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Pregnant. Blood Test Showed Raised Progesterone Level. Had Bleeding In Early Pregnancy. Any Harm On Baby?

Posted on Tue, 19 Feb 2013

Question: Hello, I am 21 weeks, 2 days pregnant today. I am not sure if this question is for reproductive endocrinologist or obgyn specialist. I came back from my endocrinologist yesterday (not specializing in pregnancies) and my blood tests were ok but my progesterone showed >635 NMOL/L while the reference range for 2nd trimester pregnancy was 61.7 - 144 NMOL/L. My doctor said he is not a specialist but it seems ok. I am having a baby boy. The strange thing is I took the blood test 1 week earlier and my progesterone was 91 and the previous week my progesterone was 84 - so very normal. Maybe this is an error. But if it's not, could it hurt me or the baby? The doctor said, I am pregnant so I need progesterone.

I am still taking the progesterone suppository 100mg per night, while initially in the first trimester I took 600mg per day after IVF. When I tried to stop at 16 weeks I had a lot of cramping lasting 12 hrs at a time so the doctor told me to stay on the 100mg. I had 3 weeks of bleeding in early pregnancy and they increased my progesterone from 400mg to 600mg and the bleeding stopped. But I also read that 100mg could only increase your progesterone by 10-20 NMOL/L so I am not sure how I have over 635 now... could you advise on the consequences?

Also, is it safe to continue to take the 100mg suppositories per night? Thanks

Answered by Dr. Rhea Chanda (53 minutes later)

Hello,
Firstly you need to be informed that progesterone is the main hormone in pregnancy that rises.Elevated levels are normal and that wont harm your fetus.Normally the levels rise in any pregnancy but since you have been taking supplementation for the last few weeks the levels are expected to be higher than normal. Although suppositories have a role in sustaining the pregnancy in early trinesters,the use of added progesterone is not so relevant after 16 weeks. It would be my advice to try and wean yourself off the added supplementation. The drug wont harm you as such but its better to avoid synthetic hormones on a long term basis.Try to come off it slowly and not abruptly.The current report you have may be an error in printing.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rhea Chanda (5 minutes later)

Thanks Dr. XXXXXXX I tried to wean off the progesterone slowly. If I dont take it for over 36 hours I start having prolonged menstrual cramping or contractions type pain. My doctor told me to remain in 100mg to avoid pre-term labor.
You said it is harmful to take synthetic hormones over the long run. Why is that?
Also, I know some women like me are prescribed to take progesterone until the end of pregnancy, does it mean I am harming the baby? I know other women are prescribed the same to avoid pre-term labor. I thought it's better to take the progesterone than go in pre-term labor. The contractions definitely feel like pre-term labor. So what could the progesterone do to the baby, if I cannot wean it off? It's only 100mg daily.
Thanks

Answered by Dr. Rhea Chanda (1 hour later)

Firstly progesterone doesnt prevent pre -term labour.It doesnt have much use after 16 weeks pregnancy because the the purpose of the hormone is to ensure implantation. Once the first trimester is over, chances of early pregnancy loss are significantly reduced.I wouldnt recommend any long term drug in pregnancy other than iron and calcium supplements. After the first trimester placenta take over the job of sustaining the pregnancy.Now some women with low progesterone levels have arisk of pregnancy loss but that too occurs in the early pregnancy. Your progesterone levels are normal. Personally i would try to stop the progesterone slowly over a period of weeks. You can talk with your doctor if he recommends the use of drugs like isoxuprine etc for uterine relaxation. Studies havent been able to prove that progesterone has a negative effect since a hormone already found on the body.But clinical trial also havent been able to prove that of progesterone in long term is beneficial.Now i suggest that you speak with your doctor about alternatives.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rhea Chanda (1 hour later)

Dr. XXXXXXX unfortunately isoxuprine is pregnancy category C in Canada and not allowed to be taken by pregnant women. In Canada my doctor prescribed me progesterone to take to prevent preterm labor...since it's only 100mg a day I think I might continue to take it... i was just wondering if it has any side effects but as you said it hasn't been proven to harm the baby. I had this discussion with my doctor but in Canada he said to take tylenol and this does not help me.

If I was not to take the progesterone and my levels are still over 635, can that be harmful for the baby? Or is any amount of progesterone, produced by my body safe for my baby?
Thanks

Answered by Dr. Rhea Chanda (9 hours later)

The levels that you have mentioned ie,635 are definitely very high .You have said that your progestrone level was 84,then 91 a week later.A jump to 635 a week after that is unusual even after taking progesterone supplements.As i have said,no studies have proved yet that progestins can stop pre term labour.But its given as a prophylactic in some cases.Also studies havent yet proved that it causes any harm to the fetus.So if you want to keep using it,its definitely your choice. Right now,the reason for that elevated levels can be either of the two.
It may be an error on the part of the lab or your body is actually producing more than enough hormone on its own. Plus the supplementation,has kept the levels high.Either way,you need not worry about that. I hope you have got a Tiffa scan done at 20 weeks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rhea Chanda (4 hours later)

Thanks Dr. XXXXXXX I will retake the test in 2 weeks when I go see my doctor and will try and stop the suppositories again. I had the 19 week ultrasound done and the baby was fine - but this is when my progesterone was still showing 91 and not 635. If I stop the suppositories and my levels are again >635 in 2 weeks (i.e. naturally high), is this XXXXXXX for the baby? Is there something that needs to be done to actually lower the progesterone? Sorry to keep asking that but since it's so high I want to clarify. Thanks

Answered by Dr. Rhea Chanda (4 hours later)

As i have mentioned,no studies have yet proven that high levels of progesterone will affect the fetus. Since this is a hormone naturally found in the body and it rises in pregnancy,its difficult to prove otherwise. Obviously low prosgesterone levels is not a problem in your pregnancy.I would just advise a regular follow up.And since your 19 wk scan is absolutely fine,dont do anything else right now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar