The two data that are inseparable from preterm miscarriage are progesterone and HCG, which we have been in contact with since the beginning of pregnancy preparation, and we should be familiar with what they are and what they do, but after pregnancy, especially when preterm miscarriage occurs, mothers-to-be are confused again. What exactly is the relationship between progesterone and HCG?
The “triangle” of HCG, progesterone and miscarriage
After a successful pregnancy, two data that we often see when we go to the hospital for checkup are progesterone and HCG, which are also highly valued by doctors. Is a bad doubling of HCG or low progesterone a problem of the mother or of the fetus? The answer is that it could be both. And both maternal and fetal problems can lead to miscarriage. Let’s discuss the relationship between these three situations.
Scenario 1: HCG doubles well and progesterone drops
The HCG doubles well and the progesterone drops, which means that the embryo is developing normally, but the HCG progesterone function is not working. In this case, if you have the conditions, you should rest and try to lie down, as long as the progesterone is not particularly low, it is possible to preserve the fetus without supplementation.
Situation 2, progesterone normal HCG doubling is not good
Progesterone is normal, but HCG doubling is not good, this situation is very rare. Because HCG promotes the production of progesterone, if HCG is bad, progesterone is generally bad. Let’s specify the following from two cases.
1, progesterone is normal, HCG doubling is “relatively” bad. What does it mean? It means that when you go to test one day, the value goes up but does not reach the multiplier, it’s a hundred or two hundred difference, that is relatively bad. If your HCG is already tens of thousands, then the doubling is not so fast and the speed will drop, which is normal.
2, progesterone normal, HCG doubling “absolutely” bad. Absolutely not good, is the value in a range, let’s say 8 days, only doubled, this situation is not very good. Many hospitals now only supplement progesterone and rarely supplement HCG, because low HCG is likely to be bad for the embryo itself, which is of little value in preserving the fetus.
The third situation, progesterone decline HCG doubling is not good
If the HCG is not doubled but decreasing, and the progesterone is also decreasing, the doctor will suggest you to keep the fetus first, and if there is no improvement after taking birth control measures, you will also be suggested to give up as soon as possible and have an abortion.
In this case, it is very likely that the embryo itself is not good and there is no point in keeping the fetus. If you force to keep the fetus, even if the fetus is successfully kept, the fetus will face more tests in the later pregnancy, and even suffer from fetal abortion, which will increase the risk of the mother-to-be when she has an abortion later.
HCG and progesterone work together to protect the fetus.
The first thing to talk about is HCG, human chorionic gonadotropin, which many people often miss or reverse some of the words, but that’s okay, everyone knows what it is. Some pregnant moms are familiar with it because they often go to the hospital to have their blood and urine tested for this value. HCG begins to be produced by the body six days after pregnancy, when the fertilized egg is ready to be laid, and it stimulates the body to produce progesterone. Progesterone is about to ensure that the internal environment of the uterus is stable and minimally disturbed by external forces, which also protects the embryo.
So how is HCG produced again? Actually, when the fertilized egg is in bed, it will extend its dendritic tentacles and grab the uterine wall, these tentacles are the villi, which will form the early placenta. When the placenta is not mature, these hairs become more numerous and attach to form a thin membrane. These membranes are gradually filled with blood vessels, which become the initial connection between the mother and the embryo for nutrients and metabolic waste. The growth of these hairs is what we call doubling. Generally speaking, HCG doubles every other day in the early stages, so there are no people who take HCG tests every day, but usually every other even numbered day, let’s say 2, 4, 6 or 8 days.
HCG also has a very important role to play, which is to reduce the rejection reaction of the pregnant mother. A parasite grows on your body and normally the body’s immune system is going to attack it, but HCG confuses the mother and tells them it’s safe and it’s your own, so the body’s immune system doesn’t kick in.
HCG and progesterone work synergistically to give nutrients to the embryo on one hand and keep it safe on the other, so one cannot be missing. a bad doubling of HCG may delay the development of the embryo or even stop it because of lack of nutrients; not enough progesterone will make the embryo unstable in bed, causing bleeding or even miscarriage. However, low HCG and progesterone values do not necessarily lead to miscarriage, but only to a higher chance. Once the bleeding occurs, you should go for a test, and if you have a history of bad pregnancy before, you can monitor it just in case.
Note: Not all bleeding means miscarriage].
There are some issues worth noting: first of all, the brown discharge, some people think it is bleeding and go to the hospital to get progesterone to eat. Pink, bright red, non-sticky, heavy bleeding or continuous bleeding is the only thing that needs to be taken into account if there is a miscarriage. This brown discharge usually has a small amount for two or three days and then it passes and does not come back.
Knowledge extension: about progesterone to protect the pregnancy
The use of large amounts of progesterone in early pregnancy can increase the risk of malformations in the spine, anus and limbs of the fetus by 8 times. If synthetic progesterone is used (e.g., norethindrone has androgenic effects), about 18% of women have masculinized fetuses.
And the use of progesterone under normal conditions of progesterone deficiency does not pose a risk, so we must have a correct understanding of progesterone, the different factors of miscarriage, and the right understanding of fetal preservation to avoid good intentions.
How to supplement progesterone is the right thing to do?
First of all, we must find out whether there is a lack of progesterone. The lack of progesterone can be confirmed by laboratory tests and also by measuring the basal body temperature. For those who are indeed luteal deficient, progesterone can be injected from 3-4 days after the basal body temperature rises in order to conceive, and used uninterruptedly for 9-10 weeks until the mother can naturally produce progesterone.