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Should progesterone be monitored in the first trimester with a history of miscarriage/infertility?

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JOCELYN HAS BEEN FEATURED ON:

In an earlier blog post I shared the important role that progesterone plays in maintaining pregnancy – progesterone literally means “pro gestate” and is critically important in sustaining a healthy pregnancy. I routinely assess my fertility patients for progesterone deficiency and treat during the first trimester of pregnancy with prescription progesterone to decrease the risk of miscarriage.

A recent study has established an important threshold for the minimum amount of progesterone needed in the first trimester to maintain pregnancy. Based on their study, the authors determined that a minimum value of 25ng/ml (80nmol/L) is required during the first trimester to sustain a pregnancy.

In practice, this means that I will now be testing all of pregnant patients with a history of miscarriage and/or infertility during their first trimester to ensure that they have sufficient progesterone levels, and will increase their progesterone dosage as needed to get up to the threshold level to reduce their risk (with vaginal progesterone, oral progesterone, or a combination of both).

I hope you have found this helpful, and do let me know if you have any questions!

If you are hungry for more evidence-based information in your pregnancy, sign up for my free webinar: 7 Pregnancy Myths Debunked – and get the information you need to have a healthy pregnancy and a thriving baby.

And if you are a care-provider looking for evidence-based resources for your pregnant patients, please get in touch with us at support@myhealthypregnancyplan.com.

In health,

Dr Jocelyn Land-Murphy, ND

Terra Life

Disclaimer: The information and content provided is for general educational and informational purposes only and is not professional medical advice, nor is it intended to be a substitute therefore. Please consult the Disclaimer and Terms of Use for full details.

References:

Hussain, M. et al. (2012). Progesterone supplementation in women with otherwise unexplained recurrent miscarriages. Journal of Human Reproductive Sciences, 5(3): 248-251.

Ikoma, D. et al. (2018). Threshold progesterone level of 25 ng/ml to sustain pregnancy in first trimester in women with history of infertility or miscarriage. Clinical Obstetrics, Gynecology and Reproductive Medicine, 4(1).

Mesen, T. et al. (2015). Progesterone and the luteal phase: a requisite to reproduction. Obstetrics & Gynecology Clinics of North America, 42(1): 135-151.

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