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Progesterone Levels Dropping

QUESTION

Dear Midwife,
I found out I was pregnant last week. My first OB appt is next Monday. This is my 3rd pregnancy. I miscarried at 4 weeks with the first and at 6 weeks with the second.

Naturally I am very nervous about this pregnancy and so I have been trending my own HCG and Progesterone levels since I found out I was pregnant. My concern is the the Progesterone level seems to be decreasing slightly each time I check.

I have listed the levels and the dates each was drawn below.
7 Aug 2009: HCG 662.3 Prog 33.8
10 Aug 2009: HCG 2346.0 Prog 30.5
12 Aug 2009: HCG 6074.0 Prog 29.6

I am drawing another level tomorrow, but am concerned that the decreasing progesterone levels could mean that I need to be on a supplement sooner rather than later. Should I wait until my OB appointment to ask or try to get in now?

ANSWER

I can certainly understand your concern, but we do not normally supplement above a progesterone level of 16 in my practice, and besides, the level of progesterone fluctuates enough day to day that I wouldn't necessarily be worried yet on that score alone. Besides, your hcg's are going up just fine.

As far as I know there is no harm in having a high progesterone level in early pregnancy, so I'm not sure that supplementing an already more than adequate level of progesterone would hurt your baby, but hopefully that won't even be needed.

Good luck!
-- Cynthia, CNM. PhD.

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.