confused- what do you think about my situation? and why don't they just use progesterone?
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Anonymous
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I've posted several times on this board because I am extremely surprised to be pregnant (history of ectopic pregnacy and 7+ years infertility).
At 5-6 weeks ish I have a relatively low HCG, 270. i Know what matters is doubling time, but if my progesterone is normal - 28 - should i not be thrilled? because what i am gathering online is that 99% of pregnancies with normal progesterone above 25 are viable and fine. only fear is that i miscarried from last month and that's why there is HCG, since i had a very long cycle and lots of bleeding. but then again I had taken a high sensitivity pregnancy (urine) test and it was negative. |
Anonymous
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Why don't they just progesterone for what?
Your post is confusing. Did you m/c last cycle? |
Anonymous
The hcg level matters more than the progesterone. Unfortunately, 270 is not a great number for the 5-6 week mark. While it's important to have a good progesterone number, that alone is not a sign of a pregnancy that will continue. Is there a chance your dates are off and you are earlier than 5-6 weeks? |
Anonymous
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OP here. Yes, huge change my dates are off. I know when my LMP is but my cycle isn't that regular and the period before that was 35 days.
270 was my number 2 days ago; today it was 650! |
Anonymous
The question is, if 99 percent of women with progesterone above 25 do not miscarry, isn't it a very good sign if progesterone is over 25? I don't think I miscarried last cycle, based on numbers today- I was just worried I may have. |
Anonymous
What you are referring to as a miscarriage would have actually been a chemical pregnancy, and no, that would not have resulted in HCG levels as high as they are. It sounds like your pregnancy is going well so far and that you have no need for progesterone supplementation. |
Anonymous
| Congratulations! |
Anonymous
If you have a link to that study, that would be great!!! Your numbers/doubling looks great! Your dates were probably off! Congrats! |
Anonymous
| Those are good doubling times. Congrats OP! |
Anonymous
Thank you 
OP here- I actually found it in a couple places. I'll look and see what I can find. I will say that I found several things (4, say, in sources that seemed semi-reliable) but it was clear there were exceptions and I even found one study that didn't seem to agree. |
Anonymous
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OP again-
here's one- it's more about ectopic pregnancies http://www.aafp.org/afp/2006/0601/p1892.html Progesterone levels may be helpful in the evaluation of suspected ectopic pregnancy if they are very high or very low. The authors quote a sensitivity of 15 percent for progesterone levels in ectopic pregnancy. Of course, the sensitivity of a quantitative test depends on the specific level selected for the cutoff, but in a meta-analysis2 of 27 studies, sensitivities ranged from 44 to 100 percent, depending on the threshold. In 12 studies with a total of 1,107 women, only 2.6 percent of women with an ectopic pregnancy had progesterone levels greater than 20 ng per mL (64 nmol per L).2 In 13 studies, only five of 1,615 women (0.3 percent) with progesterone levels less than 5 ng per mL (15.9 nmol per L) had a viable intrauterine pregnancy.2 |
Anonymous
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And another- I think this is more broadly about pregnancy viability since it mentions diff. b/t mc and ectopic - but I'd be interested in others; interpretations:
https://www.ebmedicine.net/topics.php?paction=showTopicSeg&topic_id=130&seg_id=2558 Progesterone Serum progesterone levels provide an additional or alternative marker to determine which patients need further evaluation and follow-up for possible ectopic pregnancy.39,40 Progesterone levels can be problematic since they are not universally available in a timely manner and are not accurate enough in isolation to diagnose ectopic pregnancy. However, a single value that is very high or very low can be helpful. In a prospective study of 700 patients, a progesterone level greater than 22 ng/mL reliably (99% accuracy) excluded the diagnosis of ectopic pregnancy.39 However, lower progesterone levels have a positive predictive value of only 18%. Very low levels of progesterone (less than 5 ng/mL) can reliably exclude a viable intrauterine pregnancy but do not differentiate miscarriage from an ectopic pregnancy.38 In a hypothetical cohort study based on test characteristics to evaluate diagnostic strategies, the use of progesterone alone resulted in a miss rate of 2.5%, which was felt to be clinically unacceptable.41 Therefore, progesterone should not be used alone unless it is over 22 ng/mL and only in conjunction with sonography. |
Anonymous
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OP again- okay, HERE are more things about progesterone and viability (not exclusive to ectopic... not finding the other stuff I had found before and trying to limit my OCD addition to internet at this time!
91% of pregnancies with progesterone lower than 15 ng/ml will end in miscarriage Progesterone over 25 ng/mL at 10 weeks associated with just a 2.15% risk of miscarriage |
Anonymous
Interesting. What's your source? My 12 ng/ml progesterone baby is sleeping beside me right now. |
Anonymous
This. I am currently in my first trimester and on progesterone as my doctor said it was low on the 21 day test at only 9. The thing is, is another provider in the same office said that progesterone levels vary from woman to woman and 9 may be low for me but normal for you. There's no real way to gauge it she said. The flip side is I've read that low progesterone can directly impact implantation. So who's right? But the truth is the progesterone can't really hurt anything so "why not"...that said, I don't see why your provider is so reluctant to let you try it, OP. |