QuestionHello Again !!
Dr Ramirez I hope you are well.
It is Lisa from England again..... the last time I contacted you my IVF had been cancelled due only have 2 follies, I was converted to IUI and miracle of miracles I AM PREGNANT!!!
I am over the moon but obviously very worried. I asked my consultant if I could have Cyclogest pessaries for the first 12 weeks and he refused. (In one of my earlier emails to you thought I may have LPD)
I have progesterone cream that I bought on the internet and wondered how much should I use, and for how long, indeed is the cream actually doing anything? The instructions are for menopausal women not for fertility..
As I miscarried at 9 weeks last time is it safe to say that it was NOT due to low Progesterone?.
Obviously I want to try everything that I can to hold onto this pregnancy. Also can I ask how much folic acid do ladies in America take? In England it is 400 im sure ive read it is 800 in America and also that it has been linked with preventing miscarriages in some cases. Also I have heard Vitamin helps with Progesterone production should I be taking that too?
Thanks once again dont know what id do without you.
Lisa x
AnswerHello Lisa from the U.K.,
The previous miscarriage was probably not from a low progesterone as you surmised.
I cannot tell you what dosage to use with the "natural" progesterone because I don't know how much progesterone is in it. Is it possible at all to get some natural progesterone suppositories from your pharmacy without a prescription? That is easier to use. If not, then I would probably recommend that you use the cream three times a day, but that is just a guess.
In terms of folic acid, it is recommended to take 1 mg of folic acid for the prevention of neural tube defects in the fetus. Most prenatal vitamins have that much folic acid in them now so check and make sure. You don't need more than that.
Congratulations and good luck.
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
