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Took clomifene citrate for getting pregnant. Prescribed with dydrogesterone. Any side effects of medicine that will affect the baby?

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hi,
My wife recently took clomifene citrate to assist her to become pregnant. She is now six week pregnant and yesterday she was prescribed dydrogesterone / duphaston. We looked on the internet and are concerned about (1) the side effects, in particular the risk of birth defects, and (ii) the fact that the drug is banned from certain countires (eg. UK).
We wanted to check if the drug is safe for her to take given that she is 6 week pregnant, if there is anything we should watch out for when she is taking the drug, and anything we should know about whilst administering the drug.
Thanks
XXXX
Posted Sat, 14 Sep 2013 in General Health
 
 
Answered by Dr. Rakhi Tayal 1 hour later
Brief Answer:
Get her blood progesterone levels evaluated.

Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
The purpose of progesterone - dydrogesterone/ duphaston during the first trimester is to "mimic" the function of something called the corpus luteum. It is a cyst that produces progesterone during early pregnancy that helps to 'maintain' the pregnancy until it reaches a certain point where it can survive on its own. This is usually about 10-12 weeks. This is usually given in infertility treatment and in patients with a history of recurrent miscarriages.

Abnormalities of the genitourinary tract are found in a baby whose mother had taken Duphaston (dydrogesterone) from week 8 to week 20 of pregnancy. That is why it is not recommended for use in the developed countries.
You can get her blood progesterone levels measured and if these are found to be below normal, then she can continue taking Duphaston.

Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
Above answer was peer-reviewed by
 
Follow-up: Took clomifene citrate for getting pregnant. Prescribed with dydrogesterone. Any side effects of medicine that will affect the baby? 25 hours later
Dear Dr. XXXXXXX Tayal

Thank you for the response.

We haven't been able to do a blood progesterone test.

However, my wife recently had a blood test and her Beta HCG count was 11,695, which is the lower end of normal range of 8636 - 218,085 for someone who is 5-6 weeks pregnant. In addition, she is now six weeks pregnant and she hasn't suffered from morning sickness and only on a few instances had nausea urge. Can I check with you if any of these are indicative of low levels of blood progesterone?

Also, can I check what the implications are of having beta HCG count at the lower end of the normal range?

Thank you

XXXX

Dear Dr. XXXXXXX Tayal

Further to my email just now, can I check the following. You mentioned the following in your response yesterday:

"Abnormalities of the genitourinary tract are found in a baby whose mother had taken Duphaston (dydrogesterone) from week 8 to week 20 of pregnancy. That is why it is not recommended for use in the developed countries."

1) How common are the Abnormalities of the genitourinary tract in the babies?
2) Is there anyway to minimise this risk?
3) You mentioned 8-20 weeks. If she takes dydrogesterone/ duphaston from 6-8 weeks as the doctor prescribed, what would be the risks?

Thank you very much

XXXX
 
 
Answered by Dr. Rakhi Tayal 20 hours later
Brief Answer:
HCG levels in low normal range are normal finding.

Detailed Answer:
Hello.
Thanks for writing again.
A decreased nausea and the HCG levels on the lower side do not indicate a low progesterone levels. Only a blood test can confirm this.
The HCG levels in the lower range are not indicative of any pathology. However a fall in the levels in 48 hours is suggestive of a non viable pregnancy.
The abnormalities of genitourinary tract are seen in 5-7% of cases.
Avoiding the Duphaston will decrease the risk of such anomalies.
If she consumes it only for two weeks, then the risk is much lower. It is best to get her serum progesterone levels evaluated and then decide.
Hope my answer is helpful.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.
Regards
Above answer was peer-reviewed by
 
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