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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Would a vaginal dosage of progesterone 200 mg be reasonable?

Hello, I am 33 years old and healthy. My first pregnancy ended in miscarriage at 7 weeks. I got pregnant quickly after trying for 2 cycles. I did not need a D&C. I did not have a cycle following the miscarriage and got pregnant again-I had a miscarriage around 4-5 weeks (difficult to know exact dates b/c I did not have my period after the first miscarriage). I did not require a D&C the second time either. I did have a w/u for recurrent miscarriage: normal thyroid, lupus abs, LH, estrogen, progesterone, normal hysterosalpingogram. I have had 2 normal cycles and will start trying again soon. I was prescribed a vaginal progesterone suppository (even though my level at day 21 was not low) b/c of the recurrent miscarriage. I was prescribed progesterone 25 mg intravaginal once daily (needs to be compounded). I read that doses of upwards of 200 mg are used, but when I called by OB, he said that this is the vaginal dosing traditonally used. I understand that oral progesterone s bioavailability would be much lower so 200 mg QD would need to be used, but is this vaginal dosing reasonable? I was prescribed Crinone originally, but it was not covered by insurance. Thank you!
Fri, 26 Feb 2016
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Rheumatologist 's  Response
This dosing is reasonable but you need to rule out antiphospholipid syndrome in view of recurrent miscarriage . please talk to your doctor regarding this .
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