Hi! I’m Dr. Marc Sklar, the Fertility Expert, and welcome to Fertility TV.
In this episode of Fertility TV we’re discussing the link between progesterone levels and miscarriage. This is also something that I go over in my fertility school which is my online program, and if you want to know more about that just stay tuned until the end of this video to learn more.
So first and foremost we have to clear up a couple of things. We have to first define what is progesterone. Progesterone is a hormone both found in men and women by the way, but in women your progesterone levels will rise in the luther phase of your cycle, the last phase of your cycle, and also increase in concentration once you are pregnant; they also help to hold the pregnancy, if you will, in the early part of your first trimester. There has been some research that’s been found that shows a connection between low progesterone levels and miscarriage. We don’t see this with all patients but we do see this. Now it doesn’t mean that if your progesterone levels first and foremost are low that it means you’re going to miscarry, it just means that in patients who have miscarried we have found that they’ve also had low progesterone.
So what I like to do, first and foremost, is treat low progesterone prior to conception. Yes you can, once you do realize that you’re pregnant you can jump on it and start to potentially supplement with progesterone or get tested to see if your progesterone is on the low side; but ideally you would have already had those tests done, have had that information and then started to treat that prior. So first and foremost we have to test, we need to know if there is an issue that needs to be treated. So when is the best time to test? Well the best time to test is seven days post-ovulation. Seven days post-ovulation is where your progesterone levels should be at their peak and we want to see what that number looks like. Ideally I like to see it over 20, but I’m okay with it over 15, and if it’s not then that’s something we want to take note of and start to take action to make that change and increase. If it looks fine there then the next time to test is once you are pregnant is to test it. So I routinely test progesterone levels with all my patients who get a positive pregnancy test once I also test for their HCG, their pregnancy hormones, so I do those at the same time. And so we want to see that that number’s also on the high side then, I definitely want to see it over 20 and we don’t need to see it like continually rising, we just want to see it stay at least above 20 and stay high.
The second thing is to treat it. So if we know that there’s a progesterone issue cause you’ve treated…cause we’ve tested for it and either post-ovulation or once you get pregnant we realize that there is low progesterone, then we want to treat it. The best way to treat it is with progesterone, for obvious reasons, if you’re low on progesterone you want to treat it with progesterone. There’s many different methods of doing that, both pharmaceutical and natural; there’s not necessarily one best way to do that, it really just depends on the different circumstances and patient, their levels and their needs. I will tell you that my least favorite method of progesterone is the oral pills.
So that’s the link between progesterone and miscarriage. There definitely is a link and that might be an issue for you or it might not, but first and foremost we need to get tested, find out and then take action to get treated.
So if you want to know more information about the link between hormones and your fertility, whether it’s progesterone or other hormone, then I go over all of this and more, not only how to test it and treat it, in my fertility school.