There are many cases of low progesterone in clinic, but most of them can give birth smoothly. Please don't worry too much.
How is progesterone produced? Why low?
Progesterone, also called progesterone, is progesterone. After a woman is pregnant, the embryo will begin to secrete chorionic gonadotropin (hCG), which will stimulate the pregnant mother's ovary to produce a large amount of progesterone. If anything goes wrong in this process, progesterone may be low.
1. At the time of inspection, it was at the low point of progesterone level fluctuation.
Progesterone can make it fluctuate up and down throughout pregnancy, and its metabolism is faster. Low test level does not mean forever low.
In addition, the pregnancy time is calculated according to the first day after the last menstruation, which may be different from the specific pregnancy date. The fact that the embryo does not reach the expected number of days may also lead to low progesterone.
2. Fetal problems
Embryo chromosome abnormality, abnormal development, can not secrete enough stimulating hormone. At this time, the possibility of miscarriage will be higher, which belongs to congenital deficiency. This situation is generally untenable.
3. Problems of pregnant mothers
When does low progesterone need attention?
Progesterone is low and asymptomatic, and there has been no repeated abortion before. Therefore, there is no need for abortion treatment, as long as you are in a happy mood, have enough rest, eat a balanced diet and avoid trauma.
However, if the following symptoms occur at the same time, especially in the first trimester, you must seek medical attention in time:
Doctors will comprehensively consider the results of hCG, progesterone, B-ultrasound and other tests, make professional judgments, follow the doctor's advice, and don't blindly doubt yourself to scare yourself.
What should I pay attention to in low progesterone diet?
The diet is still balanced in nutrition and mild in nature. Yes:
Is it necessary to have a "progesterone" abortion?
When it comes to the problem of low progesterone, we have to talk about the very popular "progesterone to protect the fetus", which is also a kind of behavior with China characteristics.
Although there is controversy in medicine, many authoritative institutions and organizations do not recommend progesterone to prevent abortion:
At present, many times in clinic, progesterone has a placebo effect to appease pregnant women, which is still useful from the point of view of relieving the excessive tension of pregnant mothers. However, except for 5% pregnant mothers who have insufficient progesterone due to endocrine problems, most other progesterone supplements have no therapeutic effect.
In a few cases, progesterone needs to be supplemented, such as women who have had their corpus luteum removed by previous surgery.
As for the so-called "tire protection" products on the market, let's take a break. Why use yourself and the baby in your belly as experiments?
Why do others have high progesterone and I have low progesterone?
Many women will go to the hospital to confirm their pregnancy after pregnancy. When progesterone is low, doctors will ask for abortion, so why do some women have high progesterone and some women have low progesterone? Let me start with progesterone.
1, the first is the physical problem. Some women, due to their own physical reasons, progesterone has not been high, and progesterone will not be high after pregnancy, but there is no problem and they can give birth to babies smoothly and healthily. This situation is that their progesterone value is low, and Ma Jing is such a physique. When she was just pregnant, what time was progesterone? Moreover, I have met many expectant mothers who have just been pregnant with low progesterone, but they have also given birth to children very well. So in this case, as long as hcg doubles and there is no abdominal pain and bleeding, you don't have to worry too much, just relax and raise it.
2. On the other hand, due to luteal insufficiency, progesterone secreted in luteal phase is insufficient. Severe cases may lead to biochemical pregnancy or abortion, fetal arrest and so on. In this case, you should follow the doctor's advice to protect the fetus or give up.
Is low progesterone bound to miscarry?
The answer is: not necessarily. As mentioned earlier, some women with low progesterone may have physical problems, and there is no need to "sentence the baby to death" with low progesterone.
You can have a blood test in three to five days. If hcg is doubled and there is no abdominal pain and bleeding, don't worry. Pay attention to rest, relax, let nature take its course and don't put too much pressure on your baby.
