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Provera and Miscarriage Risk: Understanding Your Options


Question
Hi, I am 33 years old and a mother of 2 daughters 16 and 9, my last menstrual cycle was Dec 23,05 I will give you a little history about myself.

I have had over 20+ miscarriages over the past 16 years, my oldest was born full term know problems, the youngest was born at 26 1/2 weeks weighing 1lb13ozs, she is fine.

I just found out in Oct 05 that I had an Auto Immune Disoder Anticardiolipin Antibody Syndrome, I was put on Lovenox 60mg once aday, folic acid, 81mg of asprin and pre-nantal pills.

I usually always have a regular cycle, for some reason I did'nt from Oct to Dec 05, I was put on Provera and got my cycle 3 days after the last pill.

Therefore I got my cycle on Dec 23,05 I had a Dr's apt on Jan 24,06 I thought I was pregnant I was given a urine test and it was negative, I started Provera that day, taking it for 7 days I took a pregnancy test at home and it was positive!

My Pharmacist said that even though Provera is a form of Progesterone it should not be taken while pregnant it will make you bleed and could cause a miscarrige. My Dr said that if I would have continued taking the Provera I would not have started bleeding, and that it probably did cause me to start bleeding and miscarry.

After all that I guess my question is do you think the Provera caused the miscarriage or is the Lovenox and 81 mg of asprin not working? I'm so confussed.

Thank you so much for your time Dr.  

Answer
You probably had the miscarriages due to antiphospholipid syndrome (due to the elevated cardiolipin antibodies). YOu definitely should take baby aspirin, Lovenox, and folic acid. That may help you get through the pregnancy.  Provera is perfectly safe for use during pregnancy. We use Provera to help prevent miscarriage in early pregnancy and it is usually taken until 12 weeks gestation, when it is stopped because the placenta has formed and the placenta produces enough progesterone to maintain the pegnancy. Years ago, before we had the modern monoclonic pregnancy tests, we used Provera as a pregnancy test. If you did not bleed, you were pregnant.If you bled, you were not pregnant. Provera will cause you to get your period if you have missed your period due to hormonal imbalance. Provera will also stop your bleeding if you have some dysfunctional uterine bleeding (twice a day for five days). During pregnancy, Provera does not cause bleeding.  Provera definitely does NOT cause a miscarriage and is definitely used during pregnancy, expecially if you have a low progesterone level. Your pharmacist was incorrect. Taking Lovenox, aspirin, and folic acid increases your chances of avoidinb miscarriage, but they are not foolproof.If you took these medications, you have done all you could to help.