Tubal Ligation Reversal & Pregnancy Challenges: A Patient's Story

Question
I had a tubal ligation reversal in March '06 and by April '06 got a positive pregnancy test. My doctor said my progesterone levels were low and prescribed prometrium 200 mg at bedtime.  Unfortunately, I miscarried anyways within a week.  We tried and tried since then and got another positive pregnancy test in January '07. Right before this my doctor had done tests to find out that i was not ovulating every month, my right tube has a blockage, and my progesterone levels were low.  So she was putting me on Clomiphene on cycle days 3-7, Estradiol cd 8-13, and Prometrium 200 mg cd 17-30 or until my period arrives. Well, I ended up pregnant right as I was supposed to be starting this.  That ended in miscarriage the doctor believes due to low progesterone levels. So now I am near the end of my first cycle on the drug regimen. I was wondering if you had ever heard of this and how likely do you think it will be to help maintain a future pregnancy?

Answer
Dear Wendi,

It sounds like your doctor is doing everything possible to make sure your hormones are at a level which will support, not only your fertility, but a potential pregnancy as well.

Progesterone is needed to maintain a healthy environment for a pregnancy. It thickens the uterine lining and keeps the endometrium thickened throughout the pregnancy, maintains the functions of the placenta and fights off unwanted cells near the womb that could cause damage to the placenta or fetus, stops the uterus from spontaneous spasms/contractions, stimulates breast tissue growth, prevents lactation until after the birth (with estrogen), strengthens the mucus plug covering the cervix to prevent infection, and strengthens the pelvic walls in preparation for labor.

So - making sure your progesterone levels are high enough to begin with are very important. The rest of the medications are simply to simulate a cycle to ensure you are ovulating in order for you to conceive.

I hope this information has helped you and answered your question. I wish you well. I'll have a good thought for you.

Brenda