Thursday, February 3, 2011


Okay so this is going to be a different drugs post. It isn't about street drugs or even about drugs taken in labor and delivery. It is actually about a life-sustaining drug that is hopefully keeping our little bean alive. I'm talking about Prometrium, a progesterone supplement.

When you ovulate a cyst is left on the ovary and is called a Corpus Luteum Cyst. It produces the hormone progesterone which signals to your body that you are pregnant and to not menstruate. If your progesterone is low it could mean the end to a viable pregnancy. This cyst will produce progesterone until the placenta forms and takes over (anywhere from around 8-10 weeks).

My last miscarriage - my progesterone was dropping while my hCG was rising beautifully. I kept asking for supplements because I was nervous. The nurse on the phone kept putting me off and suggested we keep doing blood tests. I started bleeding after one such call. Practically in hysterics I called again with the mindset of demanding the meds and I got the on-call doctor who prescribed the progesterone without a second thought. But it was too late. A sonogram several days later showed "fetal demise", a medical term for an embryo or baby without a heartbeat, and a gestational sac that was already breaking up and irregularly shaped. Mere hours after taking my last progesterone supplement I began miscarrying.

So when I got pregnant with Zoƫ, right after the miscarriage, my new doctor (yes, I switched!) didn't bat an eyelash at my request to have progesterone right away without a single blood test. I started taking it and sure enough I had a full-term, healthy baby girl. I have no idea if the progesterone was needed or not but it gave me peace of mind and my daughter is alive. You see if your pregnancy is abnormal and you're going to miscarry anyway progesterone can just hold off the inevitable. It isn't a means to bring a pregnancy "back to life" or to keep a fertilized egg healthy. It merely keeps your body from menstruating/miscarrying until you can get a sonogram to see what is going on.

Okay so now this pregnancy I got hCG checks. But because I'm with another new group, a group of midwives, they didn't want to just give me progesterone. They did blood tests over the course of two weeks and with snow storms the tests were many more days apart than you would usually have between tests.

1st Draw- hCG was 109 and progesterone a little over 15
2nd Draw, four days after 1st draw- hCG was 624 and prog over 15
3rd Draw, week after 2nd draw- hCG was 11,000 and prog 11.6

If you don't know what the numbers mean: hCG should rise at least 60% every 48-72 hours. Progesterone is a number they like to see above 14 at my midwives' office but some doctors prefer it to be over 20. Anything under 10 is worrisome to anyone in prenatal care. Progesterone should rise in pregnancy as well, though its climb is way slower than hCG. When it drops it is cause for concern.

No bleeding this time. I got the progesterone immediately after seeing that my progesterone dropped. My prescription wasn't called in to the correct pharmacy so I was there for over an hour before I finally got the pills. I took one immediately when I got home and the fun began...

Progesterone can make you very dizzy. Some nights are worse than others for me and I'm not sure why. Maybe I hadn't had enough water during the day. Anyway some nights I am so dizzy I feel like I've been out partying with one-too-many if you know what I mean.

So if you paid attention to my hCG results above you'll notice that the last draw tripled. I can't help but wonder if we could have twins (my grandmother had two sets). It is NOT always indicative of multiples but a lady can dream, can't she?! We'll know for certain what is going on on February 14 when I get my viability scan. I'm hoping for a heartbeat, or two, on Valentine's Day. I cannot tell you how difficult a time I am having while waiting to see the fate of our little one. And I'm hoping it is the best Valentine's Day I've ever had!

Sorry to sound like an infomercial (as I told a friend recently when she asked me for some conception secrets). I have to realize that some of you reading may not know all the lingo or medical terms so I wanted to explain them fully. Not the funnest post to read but hopefully informative!


The Mommy said...

As soon as I saw the hCG level, I thought twins! Wouldn't that be something!!!!?

lucky little bird said...

Everything will be fine, Joy! I lost my first pregnancy, presumably, to a progesterone deficiency. With my second pregnancy there were lots of blood tests in the first week after my BFP, showing that progesterone was going to be a problem. I used a progesterone suppository for the first 12 weeks, and I now have a gorgeous 13 month old little boy. By the time I realized I was pregnant this 3rd time (I was/am still nursing), my progesterone was at 7. No one was very hopeful, but we supplemented again during the first trimester and here we are at 23 weeks with a very healthy looking little fetus!:)

Also, for me, the suppositories had less side effects than the oral Prometrium. But insurance won't cover I guess it's a toss up.

Anyway, sending happy thoughts your way!

Adrienne said...

Twins! I hope you're right! Sending prayers for a safe and healthy pregnancy. :)

Susan Sene said...

ohhh twins! I've always thought it'd be fun to have twins. :)

Kaysha said...

Good luck! I'm sure everything will be fine, but I've been praying for you guys anyway!

Twinside Out said...

It is fun to have twins!! :) :) And that is the first thing I thought of when I saw your hCG levels, too...waiting anxiously to see what Valentine's Day brings!

Kahla said...

As an IVFer (five of 'em) unfortunately HCG really tells you nothing. With our singleton our number was higher than either set of twins. Crazy. But for your sake I hope it's twins since you want them! ;o) Hoping the days fly by until your ultrasound. Congrats!

Kahla said...

I should have said HCG tells you nothing other than you're pg... which you obviously are! ;o)