QuestionI have had 3 healthy pregnancies before the age of 34. Now I'm 39 and have had 2 miscarriages in 2 months. All my lab tests are normal. My obgyn wants to start me on progesterone suppositories(crinone 8%) she said it "can't hurt"
My question- is baby asprirn ever recommended even if the clotting disorder tests are negative. Is it one of those things that also "can't hurt"? I'm writing from Michigan. Thank you so much.
AnswerHello Julie,
I would concur with your doctor and add the progesterone, since they are natural formulations and don't have any adverse effects. I would also add the low dose aspirin (81mg) per day starting now, as you suggested. It also is innocuous but can potentially help.
Probably the main reason for the miscarriages in your case is the "age related egg factor." This is where the quality of the eggs diminish with age, especially occurring after the age of 35. We know from IVF genetic testing that at age 37, only 20% of embryos formed will be genetically normal due to spontaneous chromosomal breakages during division. That leads to no implantation or, if implantation occurs, miscarriages. The chances of miscarriage at your age is up to 40% per pregnancy. Because of this age factor, you need to be prepared that your pregnancy has a high chance of miscarriage despite medications, however, because you have been able to become pregnant easily, chances are almost 85% that you will eventually have a successful pregnancy. You just need to keep trying and hope that the good egg is the one that gets pregnant. The only way to speed up the process and increase your chances for that good egg is through IVF because the ovaries are stimulated to grow many eggs at a time, whereas, you are only ovulating one egg at a time with a natural cycle. Not only does ovulating only one egg at a time slow the time to pregnancy, but your chances decrease with the passage of time as well, as more and more eggs become debilitated. I would recommend IVF or at least an ovarian superovulation with IUI cycle so that you are ovulating more than one egg at a time.
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 follow me on Facebook at http://bit.ly/9Iw9oV
