Progesterone is the hormone that supports a pregnancy. If you become pregnant but are unable to sustain the pregnancy past week ten, there is a high probability that you may be progesterone-deficient.
A woman prone to miscarry can try a low dose of natural progesterone cream from days 12 to 26 of her cycle until a pregnancy is confirmed. If spotting occurs at week 6 or 7 of pregnancy, a higher dose is applied two or three times daily. Use of natural bioidentical progesterone cream is often continued through a full term pregnancy.
If the problem is incompetent cervix, the treatment is to sew the cervix shut during Weeks 14 to 16 of the pregnancy. Your doctor must remove the stitches between Weeks 36 to 38 so you can give birth. This treatment is called Cerclage.
Cerclage cannot avert an inevitable miscarriage, so it cannot be performed if your cervix has already dilated 4 centimeters, or if membranes have ruptured. You are also ineligible for cerclage if your cervix is irritated. Cerclage is generally well tolerated by mother and baby, but it is not a cure-all.
If the cause of your miscarriage is an immune problem, treatments vary:
o Rh incompatibility requires RhoGAM injections at particular times during the pregnancy and shortly after delivery
o Antiphospholipid antibodies requires daily low dose aspirin or heparin
o Lupus requires prednisone
o Faulty fetal-blocking antibodies require the mother to receive injections of the father's white blood cells
Many insurance companies don't cover immune testing until there have been at least three miscarriages. Plus, you may have to travel a long distance to get help for faulty fetal-blocking and HLA antibody problems. Within the immune system there are different types of white blood cells. Progesterone supplementation works to influence the way your white blood cells react to a pregnancy. The immune responses most likely to impair your pregnancy are:
o T and B cells that can cause placental rejection
o Natural killer cells that release tumor necrosis factor (TNF) that damages the placenta and endometrium
o Lymphocytes that stick in the placenta and damage it
Progesterone soothes inflammation which can scar and damage the placenta. Progesterone encourages increased placental HCG production, blocking NK cells' killing power. Progesterone can also prevent the uterus producing irritating prostaglandins, making it contract far too early. Progesterone encourages the cervix to make an antibody-rich plug protecting the baby and placenta from germs.
Women with autoimmune disorders usually require bioidentical progesterone supplementation until the end of Week 16 of pregnancy. Sometimes, newly pregnant autoimmune women are allergic to their own hormones, including progesterone. Your doctor can test for allergies with a skin or blood test.
See a gynecologist with CREI (Certified Reproductive Endocrinology and Infertility) qualifications about repeated miscarriage. Your doctor must rule out other causes than just progesterone deficiency. For example, Turner's syndrome is a chromosomal abnormality affecting only girls, where one X chromosome is missing. Turner's syndrome is responsible for 20% of all miscarriages that occur in the first trimester, and 98% of pregnancies affected by Turner's syndrome end in miscarriage.
Women with reproductive difficulties may successfully deliver a baby through Assisted Reproductive Technology (ART). The cost of ART varies, depending on the complexity of the method the doctor uses. ART is usually successful in three cycles. Be sure ask your doctor to define 'success' before you make your down payment, because some clinics define success as any conception, and others define it as taking home a baby.
If you have had a molar pregnancy, wait a year before attempting another pregnancy. Your ßhCG level must return to 0 to ensure that no moles have migrated through your body (metastasized). In all other cases, wait at least one to three cycles before attempting another pregnancy. Allow yourself ample time to recover. Take a 400 micrograms (0.4 milligrams) folic acid supplement daily and eat a nutritious diet while you are waiting. Reduce caffeine intake. Avoid alcohol, smoking, contact sports, environmental hazards, and people with infectious diseases. Before you use an over-the-counter medication, check with your doctor or pharmacist.
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