QuestionQUESTION: Hello Dr. Ramirez,
I am on prometrium 200mg/1morning and 2evening. I forgot evening dose on
my 12th dpo. Experienced spotting and pencil line blood in mucus next 3
days. Since I forgot to take the prometruim could I be miscarrying? Today it's
16dpo and my beta came back + but at 77. Thanks!
ANSWER: Hello Monica from the U.S.,
It is unlikely that this missed dose would cause you to miscarry. Remember, the progesterone you are taking (prometrium) is a supplement and not the only source of progesterone. Your ovary, or follicle that you ovulated from, becomes a corpus luteum cyst and is the natural source of progesterone to support implantation and an early pregnancy. Once the placental develops, it takes over the production of progesterone. The number for your first bHCG is fine. It should double approximately every other day (48 hrs) and the trend gives a good indication of how the pregnancy is progressing until an ultrasound can be done at 6 weeks gestational age. The actual amount of rise of the bHCG is at least 80% so if it doesn't double completely, don't be worried as long as it is going up.
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
---------- FOLLOW-UP ----------
QUESTION: Hi Dr. Ramirez, I got retested and my blood bHCG is the same (4 days later). Dr. wants me to retest in another 2 days. Should I still be taking both prometrium and estrodiol until then? What is the estrodiol for and how long does a person take it after the ET? Is it only for implantation or is it taken up to the first trimester? thank you!
AnswerHi Again,
If your bHCG did not rise, then that is not a good sign. I agree with your doc and would recheck it one more time 48 hrs after the last one. I would not recommend stopping any medications just yet.
Both the prometrium (progesterone) and estradiol are to supplement the uterine lining to help with implantation and support the pregnancy until the placental takes over. I usually will stop them at 10 weeks gestational age, but some clinics stop sooner and some stop later (12 weeks).
Sorry to hear the news, but the good thing is you got pregnant, so it can happen again!
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
