Role of Progesterone in Miscarriage

Abstract

About 10-15% of clinically recognized pregnancies end in a miscarriage. Recurrent miscarriage defined as loss of three or more consecutive pregnancies complicate about 1-2% of couples trying to conceive. The most common cause of miscarriage is chromosomal aberration in the fetus. However in a vast majority, the cause of miscarriages remain unknown. This makes treatment options difficult and often empirical. It has been postulated that a causative factor in many cases of miscarriage may be inadequate secretion of progesterone during the luteal phase of the menstrual cycle and in the early weeks of pregnancy. Therefore, progestogens have been used, beginning in the ï¬rst trimester of pregnancy, in an attempt to prevent spontaneous miscarriages. In women presenting with a clinical diagnosis of threatened miscarriage, there is preliminary evidence of a reduction in the rate of spontaneous miscarriage with the use of progesterone. Larger RCTs may help to validate these findings. Initial reports of favourable outcome with use of progesterone in recurrent pregnancy loss (RPL) could not be confirmed uniformly by larger randomized trials. This article aims at reviewing the role of progesterone in treatment of threatened and recurrent miscarriages.