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  #1  
November 6th, 2007, 07:29 AM
ShannonMVT's Avatar Platinum Supermommy
Join Date: Sep 2006
Posts: 10,874
Why can I never just make a decision and be confident that I'm doing the right thing? Ugh.

So since my progesterone was low while I was pregnant last time, the dr said I could take supplements the next time I got pregnant. I had read that it was actually better and gave the baby more of a chance if you actually started them before you knew you were pregnant, so I asked my doctor if I could take them after I ovulate. She said okay, start them 5 days after you O.
Well I posted a question about it in reccurent pregnancy loss and one of the women on there told me that taking progesterone in the 2ww can cause a higher rate of ectopic pregnancies and her dr thinks that's what caused hers.
So now I don't know what to do!
I read things online about it but it seems like a lot of websites contradict each other and who knows which you can trust. Why can't they do research on these things and then make scientific articles available to the public so that I know what to do!
I've read that having LOW progesterone can cause higher rate of ectopics and I've also read that HIGH progesterone can cause a higher rate of ectopics.

But logically speaking...I would think that by the time you are 5 dpo, the baby would have already started traveling down to your uterus to implant OR it would have already stuck in the tube. So it SEEMS like taking the progesterone once you are already that far past O wouldn't make a difference as far as where the baby would implant.

I just want to do the right thing and now I don't know what to do. I realize you girls may not have advice for me in this matter necessarily, but I just needed to vent.

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  #2  
November 6th, 2007, 09:45 AM
LadyCoconut's Avatar Platinum Supermommy
Join Date: Sep 2005
Location: Georgia
Posts: 35,234
Aw girl, vent away! I am like you in that I often worry I may be making the better of two choices, but is it the 100% BEST OF ALL decision? I've always heard that low progesteron can lead to mcs but I've never heard the high prog. leads to ectopic bit -- but, your logic makes sense to me... around 5 DPO is when the baby should be implanting, so, I wouldn't think adding in progesterone then would hurt anything.

I'm sorry there's no clear cut answer.... maybe one of the well read ladies on this board will have more helpful advice!


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  #3  
November 6th, 2007, 10:35 AM
Mega Super Mommy
Join Date: Aug 2007
Location: Southern Germany
Posts: 4,654
Definately go with whatever your doctor recommends. He/she knows your particular situation and can help you decide whats best. Theres so much dodgy (and false) information of the internet! I have access to the medical library at school so I searched for published medical articles on risk factor for ectopic pregnancies. I pasted parts of the abstracts from 2 studies below. I couldnt find anything about progesterone increasing the risk. The first part is a rel. old study (1991). The 2nd paper is recent, 2006. Let me know if you want the full references... Good luck.

A case-control study was conducted in seven maternity hospitals in the Paris area in 1988 to evaluate the role of several risk factors in ectopic pregnancy (EP). A total of 279 cases and 307 controls were compared for sociodemographic characteristics, cigarette smoking, sexual reproductive and surgical histories and for the conditions under which conception occurred. Many factors were found to be associated with an increased risk of EP: cigarette smoking related to the number smoked at the time of conception (Odds Radio (OR) 1.26 to 2.72), appendicectomy (OR 1.25, 95% CI = 1.02-1.56), prior tubal surgery (OR = 2.42, 95% CI = 1.37-4.22), prior use of intrauterine devices (OR = 1.34, 95% CI = 1.02-1.80), induced ovulation cycle (OR = 1.66, 95% CI = 1.01-2.74) and prior EP (OR = 3.90, 95% CI = 2.27-6.75). Chlamydia trachomatis seropositivity was associated with an increased risk of EP (OR = 1.50, 95% CI = 1.04-2.13), but clinically reported pelvic inflammatory disease was not. Maternal age, parity, previous induced abortion and previous spontaneous abortion were not associated with EP. Use of an intrauterine device, progestagen micro-pill or the combined oestrogen/progestagen pill at the time of conception were associated with a lower risk of intrauterine pregnancy than of EP.

RESULTS: The main risk factors for ectopic pregnancy were prior ectopic pregnancy (adjusted odds ratio (AOR): 13.1) and a history of infectious reproductive system (AOR for pelvic inflammatory disease: 6.8). Other risk factors found to be associated with an increased risk for ectopic pregnancy were multisexual partner (AOR: 3.5), history of infertility (AOR: 2.5), induced conception cycle (AOR: 3.4), current intrauterine device usage (AOR: 3.2), prior Caesarean section (AOR: 2.1) and cigarette smoking at the time of conception (AOR=1.7). On the contrary, barrier methods were protective from ectopic pregnancy (AOR: 0.4). CONCLUSIONS: The increased awareness and knowledge of risk factors have enabled an early and accurate diagnosis of ectopic pregnancy. This study has found prior pelvic infection to be a major aetiological factor for ectopic pregnancy. Furthermore, other factors found to be associated with ectopic pregnancy, such as prior ectopic pregnancy, infertility history and induced conception cycle, may be the result of a previous pelvic infection that may cause tubal sequelae. These factors are potential targets for intervention and modification.
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  #4  
November 6th, 2007, 08:19 PM
ShannonMVT's Avatar Platinum Supermommy
Join Date: Sep 2006
Posts: 10,874
Thank you so much for finding those articles and posting them for me! That was so sweet of you; JM girls are the best!

I think the rationale (after looking online) is that they have show in vitro cilia cells of the fallopian tubes will stop beating when exposed to high progesterone. And that means the embryou doesn't move down as quickly as it is supposed to. http://www.ingentaconnect.com/content/klu/...000002/00223489

But, that said, I haven't found any evidence that taking it leads to a higher incidence of ectopic pregnancies. Plus, someone else who is taking it told me that her dr told her that the reason you wait until 5 dpo is so the embryo has already traveled down through the tube. So it sounds like my dr is telling me the right thing.

I'm going to start taking it tonight. I don't want to end up with another 9 day LP. For all I know, that was the reason I did not conceive the first cycle we were TTC.

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