17p Shots Are too expensive - is there an alternative?

This piece is in reference to the recent news of progesterone shots becoming insanely expensive : http://blogs.wsj.com/health/2011/03/10/price-of-drug-to-prevent-preterm-labor-skyrockets/ I have a bit of a love hate relationship with progesterone - but that's partly because of my IVF experience with progesterone-in-oil shots, the fact that I'm on 17p shots, and the fact that with my PCOS my progesterone levels are always too low! I won't go into all of that, but in light of the price of 17p shots skyrocketing from 10-20 bucks to 1500 bucks a shot - I thought I'd share an alternative perspective on this dilemma.

Now we know that women at risk for pre-term labor need their 17p shots. Well... perhaps I should say they need progesterone supplements to prevent uterine contractions and reduce their risk of pre-term labor. The question is - although the 17p shot is the most common form of this - is it our only option. And if the 17p shot is suddenly above and beyond all of our means , what's the next best option.

I'm only aware of this because my perinatologist told me that I could have a second option if I was unable to tolerate the injections. I did Progesterone-in-oil shots during my IVF cycle and they literally crippled me. I couldn't lie down, sit, lay on one side, or walk without excruciating pain! After 3 weeks of being in unbearable pain, using heating pads for hours on end, and being miserable, I was switched to vaginal suppositories - endometrium. I told my perinatologist about this - and he mentioned that I could do vaginal suppositories instead of the 17p shots if I couldn't tolerate the shots. I decided to do some digging online to see what I could find on those suppositories.

From March of Dimes :  http://www.marchofdimes.com/baby/premature_indepth.html

Treatment with the hormone progesterone may help prevent another premature birth in women who have already had a premature baby. The American College of Obstetricians and Gynecologists (ACOG) recommends that this treatment be offered only to women with a previous spontaneous (not induced) premature birth who are currently pregnant with one fetus (21). Studies show that weekly injections of a form of progesterone (called 17P) reduces the risk for preterm birth by about one-third in these women (22).

Another study found that treatment with vaginal progesterone suppositories greatly reduces the rate of premature birth in women with a short cervix (most of whom had no history of premature birth) (23). A vaginal ultrasound can determine whether a woman has a short cervix. ACOG recommends that providers consider progesterone treatment for these women, but does not recommend screening all women for a short cervix (21).

Studies have not found progesterone treatment helpful in preventing premature birth in twin pregnancies (21). More studies are needed to clarify which high-risk women may benefit from progesterone treatment and which form of progesterone is most effective.


Research Findings From some online journal: http://www.jfponline.org/Pages.asp?AID=1888&issue=March_2005&UID=

.... large double-blind, placebo-controlled, randomized study established the effectiveness of 17 α-hydroxyprogesterone caproate in preventing preterm delivery.....Vaginal progesterone suppositories have also been shown to decrease the rate of preterm birth in patients at increased risk.


I guess my point is that we may have other options. If the FDA and Makena are going to screw us so badly that our pregnancies may cost as much as $30 000 out of pocket to save..... we may have to look to alternative forms of progesterone to keep our babies cooking.