So my wife has been prescribed this drug by her gynocologist, and she’s a little concerned about some of the risk factors both to herself and the baby. As far as we know, her progesterone levels aren’t known. She took a blood test, but the doctor prescribed this to her before receiving the results.
I’ve googled the drug a bit, and apparently some doctors aren’t prescribing it because they don’t feel the scientific evidence for it’s efficacy is very solid yet, while others don’t feel there’s any risk involved so they are prescribing it to anyone who has had a miscarriage before.
Anyone known anything about this drug? Taken it during pregnancy? Have a link to summaries of studies I can take a look at?
She’s mostly concerned about reports of blood clots and birth defects.
Does she have a history if miscarriage? Progesterone is one of the standard drugs prescribed by Ob/Gyns in women who have a history of loss, however they usually know that the woman has persistent low progesterone already.
I have used progesterone post positive pregnancy tests for five of my pregnancies (they were all early losses - not due to the P4) and never had any issues.
Here’s a start: Links in Google Scholar. Note that most of the P4 studies relate to post IVF progesterone support though.
I would make the doctor argue the case for taking it - what is its purpose, and what are the risks? Is she doing it “just in case?” If so, what is the risk of waiting for the blood test results before taking it? Also, if I’m recalling what my midwives said correctly, if you’ve had less than three miscarriages in a row, that’s not considered anything pathological.
Of course, I admit I’m very conservative about obstetric interventions. But on the other hand, I’ve lost a pregnancy, and I was so scared during my next one, I understand wanting to do everything to protect the baby. (And mine turned out fine - she’s almost 10 now!)
I don’t know what your situation is, but progesterone is a standard element of IVF, because some of the medications the woman takes pre-ovulation can reduce her own progesterone production. In that context, its use is endorsed by the American Society of Reproductive Medicine and the American Fertility Association.
I have seen statements from OBs that natural progesterone has no known side effects on a pregnancy. Synthetic progesterone (progestin), however, is contraindicated.
What I’ve seen about blood clots has generally addressed birth control pills that contain estrogen (which definitely has a big effect on clotting) and progestin. Progestin-only birth control pill are favored, however for women with a history of blood clots, and I have seen some sources that say outright that they do not increase clotting risk.
Women undergoing IVF are at a higher risk of clotting than women who get pregnant naturally, but that risk is generally ascribed to estrogen levels, not progesterone.