The arrival of a new life is very happy for every family. Pregnant women find that their progesterone value is low, and they are afraid that low progesterone will lead to abortion, so they may choose to take progesterone to "protect the fetus". Is it necessary to take progesterone to "protect the fetus"? Can low progesterone really miscarry?
Abortion refers to the termination of pregnancy when the pregnancy is less than 28 weeks and the fetal weight is less than 1000g, of which 80% is early abortion, which occurs before 12 weeks of pregnancy. There are many reasons for early abortion. Chromosome abnormality of embryo or fetus is the most common cause of early abortion, and luteal insufficiency is also one of the important causes of early abortion.
Progesterone is mainly secreted by corpus luteum and placenta. When pregnant women are less than 6 weeks old, progesterone mainly comes from ovarian corpus luteum. After 6-9 weeks of pregnancy, the main source of progesterone is placenta, and the secretion of progesterone increases with the continuous growth of placenta.
Progesterone can protect pregnant women's endometrium, promote endometrial thickening and vascular gland hyperplasia, make endometrial changes at molecular level suitable for embryo implantation and prevent maternal rejection, provide support for early fetal growth and development, reduce the sensitivity of uterus to oxytocin, reduce uterine contraction, and provide favorable conditions for the normal development of fertilized eggs in uterus. Progesterone can protect corpus luteum and maintain early pregnancy.
Many scholars have studied the serum progesterone level of pregnant women in early pregnancy, and found that the lower the progesterone level, the higher the risk of adverse pregnancy outcome (including ectopic pregnancy or intrauterine adverse pregnancy), and the progesterone level is highly sensitive to predict the early pregnancy outcome.
Therefore, more and more clinicians evaluate the luteal function of pregnancy and predict the outcome of early pregnancy by measuring the serum progesterone level of early pregnant women, and serve as the basis for progesterone complementary treatment. However, the threshold of serum progesterone for good early pregnancy outcome has not been unified, and the threshold obtained by different studies is very different (9.4-32.7ng/ml). Most scholars believe that serum progesterone level of 25ng/ml can be used as a threshold for good early pregnancy results.
Therefore, many clinicians treat early pregnant women with 5-25ng/ml progesterone level to improve the early pregnancy outcome. However, the effect of progesterone supplementation on early pregnancy outcome is still controversial.
In fact, most abortions are eliminated because the child cannot continue to grow in the mother's womb. What is eliminated is the choice of natural selection. It is useless to supplement progesterone blindly. Novice mothers do not need to check progesterone at the beginning of pregnancy.
If there are no abnormalities such as abdominal pain and vaginal bleeding, as long as you wait patiently for pregnancy for more than 6 weeks, confirm intrauterine pregnancy by ultrasound at an early stage, and conduct regular prenatal examination under the guidance of professional doctors, you can safely spend the pregnancy. For pregnant women with a history of recurrent abortion, they should communicate with doctors and supplement progesterone appropriately.
Finally, I wish every mother a healthy and smart baby safely and smoothly!
References:
Clinical value of progesterone, estradiol and human chorionic gonadotropin in the diagnosis of missed abortion
Nanjing Medical University Gulou Clinical Medical College Nanjing University of Traditional Chinese Medicine Affiliated Nanjing Hospital of Integrated Traditional Chinese and Western Medicine
Effect of progesterone supplementation on early pregnancy outcome with low progesterone level Jia Xiaowen, Xu Yanping
20 13 Postgraduates of Shaanxi University of Traditional Chinese Medicine
Can low progesterone in early pregnancy lead to abortion? Yue Yuhuan Huzhong Hospital
It is not because of low progesterone that abortion occurs, and the causal relationship is not established like this.
Low progesterone is the result, not the cause. Many people don't understand this logical relationship, especially in China. Therefore, most of the progesterone tests in the first trimester in China belong to over-examination.
For embryos that are about to abort, or destined to abort, progesterone will definitely drop, sooner or later. Because this phenomenon was discovered, there was a panic of low progesterone.
