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PREVENTING MISCARRIAGES: HORMONAL PROBLEMS

Luteinising hormone (LH) controls the development and release of the egg from the ovary. Women who have high levels of this hormone in the first half of their menstrual cycle seem to have a greater risk of miscarriage. In addition, women with polycystic ovary syndrome (PCOS) have raised levels of LH.

Progesterone is the hormone which maintains the pregnancy during the first few weeks. After the egg has been released from the ovary, the ruptured follicle then develops into the corpus luteum which produces progesterone. If the egg is not fertilised, after 14 days the corpus luteum withers, progesterone levels fall and a period occurs. If the egg is fertilised and the embryo implants successfully and starts to produce another hormone hCG (human chorionic gonadotrophin) then the corpus luteum gets the message to continue producing progesterone. Without sufficient levels of progesterone, the pregnancy cannot continue, and that is why anti-progesterone drugs are now used to terminate an early pregnancy without the need for an operation.

Because of this obvious link between progesterone and maintaining pregnancy, many doctors give progesterone as injections or pessaries to prevent a miscarriage. But Professor Lesley Regan, in her excellent book Miscarriage, states that ‘Injections of hormone, in the early weeks of a pregnancy at risk, may prolong the miscarriage but they cannot reverse it. Low progesterone levels in early pregnancy are the result rather than the cause of miscarriage.’

After the egg has been fertilised, the womb (endometrium) lining will also stay thick where the embryo will implant and develop. If the womb lining is inadequate, then the embryo will not ‘hold on’ and a miscarriage will occur. It is possible to have good levels of progesterone and yet have a thin womb lining, perhaps because the womb lining is not responding to the levels of progesterone. Other doctors, however, do give progesterone to women with a history of recurrent miscarriages and they have gone on to have a successful pregnancy.

Ultrasound can also be useful for those women with a history of recurrent miscarriages, as it can often pick up an indication of corpus luteum failure before any drop in progesterone level is seen in the blood. This is where the use of progesterone can be beneficial.

There are so many factors that govern the efficient functioning of the cycle that it is not always easy to identify cause and effect. Every part of the cycle is dependent on what went before so we may not be able to ‘fix’ problems in the second half of the cycle without looking at what has gone wrong in the first half. By going back to the basic foundations of health and getting yourself back into balance, you have a much better chance of maintaining a pregnancy without the need for hormones or other drugs.

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This entry was posted on Thursday, April 23rd, 2009 at 7:23 am and is filed under Women's Health. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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