QuestionHi!Iam 33 years old.I have 2 kids.My youngest one is 8 years old.I have been trying to get pregnant for the past 3 years.I had two miscarriages.One in 2007 and another in 2008.by the time i get a positive pregnancy test i would be spotting and then a week later i start bleeding.no D&C was needed.my doctor did all kinds of blood tests on me including those that checked if i had any blood disorders.everything came out negative.i tried another doctor and she ordered a progestrone test.she said it should be done on 4 july and my periods were expected on 12 of july.the progesterone level was 0.443.i dont know what phase was my cycle in.the luteal phase or the follicular phase.my doctor is recommending to start vaginal progesterone suppositories after i get a positive pregnancy test,but iam already spotting by the time i get to that point.also my periods have been really weird i had spotting on aug 8 which lasted for 3 to 4 days and on 29 i had my periods which my doctor predicted that i will have periods sooner then i normally have.please help me.i would greatly appreciate your help.
AnswerHello Farah from the U.S.,
You are correct that the progesterone needs to be started PRIOR to finding out if you are pregnant. Your doctor should know that. Certainly trying progesterone supplementation would be an easy thing to do and I would recommend it also. You will need to use the calendar method to know when to start, AND you need to start in the cycle that you are trying to get pregnant. Waiting for pregnancy is already too late.
Mark your calendar when your period starts. That is cycle day # 1. On cycle day # 16, start the progesterone supplements used vaginally and continue this. You will need to have a pregnancy test done two weeks later because the progesterone could keep you from having a period. I use and recommend either Crinone 8% or Prochieve 8% each morning, or Endometrin 100 mg twice per day. I would also recommend that you take Aspirin 81 mg each day starting at the beginning of your cycle. If you get pregnant, you would continue both these medications until you are 10 weeks pregnant.
If you miscarry again, you need to see a reproductive specialist for more testing. In addition, I would had heparin 2000 Units twice per day to the above medications, starting at the beginning of your period.
Sincerely,
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 facebook and twitter with me at @montereybayivf.
