Miscarriage & Hormonal Imbalance: Exploring Progesterone & Weight's Role

Question
QUESTION: I am 43 and recently had my third miscarriage. It always happens around the end of the first trimester. The baby just stops growing. Could this be because my hormone levels (possibly progesterone)are too low. The reason I ask this is: each time I have gotten pregnant was when my weight dropped below 200 lbs. Then when I started gaining weight with the pregnancy and got over 215 lbs (around the end of the first trimester) the baby would stop growing.
We really want another child but I don't want to try again if this is going to happen again.
I hope this makes sense.

Thanks,

Cynthia

ANSWER: Dear Cynthia

I wonder if these 3 miscarriges are successive in order or sporadic.

If successive, then this is a case known as habitual abortion and the most common cause for it is patulous internal cervical os if it occurs around the second trimester. However other reasons may also occur. The investigations for recurrent miscarriages is somewhat lengthy and it depends on many factors such as the time pattern of the abortionr..for example, if you had miscarriages in ascending order such as 10the 11 then 12 weeks, this may have different causes than if happened at 12, 11 then 10 weeks.

The determination of antiphospholipids which is another factor that may cause recurrent miscarriages is important in your case..have you ever had id done??

Please send me more details about your case, any trauma you had in any of your deliveries/abortions...etc and I will be glad to discuss it in more details with you.

Good luck

---------- FOLLOW-UP ----------

QUESTION: The miscarriages have been successive. The first was at 8 weeks, the second at 11 weeks, and the third around 14 weeks as close as we can tell.
The only testing I had done was before the birth of my second child where it was discovered my hormone levels were very low.
I had a normal pregnancy, a miscarriage, another normal pregnancy, then the 3 miscarriages. As I said before, we would really like to have another child but are apprehensive. I had a D&C last week and will return to the doctor in a few weks for follow up.

Thank you,
Cynthia

Answer
Dear Cynthia

I have a feeling that you might be having an incomptent cervix that could  have happened as a result of cervical injury especially if you had your second delivery an instrumental one. e.g. forceps delivery. Incomptent cervix is the commonest cause for habitual abortion (3 successive).

This possibility should be investigated thoroughly and before any other possibility. An experienced sonograher can easily diagnose the case. Such cases need cervical cerclage which is a simple procedure to tighten the cervix till the end of pregnancy together with bed rest and other precautions to avoid miscarriage.

Please check with your caring obstetrician regarding this possibility and I would like to hear from you about your progress.

Feel free to contact me again..I do not want to discuss anymore possibilities at this time..the commonest should be excluded first.

Good Luck