HomeAnswersObstetrics and Gynecologyin vitro fertilizationIs it safe to reduce Gestone injection after the fetal heartbeat is heard?

Does reducing Gestone injection after six weeks of pregnancy cause bleeding?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At April 2, 2022
Reviewed AtDecember 13, 2023

Patient's Query

Hi doctor,

I am six weeks and three days pregnant with the help of IVF, and it is frozen embryo transfer on day 20. My doctor suggested reducing Gestone injection frequency from daily to alternate days when heartbeats were checked after the sixth-week scan. And to continue oral Duphaston and vaginal tablets. Does reducing the frequency of Gestone injection this early cause bleeding? Or is it safe to reduce from daily to alternate days once the heartbeat is visible? Kindly help.

Hi,

Welcome to icliniq.com.

I understand your concern. Once the fetal heartbeat is seen, it is safe to reduce the progesterone injections, as now the placenta will start producing its progesterone. You still have oral and vaginal progesterone to support it, but excess progesterone can cause nausea and vomiting. So, I suggest it is better to take it on alternate days.

Patient's Query

Hi doctor,

Thank you for the reply. My doctor advised me to be alert, as bleeding may happen. So, I got scared because I have a history of miscarriage. Currently, I am taking the following medications,

1) Injection Gestone 100 mg on alternate days, which was previously (till yesterday) taken daily, and it did not cause bleeding.

2) Tablet Duphaston 10 mg twice a day.

3) Tablet Emprogest 400 mg two tablets twice a day vaginally.

4) Tablet Evadiol 2 mg four tablets twice a day.

5) Tablet Ecosprin 75 once a day.

6) Injection Exhep S.C daily.

7) Injection GCCF S.C daily.

Kindly help.

Hi,

Welcome back to icliniq.com.

The doctor has just warned you as reducing the dose in some patients may cause bleeding. Therefore, I suggest these medicines be continued along with folic acid supplementation.

Kindly revert in case of further queries.

Thank you.

Patient's Query

Hi doctor,

Thank you for the reply. I asked my doctor whether reducing the dose could cause bleeding. So she told me to continue injection Gestone daily for the next ten days, which got me confused? Should I continue it daily, as she said? Does excess progesterone affect the fetus? Or should I go with her first suggestion of alternate days? She told me if bleeding happens, I have to be hospitalized for three days. Kindly help.

Hi,

Welcome back to icliniq.com.

I understand your concern. The bleeding that occurs is not due to miscarriage. It is just slight bleeding due to the body's reaction to reduced progesterone which may occur in some people. Excess progesterone does not affect the fetus. The only concern is it might cause excess nausea and vomiting. If that is your concern, I suggest you continue daily progesterone till 10 to 12 weeks; after that, the placenta secretes its progesterone entirely, so you would not need the injections, and the chances of miscarriage are reduced significantly.

I hope you understand.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Manwani Saloni Dilip
Dr. Manwani Saloni Dilip

Obstetrics and Gynecology

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