But this is not the case. There is indeed a dependence between progesterone and embryo, but the production of progesterone is the result of active stimulation of pregnancy and its appendages due to the needs of embryo development. The menstrual corpus luteum formed after ovulation should disappear after 14 days. Because of pregnancy, he continued to develop and became pregnant corpus luteum, which continued to produce progesterone to help maintain pregnancy. That is to say, because of pregnancy, there is corpus luteum. Progesterone is secreted by the corpus luteum of pregnancy. It is now clear that HCG is an element that stimulates menstrual corpus luteum to become pregnant corpus luteum.
If the pregnancy is terminated, or because of embryonic dysplasia, pregnancy death, HCG decline, and the reason for the existence of corpus luteum gradually disappears, progesterone in the blood will continue to decline.
In normal pregnancy, progesterone is not constant, and it may fluctuate. Some pregnant women may have low progesterone levels in the first trimester, but as long as the pregnancy activity is good, there should be no problem with your pregnancy itself, and progesterone will not continue to decline. Examination of progesterone has no significance for the diagnosis of live embryos.
Only when we don't know whether the embryo is dead or alive can we help to judge whether the embryo is normal or abnormal by the level of progesterone. At present, our reference value is that if the progesterone level is lower than 5ng/ ml, embryo death or abortion should be considered.
Clinically, I have seen normal pregnancy with the lowest progesterone, which can be as low as below 9. No intervention, no abortion, no artificial progesterone supplement, normal pregnancy to full-term delivery!
Conclusion: Pregnant women with threatened abortion often have low serum progesterone levels. But on the other hand, the low level of progesterone does not indicate the possibility of abortion, because it is possible that the embryonic development has not yet reached a certain stage, so the progesterone value is temporarily low and may become higher in the next review. Therefore, what the subject said is inaccurate. It is better to draw blood to check progesterone than HCG!
Under physiological conditions, the level of progesterone in blood fluctuates within a day. It means that different blood drawing times may be biased.
In China, at present, the monitoring of progesterone level in early pregnancy has formed a chaotic clinical situation. Overemphasizing the significance of progesterone level has caused panic among pregnant women, and it has also played an unshirkable role in forming a "disaster area" with excessive diagnosis and treatment and irregular medication.
(1) Progesterone is synthesized and secreted by ovarian corpus luteum only in the second half of each menstrual cycle. In addition, the brain, liver and adrenal gland will also synthesize and secrete a small amount.
(2) Early pregnancy (the first trimester of pregnancy)-progesterone is synthesized and secreted by the corpus luteum of pregnancy, which can promote decidualization of endometrium and provide good implantation conditions for embryos; And induce immune protection mechanism to prevent embryos from being "rejected" by the mother; It can also reduce the sensitivity of uterine smooth muscle and play the role of "fetal protection". After three months of pregnancy, the luteal phase of pregnancy degenerates, and gradually transitions to a large amount of progesterone synthesis and secretion in the placenta, and the progesterone value gradually increases and lasts until full term.
In the early pregnancy, when the resolution of ultrasound examination can't distinguish whether it is intrauterine pregnancy or not and can't prove whether the embryo is healthy or not, it is more meaningful to draw blood to check HCG to evaluate embryo development than to draw blood to check progesterone, because the well-developed embryo will double every other day, and progesterone will be affected by various factors, and the value fluctuates greatly. In addition, if you see fetal heart beat, it is the standard of normal pregnancy at that time, and progesterone level is not as valuable as fetal heart beat.
For patients with inevitable abortion after 8 weeks of pregnancy, the decrease of progesterone level is one of the results of inevitable abortion, not the cause of abortion. According to this causal relationship, it can be inferred that even progesterone supplementation is irreversible for the outcome of abortion.
Guangzhou Zhuo Zhi clinic Liang Lili attending physician
Thank you for your invitation. I'm Shen Huan, a reproductive doctor. I'm glad to answer this question for you.
