesterone
  3. Severe PMS and weight gain
  4. Stress, which stimulates cortisol production, will also decrease progesterone production making conception more difficult and could jeopardize a pregnancy. Progesterone actually produces a more calming effect than cortisol which increases stress

Natural or Synthetic (man-made) Progesterone:

Although I'm reading a lot on the benefits of both synthetic and natural progesterone in maintaining a pregnancy, there does seem to be some consensus that synthetic progesterone may cause some birth defects. I haven't really seen that those studies are reproducible and am unsure how valid they are, but the risk of birth defects should be taken into consideration. Natural progesterone, however, looks to be much safer with no side effects as long as you don't overload yourself with it. Also topical progesterone and injected progesterone seems to be more effective than progesterone taken orally. This is definitely a topic of discussion for you and your physician.

What it boils down to is this:

If you have short cycles, have suffered from infertility or are a bit older than the average mother, you may want to have your progesterone checked. The best time to get checked is around the time of ovulation so you can begin taking supplements if needed. Natural progesterone seems to be a safer than synthetic progesterone and can aid in both achieving and maintaining a pregnancy. Take what you've learned about progesterone to your doctor. If you have a doctor who is not open to testing for progesterone, it may be time to find a new doctor.

Hope this helps.

What are Typical Progesterone Levels?

(taken from fertilityplus.org 's website)

Mid-Luteal Phase

5+ ng/ml -- A level of 5 indicates some kind of ovulatory activity, though most doctors want to see a level over 10 on unmedicated cycles, and over 15 with medications. There is no mid-luteal level that predicts pregnancy.

First Trimester

10-90 ng/ml -- Average is about 20 at 4 weeks LMP, and 40 at 14 weeks LMP. It is important to note that while a higher progesterone level corresponds with higher pregnancy success rates, one cannot fully predict outcome based on progesterone levels.

Second Trimester

25-90 ng/ml Average is 40 at beginning, 90 at end.

Third Trimester 49-423 ng/ml Usually peaks at about 175.

One note, FertilityPlus has some wonderful information, however, they do take the stance that beginning progesterone supplements after a positive test is unlikely to do much. I've been able to find studies online to contradict that opinion. I'll be sharing some of those studies on this page as well.

Studies involving Progesterone

why progesterone may be more important than you or your doctor realize

Some studies I have stumbled across in my quest for more information on progesterone in pregnancy. I'll post the conclusions of the studies. Feel free to take a look at the links and then take this information and discuss it with your healthcare provider.

more to follow...

The effect of luteal phase progesterone supplementation on natural frozen-thawed embryo transfer cycles.

This study shows that luteal progesterone supplementation during the luteal phase decreased miscarriage rate and improved the live birth rate. While most women are not going through this procedure, it once again points to the importance of progesterone.

A combination treatment of prednisone, aspirin, folate, and progesterone in women with idiopathic recurrent miscarriage: a matched-pair study.

In a nutshell, this study found that taking this combination resulted in a much higher rate of live births (77% vs. 35% in the group who were not treated) in women who have had recurrent miscarriages.

Use of synthetic progestogen in the treatment of threatened habitual miscarriage

Synthetic progestogen was begun no earlier than 7 weeks in women who were 7 to 16 weeks pregnant and experiencing a threatened miscarriage. Of those studied, approximately 8% miscarried, 9% experienced preterm birth and 82% gave birth 'normally'.

Effects of vaginal progesterone on pain and uterine contractility in patients with threatened abortion before twelve weeks of pregnancy.

This study found that the use of vaginal progesterone diminished pain and contractions in women with threatened abortion. They also found that the placebo group had twice the miscarriage rate of the supplemented group.

Progesterone Testing Poll

Do you think doctors should routinely check progesterone levels?

See results

Important New Guidelines for Diagnosing a Miscarriage

The UK is the first to acknowledge that misdiagnosed miscarriages are indeed a problem. The Royal College of Obstetricians and Gynaecologists has revised its guidelines. If your gestational sac is more than 25mm and/or the CRL is 7mm or more, you should wait a week to verify (if there are no complications). If the measurements are less, you are too early to diagnose. For more information (and something to take to your doctor), please, see my new page:

New Blighted Ovum Guidelines! You ARE Being Diagnosed Too Soon!

Need to contact the author? You may e-mail Cari_Kay at misdiagnosedmiscarriage@gmail.com

Thoughts? Comments? - I'd love to hear from you

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      yurisz 3 years ago

      Really excellent info thank you. If you are concerned you can get your levels tested without the expense of first seeing a doctor. Hereâs one place to do it http://bloodtestsonline.net/ There are other services as well

    • profile image

      anonymous 4 years ago

      I am a firm believer in progesterone supplements. I experienced 1 miscarriage and then my fertility Doctor put me on 200mg of Prometrium twice a day. I now have a 17 month old baby Girl. It works...Unfortunately most Ob Gyn's won't consider it until your 3rd miscarriage. :) God blessed me and did what only he could do with medicine. And gave me my Beautiful Kaleigh Joy........

    • WriterJanis2 profile image

      WriterJanis2 4 years ago

      You have shared some very valuable information about this. I had no clue.

    • LouisaDembul profile image

      LouisaDembul 4 years ago

      I got progesterone when I had some bleeding early on in my third pregnancy. Don't know if that was the reason, but it led to my having my first surviving child.

    • Kalafina profile image

      Kalafina 4 years ago

      My doctor prescribed me topical progesterone to help with my many health problems. I have not noticed any difference but I keep using it nightly. I believe pregnant women/women trying to become pregnant should get their hormone levels checked as they play a huge part in the body.

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