Unfortunately, the cause of many miscarriages remains unknown. Unexplained miscarriages are emotionally devastating and can leave families with several questions. However, despite some promising preliminary studies, the American College of Obstetricians and Gynecologists (ACOG) does not consider progesterone or hCG to be proven interventions for the prevention of early pregnancy loss. Here’s what the research indicates so far.
Progesterone Supplementation
In the past few decades, it’s become more common for doctors to prescribe progesterone supplements to women who have experienced recurrent miscarriages, with the suspicion that an underproduction of progesterone might contribute to early pregnancy loss. For some women, a condition called luteal phase deficiency (LPD) results in low progesterone levels during implantation or early pregnancy. LPD may be present in as many as 20% of infertile patients and is observed in about 8% of the general population. According to the ACOG, current clinical guidelines support the use of supplemental progesterone for women who have had at least three prior miscarriages. Nonetheless, more data is needed to determine the ultimate efficacy of this treatment.
HCG Injections
Far less attention has been paid to the idea of supplementing the other pregnancy hormone, hCG, to prevent miscarriages, even though hCG is the hormone measured in home pregnancy tests and the serial blood tests doctors use to evaluate early pregnancy viability. Is it fathomable that supplementing hCG might benefit women with recurrent miscarriages? Could the underproduction of hCG actually contribute to a miscarriage rather than simply being a sign of an impending miscarriage? The hormone hCG plays a key role in helping a pregnancy get established, and it is theoretically possible that reduced hCG production could play a causal role in miscarriages. However, that doesn’t mean hCG injections are effective for preventing early pregnancy loss. Studies so far have been low-quality and had mixed results. A 2016 trial suggested that hCG injections given during the mid-luteal phase were associated with a lower rate of miscarriage. However, because this was a cohort study, randomized controlled trials will need to be conducted to produce evidence of a cause and effect.
Should You Try These Therapies?
If you’ve experienced multiple miscarriages and haven’t been able to determine the cause, it’s understandable that you would want to experiment with unproven therapies to give yourself the best possible chance of a viable pregnancy. Even when results are mixed, it may seem worth it to try hormonal treatments that seem to be generally safe. If you’ve had two or more miscarriages, ask your doctor about testing for antiphospholipid syndrome and structural problems in your uterus. These are two potential contributing factors with well-established treatments to boost the odds of a healthy pregnancy. In addition, there may be lifestyle changes you can make to improve your chances of a healthy pregnancy. Maintaining a healthy weight, eating nutritiously, managing stress, and not smoking are all associated with reduced risk of miscarriage. These lifestyle changes stand to benefit you, both during pregnancy and beyond. Talk to your doctor about your feelings and see what might be done to lower your likelihood of further miscarriages. Although some studies on progesterone and hCG seem promising, the data remain uncertain. Your doctor may prefer to suggest other interventions first to give you the best chance of a successful pregnancy.
Finding a Specialist
When your doctor seems to be all out of answers, it can be tempting to turn to social media or online sites with questionable credibility for more information. However, seeing a qualified specialist is a much better way to explore potential new solutions. In addition to your regular OBGYN, consider making an appointment with a reproductive endocrinologist. These specialists are OBGYNs with additional training in infertility and endocrinology of the reproductive system. Reproductive endocrinologists are likely to spend more time dealing with women who have difficulties related to becoming and staying pregnant, whereas OBGYNs may spend more of their time dealing with women having normal pregnancies. You’re less likely to see visibly pregnant women in the waiting room when you attend your appointments, and your doctor might have more insight into the latest treatment options available.
A Word From Verywell
Early pregnancy loss is a deeply challenging and personal issue, especially when it’s happened more than once. Seeking evidenced-based therapies can help you achieve a full-term pregnancy. Protect yourself against misinformation and faulty treatments by running ideas by your doctor and working as a team to find the best solutions.
