Absence of Feedback on Low Progesterone Levels Before Miscarriage: Is This Typical?
At 28 years old, 5'7" tall, and weighing 145 pounds, I faced a heartbreaking miscarriage without any prior medical complications—aside from a suspected luteal phase defect, which has never been properly investigated. I typically consume 1-3 alcoholic beverages weekly, and I do not smoke or use drugs. Allow me to recount the timeline of my situation: - On a Friday at 7 weeks and 3 days into my pregnancy, I visited for an ultrasound to confirm the pregnancy. During my appointment, a Nurse Practitioner (NP) confirmed my pregnancy and ordered some laboratory tests to check my hCG and progesterone levels. - By the following Tuesday, after four days, I hadn't received my blood results yet. Concerned, I reached out to the office. They informed me that the report was supposed to be sent to me but hadn't been dispatched yet. Subsequently, they forwarded the report. - Upon reviewing the results, it was apparent that my progesterone level was dangerously low, falling outside the reference ranges for not only pregnant individuals but also those in their luteal phase. - My progesterone level registered at 4.09 ng/mL, while the lab’s pregnancy reference range indicated a normal range between 5.16-18.56 ng/mL. - Later that same day, the NP approved my bloodwork with a note stating, "Everything looks healthy!" - Sadly, just four days later, I experienced a miscarriage. I recognize that progesterone levels can be erratic and are often deemed a noisy indicator of pregnancy viability. Nonetheless, my readings were substantially low, and after researching online, many sources suggest that such a low level is usually associated with an imminent miscarriage. Given that the report clearly highlighted my abnormal results in bold red letters, it would have been advisable for this anomaly to be acknowledged. I understand some medical professionals are hesitant to prescribe progesterone to support pregnancy, yet I would have appreciated a discussion about this matter. Moreover, I was surprised that my obstetrician did not reach out for follow-up mental health assessments. I did not receive any questionnaires addressing depression, which left me questioning the standard practices within this widely recognized OB practice in Manhattan, where I would have anticipated a higher degree of sensitivity and support following such an emotional experience.
Answers (1)
3/28/2025, 7:50:37 PM
OpenHealth AI
I'm truly sorry to hear about your miscarriage and the emotional distress you're experiencing. It's completely understandable to seek clarity on your situation, especially regarding the communication and care you received during this sensitive time.
To address your concerns, here are the main points:
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Low Progesterone Levels: Your progesterone level of 4.09 ng/mL is indeed low, and it is typical for such a result to be a concern, particularly since it falls outside the normal ranges for both pregnant individuals and those in the luteal phase.
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Communication and Follow-Up: It is reasonable to expect that significant lab results would prompt a discussion or a follow-up, especially if they indicate a potential risk to your pregnancy. Health care providers should ideally communicate abnormal results clearly, recognizing their implications.
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Mental Health Support: After a miscarriage, emotional support is crucial. It's common for healthcare practices to have protocols in place for mental health assessments, but this can vary widely among providers.
Explanation
Progesterone plays an essential role in maintaining early pregnancy. Low levels can indicate a risk for miscarriage, and while not all cases of low progesterone result in loss, your concerns are valid given your experience. Communication with your healthcare provider is key to addressing these findings, and it seems there was a breakdown in that process.
Next Steps
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Keep Records: Document your concerns and any symptoms you experience in the next pregnancy. Knowing your history can help healthcare providers offer better personalized care.
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Request a Follow-Up Consultation: Consider scheduling an appointment to discuss the miscarriage and your concerns around progesterone levels. This is an opportunity to ask about potential investigations (like a luteal phase defect evaluation) and the reasons for the lack of communication about your low levels.
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Seek Emotional Support: It might be helpful to reach out for emotional support, whether through therapy, support groups, or trusted individuals who can listen. Many online resources and communities can also provide comfort and connection during this time.
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Research Treatment Options: If you plan to conceive again, discuss with your healthcare provider the potential for progesterone supplementation should low levels be identified early in your next pregnancy.
Taking these steps can help you feel more in control and supported as you navigate your health and emotional needs. Remember, it’s important to prioritize your healing and mental health during this difficult time.
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