After doing some research I am more conflicted about the causes of past and likelihood of future miscarriages.
I’ve read Lesley Regan’s book, Miscarriage, which was recommended to me and haven’t been comforted by it in the slightest. The most helpful information is contained in part 3, a section of FAQs. By the time I reached that section I was “over” the book. Part 2, “Understanding the Causes”, does not live up to its title. I certainly don’t understand the cause(s) of my miscarriages from reading this book. I don’t know if I’m a sporadic or recurrent miscarrier or what if anything can be done to assist me. I don’t know what kinds of tests might be offered to me or other tests that a regular OB with limited experience in reproductive endocrinology might not know to request. Furthermore, the book is out of date having been published in 1997.
Regan does not believe that low progesterone is the cause of miscarriage but rather a symptom. “The die is cast.” (129) Ick. Low progesterone means that there’s something wrong with the eggs that are released or the corpus luteum. Ok, so follow up with something helpful like . . . “so instead of progesterone therapy, it is recommended that . . .” For women with a history of recurrent miscarriage, luteal phase defect is a common cause. However, no follow-up information for non-IVF “patients” is presented.
And it’s not like the “experts” agree. For instance, there’s this article about preventing miscarriage. The title, Miscarriages can be Prevented, is a tad ludicrous. Maybe some can be prevented, though I’m not even sure. But for what it’s worth, this site claims 5 main reasons for miscarriage.
|Progesterone level low||20%|
|Primary miscarrier (no live births)||7%|
|Secondary miscarrier (one or more live births)||50%|
This information strongly contrasts with Regan’s book and with information posted at this infertility blog that I stumbled upon. This NY-based doctor has been in the infertility business for 15 years.
Regarding luteal phase defect, he states:
In general, most reproductive endocrinologists do not believe in the luteal phase defect [though Regan does] and do not test for it. In the old days, doctors would use progesterone clomid or FSH to treat the supposed defect, and today women are getting on those meds more quickly than before. And it takes time; months and months can go by while you’re waiting to see if the progesterone is working. In most cases you don’t have the time to waste.
I realize there are some of you who were diagnosed with luteal phase defect and were given progesterone with great success. I am very happy for you, but your success is the exception, not the rule.
So like Regan, he believes that weak progesterone signifies an ill-fated pregnancy. Very few women actually have LPD or do recurrent miscarriers have LPD/hormonal issues? So very few women will benefit from progesterone therapy? Though the chart above indicates that a substantial rate of miscarriage happens because of low progesterone. Chicken and egg??
From what I can tell, direct entry midwives (DEMs) turn to progesterone supplementation for women like me. In fact, a DEM I know suspects that I have a progesterone deficiency. Perhaps this is why I needed progesterone to stop my irregular periods that were caused by the Nuvaring falling out (unbenownst to me) this past March. Perhaps this is why I lost my summer pregnancy. Maybe this is why I spotted in my first post-miscarriage cycle around ovulation time. Maybe that’s why I lost my fall pregnancy. Perhaps this is why I spotted again in the middle of this cycle – the first one following my recent miscarriage.
Ronnie Falco is a well-respected midwife who archives at Gentle Birth. Here is information she has gathered on potential causes of miscarriage and how to possibly prevent miscarriage. Scroll down to the information on progesterone, and you will find much disagreement on the relationship between progesterone and miscarriage.
I came across a forum at Ovusoft that contained an informative thread regarding progesterone. I also post from time to time at Misdiagnosed Miscarriage and recommend that site to anyone who is experiencing or has experienced a pregnancy loss. I plan to check out these links at a low progesterone site I found via Misdiagnosed Miscarriage.
And now, truthfully, I’m worn out from this post.