Low progesterone does not necessarily lead to progesterone abortion, but high progesterone on the one hand shows that villi have good activity, and secreting enough H C G can stimulate corpus luteum to secrete enough progesterone. But low progesterone does not necessarily mean that the activity of villi is not good. Whether the embryo develops well depends mainly on whether the fetal heart of the embryo bud is normal by ultrasound.
The level of progesterone reflects the quality of embryo development to some extent.
If progesterone is found to be low after pregnancy, it means that there is the possibility of embryonic dysplasia and low corpus luteum function, and timely supplementary treatment is needed.
If progesterone is low and there is no fetal heart, embryonic development may stop or abortion may occur.
First of all, low progesterone is indeed one of the causes of abortion. Low progesterone is a relatively phased problem, because the value of progesterone will constantly change according to the number of days you are pregnant, the quality of your embryo, the changes of your embryo, and sometimes it will change because of your diet and mood.
Abortion is related to many factors, such as poor embryo quality, improper implantation position, or hormone not increasing reasonably according to the number of days of pregnancy. One of them is low progesterone, so now many people find themselves pregnant and will take oral drugs such as desdrogesterone to protect their pregnancy. But it is not low progesterone that causes abortion.
If you are a novice mother, the first thing to do after pregnancy is to determine whether you are an intrauterine pregnancy or an ectopic pregnancy, which is often called ectopic pregnancy. How can I make it clear? On the one hand, indicators, on the other hand, gynecological three-dimensional ultrasound, that is, B-ultrasound, can be said to be the gold standard. Generally, gestational sac can appear in the uterus as early as 50 days of pregnancy, and ectopic pregnancy can be ruled out.
From the discovery of pregnancy, it is necessary to monitor blood HCG (human chorionic gonadotropin) in stages. If this index is all normal, it usually doubles on the second day of early pregnancy, indicating that the embryo is well developed. At this time, if the progesterone value is lower than the normal range corresponding to the number of days of pregnancy, you can take progesterone orally, which does not mean that it will definitely lead to abortion.
It is very important for pregnant women to strictly follow the doctor's advice to monitor various indicators in the first trimester, so as to avoid affecting their mood and causing panic or anxiety because of the level of a single indicator.
Answer: Li Xiaochun, Master of Medicine.
Welcome to pay attention to Xinghua Island to gain more useful health knowledge.
Progesterone is an important index to measure the growth and development of gestational sac in early pregnancy. Progesterone plays an important role in supporting fetal growth and development. First, it can promote the implantation of gestational sac and play an immunosuppressive role. Low progesterone sometimes does not necessarily lead to abortion, because monitoring progesterone in clinical work at present sometimes leads to inaccurate results, because progesterone is often secreted in the form of pulses and is closely related to detection methods, so the results of progesterone sometimes do not reflect the normal progesterone value in the body, so low progesterone does not necessarily lead to abortion. Although monitoring progesterone during pregnancy has certain clinical significance, it is not necessary to detect progesterone if the fetal heart has been found by B-ultrasound and the patient has no abdominal pain or bleeding symptoms. On the contrary, if abortion is caused by low progesterone, this idea is not entirely correct, sometimes because abortion leads to low progesterone.
The level of progesterone does not represent the quality of embryonic development. No matter domestic or foreign experts, they do not advocate checking progesterone to judge embryonic development, nor do they advocate using progesterone to protect the fetus. Because progesterone abortion is only established in one case, that is, luteal insufficiency, which is very rare in clinical pregnant women. Therefore, when pregnant mothers see that your progesterone is low, don't be particularly nervous and don't panic. First of all, we should make a review to see the doubling of HCG. We know that HCG usually doubles 1.5-2 times in 48 hours. If it's better to double your HCG, we won't have to worry about your embryo. Our doctors often say that it depends on the doubling of HCG before 7 weeks of pregnancy, and the development of fetal heart rate and embryo buds in intrauterine pregnancy sac after 7 weeks of pregnancy.