QuestionHi Brenda,
Thank you for making yourself available to answer people's questions, I think that's really great!
Ok, a little history, I'm 31, and me and my partner have been trying to fall pregnant from Feb last year. I've been charting my temps since then. My Luteal phase has been 11 days since I started temping. I did a little research into this, and found out that it is a little on the low side. I also found out that a herb called Vitex (agnus castus or chasteberry) can be beneficial in lengthening the LP, as it works on the pituitary gland and balances estrogen and progesterone. I started taking this in August, along with 100mg of vit b6. From August onwards, my LP has extended to 14 days and my ovulation day shifted from around day 16-17 to day 12, like clockwork! I fell pregnant in November last year (so excited, as my mom had huge hassles falling pregnant with me, and I thought I may follow in her footsteps), and discontinued the vitex as there is controversy about taking this during pregnancy, and what with it being my first pregnancy, I wanted to rather err on the side of caution. I then miscarried at 6 weeks (over Christmas, I cannot even begin to tell you how terrible it was - my mom in law desperately wants a grandchild, although we haven't told anyone we're trying, so she brought up babies almost every time we saw her...) I realise that it was probably a genetic thing, but due to the fact that my LP was short, I feel that perhaps I have a slight progesterone deficiency. I have been thinking about taking a nature identical progesterone cream containing 30mg progesterone from the day after Ovulation, till my period begins. I realise it may not necessarily help, but it won't hurt will it? I think that as it's a dose that a woman's body should produce in the LP it should be safe to use?
sorry for the long story, but essentially I would like to use it as it would make me feel more confident going in to the next pregnancy, because if something goes wrong this time, I'll feel that I did everything to hold on to the baby. Right now, I feel like I perhaps could have prevented it by not going cold turkey on the vitex. Again, I know it was probably just genetic...but what if?
Also, I just wanted to check that I've got the instructions correct. use from the day after ovulation and continue using until my period comes or if pregnancy is confirmed, then continue till week 12 before slowly tapering off.
Thanking you in advance.
AnswerDear Kat,
I'm sorry to hear about your difficulties - and your loss. Although I cannot actually prescribe a medication for you, I can tell you that the early miscarriage may have had many potential causes, most likely a genetic one, as you suggested. It may also have been related to luteal phase defect or the progesterone issue. In the first half of your menstrual cycle, lots of things are going on including various hormonal fluctuations to prepare the egg for ovulation and ultimately to actually cause ovulation itself. In the luteal phase, the major hormonal event is the rise of progesterone levels and the uterine lining's preparation to receive a fertilized egg (in the event that conception has occurred#. Luteal phase defect means that a problem exists with the luteal phase, resulting in the uterine lining not being optimally prepared for implantation of a fertilized egg. Two common occurrences or symptoms which are seen with LPD are a short luteal phase #a woman getting her period 10 days after ovulating rather than 13 or 14 days afterward) and a low progesterone level. But many times LPD can contribute to early miscarriages because, as I said, that uterine lining is just not fully ready for implantation. The Vitex may or may not have been preparing that lining fully.
There really is conflicting data on the use of progesterone during pregnancy. Many doctors have had really good results in using it to boost the progesterone levels of women whose levels are not high enough to support the pregnancy on their own. But if your levels are ok on their own, there really is no need for it beyond the 8th or 9th week.
Progesterone is first produced by the corpus luteum of the ovary and production from this site is necessary for the first 8 weeks of pregnancy. From implantation of the embryo onwards for 40 weeks the placenta takes over the production of progesterone. After week 8-9, you should be able to gradually taper off use of the supplement. Placental production of progesterone should be more than enough at that point to sustain the pregnancy. The thing that you want to avoid is a sudden drop of the hormone. I would assume that when you begin to taper off, your doctor will want to run progesterone levels to make sure the placenta is picking up the slack, so to speak. As long as it is, all is good. By the end of your pregnancy, the placenta will be making hundreds of times more progesterone than the supplement provides.
Although I don't know what is available to you or what natural supplement you are considering, progesterone suppositories are administered vaginally where it is absorbed locally. Side effects that may occur include: insomnia, somnolence, rash, nausea, vomiting, diarrhea, breast tenderness, breakthrough bleeding, headache, bloating. If you experience an allergic reaction: difficulty breathing; closing of your throat; swelling of your lips, tongue or face; or hives; seek emergency medical attention immediately.
I hope this has helped you and answered your question. I wish you well!
Brenda
