Need help from OB nurses...or anyone with fertility problems

  1. I need a little advice/input here. I am 30 years old and found out recently that I was pregnant. I was thrilled. I have endometriosis and didn't know if I would ever be able to have a child without medical intervention.

    Anyway, now my world seems to be crumbling. I was spotting (just a scant amount upon wiping, nothing that even dotted a pad) so I called my OB. Well, an emergency ultrasound was done and showed that I was a week less than I had thought (I may not have the correct date because I never marked the first day of my LMP on my calender). I am approx 6.5 weeks right now. The OB ordered some blood tests. My hcg level is rising, but not at the rate that the doctor would like. Also, my progesterone level is slightly low (he didn't give me numbers or tell me how slight slightly means). He thinks the implantation may be a little weak so he wants to put me on a progesterone supplement until I reach twelve weeks. I am terrified to take this. It is a class X drug and I am worried about birth defects.

    Does anyone out there have any experience with pregnant women taking progesterone? I hear that cleft palates and masculization of a female child can occur. My OB said that progesterone is used a lot in pregnancy for women with infertility problems and not too many ill effects occur (even though the literature states otherwise). I will call my OB and ask more questions before taking this drug.

    I am so scared right now. I want to have a healthy baby. I am not an OB nurse...and I have found that my nursing books don't tell me squat about what I am going through. Does anyone know of any good web sites I can go to for information?

    Any advice, facts, or words of encouragement would be greatly appreciated. Feel free to post replies here or email me.

  2. Visit Rileycat profile page

    About Rileycat

    Joined: Jan '01; Posts: 130; Likes: 2
    Med-surg RN


  3. by   RNforLongTime
    Congratulations! I wish I had some helpful information for you but I don't. I'll say lots of prayers for you! Keep us posted!
  4. by   shay
    First, congrats. Second, yes, your OB is right. Progesterone is used A LOT with infertility patients, ESPECIALLY with in vitro pts. who are at risk for having implantation problems. Most pts. who have gone through/are going through infertility tx take progesterone, sometimes up to the 20th week of pregnancy. Even though you're not an infertility pt., you have the potential for implantation problems secondary to the endometriosis.

    Here's my personal suggestion, both as an OB nurse and as a woman....go online, find an online infertility support/info page. No, everything you read on the net is not always true or good, but from what my friends who've had fertility problems have told me, these kinds of web pages have been very helpful.

    Some light spotting can be normal during implantation, as I'm sure you've already read. Write down the questions you have, and take someone with you to your visits who can write down what the doctor says, since you're emotionally stressed and probably won't remember half of it...which is normal. That way, when you're thinking to yourself, 'now, what did he/she say about so-and-so?' you have a written record of what the doc said when he/she answered your questions.

    Hope this has been helpful.....keep us posted!
  5. by   Huganurse
    Congratulations! My thoughts and prayers are with you. I too had a high risk pregnancy. I was so scared the entire 9 months. Good luck and don't forget we are praying for you!
    Last edit by Huganurse on Jun 30, '02
  6. by   NicuGal
    The progesterone shouldn't cause any will be a suppository most likely. A lot of girls I work with used them and their babies were fine. If it would make you feel better, you could consult with a high risk OB. The progesterone will help you maintain the pregnancy...if the levels drops down, you will miscarry. Have you had any repeats drawn?
  7. by   Rileycat
    Thanks for your responses, everyone.

    Kaknurse: You're the one trying to get pregnant, right? I am confident that you will have a baby some day. Thank you for the prayers.

    Shay: Thank you for validating the information my doctor has given me. Your personal and professional experience means a lot to me. I will take your suggestion and write down my questions as they come to me and I will be looking for some support groups.

    Huganurse: I am so happy that your pregnancy was a success. I am not so worried about the cleft palate. I was more concerned because the OB told me that the literature suggests that female offspring can end up with a penis. I have seen programs on intersexed people and the pain they go through (usually from doctors trying to "fix" them) and was worried about the possibility of a child having to go through that. Anyway, the doc said he has never actually seen this side effect happen...he just knows the risk is out there. He also warned me that I would hear a bunch of awful side effects from the pharmacy, but reasurred me that these effects do not occur very often...that many fertility specialist use progesterone like crazy and have no problems. I do not know if my OB is a high risk OB, but he does deliver at a high risk hospital. I am new to his practice. He came highly recommended by the OB nurses at my hospital. He has been wonderful and supportive so far. Thanks for the prayers.

