Provera in Early Pregnancy: Safety and Usage - A Doctor's Explanation

Question
Hi  I am 4 weeks pregnant and 41years old. I have a history of miscarrage in
the first trimester. My Dr has put me on pregnyl inj 500 twice a week which I
have started. Asprin 100 and vitamins da.ily.Daily blood tests He also wants
me to start provera 20mg 3 times a day from week 5. I am a bit unsure about
the provera as I have read that there are side effects and ? possibility of birth
defects....Is this a usual treatment.

Answer
Hello Jane from Australia,

Congratulations on your pregnancy.  I do not recommend provera and you are wise to question that order.  Provera is a synthetic progesterone and is not recommended to be used in pregnancy.  You seem to be taking HCG injections already, which act like progesterone, so why take more?  If your doctor wants to prescribe more, and more will not hurt, then he should use a natural progesterone such as Endometrin, Procheive, Crinone or Prometrium and should be used vaginally, not orally.  Oral progesterone has been extensively shown to be ineffective in endometrial support.

Bear in mind, however, that most miscarriages occur because of abnormalities in the embryo or pregnancy, and not due to a lack of hormone.  These are usually spontaneous chromosomal abnormalities that occur when the weakened egg divides to form the embryo.  The eggs are weakened from age.  Because of your age, you are at increased risk of miscarriage, which can be as high as 40%.

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