    NicuGal: Thanks for your support. I am glad to hear that a lot of women were on progesterone without any ill effects. Do you know if the oral form of progesterone is safe? I'm not sure what my form will be yet. I guess I will find out when I pick up my prescription in the morning. I have read that the suppository form of progesterone is realtively safe. I haven't had repeat labs drawn yet. I am supposed to go in on Weds or Friday for a repeat ultrasound. My first ultrasound looked alright...the sac was well formed. The doc just wants to get a better look and see if growth is occurring. Thankfully the spotting has stopped on its own.

    I will keep you all updated on what's going on with me. Thanks again for the support and suggestions.
  8. by   Doey
    Hi Rileycat,
    First of all, congratulations!! I went through something like 6 cycles of intrauterine insemination and 5 cycles of IVF. I was prescribed progesterone in one form or another (supps then injections) for each. Unfortunately I was not successful but all of the women in my support group were also given progesterone and those that did get pregnant had no problems whatsoever and all the babies were born fine. I too was at first concerned after reading about progesterone but did some research and found that it is used extensively (especially in infertility treatment) without any ill effects. Take care, and will keep you in my thoughts.
  9. by   Rileycat
    Doey: Thank you so much for taking the time to respond to my post. It is very reassuring to hear that all the women you know who were on progesterone had no ill effects. I did some more research on progesterone...and the web site I was on classified it as a class B drug, not a class X drug (which is what my drug book stated). I feel better about taking progesterone now that I have done some research...and heard everyone's responses to my post. Thanks again for taking the time to respond to my post.
  10. by   RNforLongTime
    Thank you Rileycat for your prayers! It is much appreciated. It is my personal belief that if you have faith and prayer then the Lord will give you what you wish for--in His time. Never underestimate the power of prayer!
  11. by   fiestynurse
    You always have the option of seeking a second opinion from a Perinatologist, who specializes in high risk pregnancies. If your Ob doctor has your best interests at heart, he/she will not be offended if you request this. It is ultimately your decision, but just make sure you are well informed of the pros and cons.

    Spotting is common in the first weeks of a pregnancy as implantation takes place. Your HCG levels are rising, which is good. Have you ever had a miscarriage in the past that would cause your doctor to be concerned about implantation problems?
  12. by   live4today
    Hello Rileycat,

    Over 32 years ago when I was pregnant with my first child, I went through very much the same thing you have gone through, so therfore was put on an oral tab of progesterone along with bedrest the first five months of my pregnancy. I was only allowed to get out of bed to go potty, walk around our one floor apartment to stretch me legs a bit, and to fetch my own meals as long as I didn't 'over do it'! I delivered a healthy eight pound (almost) baby girl who grew up without any ill effects from my having taken that drug. Today, she is married with many rugrats of her own!

    Congrats on your pregnancy, and I'll say prayers of health for you and your unborn baby that in seven plus months from now, you will deliver a healthy baby! BTW: Renee's a nice name if you have a girl! If you have a boy, Renee is still a nice French name to name him, only drop an 'e' off the end and spell it the way the French do [Rene`] :kissblush
    Last edit by live4today on Mar 17, '02
  13. by   naturalhealth
    Hi Rileycat,
    I agree with your taking the progesterone to ensure a viable pregnancy. I reccomend this book that talks about natural progesterone. "The Estrogen Alternative" by Raquel Martin, and Judi Gerstung, DC. It's got great information about progesterone and estrogen. According to this book there is a major difference between natural hormones and synthetic ones. Sincerely, Gabriele RN
  14. by   Rileycat
    fiestynurse: I haven't had a miscarriage in the past. This is my first pregnancy. I think my OB was concerned about an implantation problem d/t my low progesterone levels and the spotting. My mother talked to our family pharmacist today about progesterone. He also said it was highly used and that he has not heard of any bad side effects to the baby. He gave my mom a pamplet of information on progesterone. I guess there was one noted case of cleft palate, but they were not able to determine if it was from the progesterone or not. He seems to think it is relatively safe. I will probably call another doctor just for a second opinion, but so far everything I hear and read makes me feel pretty safe about taking progesterone. The side effects for the me taking progesterone sound scarey, but they sound pretty much the same as taking birth control.

    Gabriele: Thanks for the tip on the book. I will have to check it out. Also, thank you for taking the time to respond to my post.

    Renee Williams: Thank you so much for the reassurrance. It is so comforting to know that you went through a similar situation and still ended up with a healthy baby girl. Thanks for the prayers as well.

    Well, everyone: my next ultrasound is on Wednesday. Wish me luck.