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Progesterone increases pregnancy success in women with recurrent pregnancy loss
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Among women with a history of two or more unexplained pregnancy losses, progesterone may increase the rate of successful pregnancies, study data show.
“This study provides strong evidence that progesterone supplementation, beginning in the luteal phase of the menstrual cycle, can be a safe and effective treatment option for women who are suffering from unexplained pregnancy loss,” Mary D. Stephenson, MD, MSc, director of the recurrent pregnancy loss program at the University of Illinois Hospital and Health Sciences System, told Endocrine Today.
Stephenson and colleagues evaluated 116 women with a history of two or more unexplained pregnancy losses (< 10 weeks in size) to determine the effect of progesterone on pregnancy success (ongoing pregnancy > 10 weeks in size). An endometrial biopsy was performed in participants 9 to 11 days after luteinizing hormone surge. At 3 days after the luteinizing hormone surge, vaginal micronized progesterone was prescribed at a dose of 100 mg to 200 mg every 12 hours when glandular epithelial nuclear cyclin E expression was elevated (> 20%) in endometrial glands or empirically despite normal nuclear cyclin E expression ( 20%). A control group was made up of women with normal nuclear cyclin E who did not received progesterone.
Overall, 51% of participants had elevated nuclear cyclin E.
Among participants with elevated nuclear cyclin E, there were 255 prior pregnancies and 83 subsequent pregnancies after progesterone use. After treatment, pregnancy success improved from 6% to 69% (P < .001).
Among participants with normal nuclear cyclin E, there were 244 prior pregnancies and 80 subsequent pregnancies. After treatment with progesterone, pregnancy success improved from 11% to 60% (P < .001).
compared with participants treated with progesterone (n = 38). However, participants prescribed progesterone had a higher pregnancy success (68%) compared with controls (51%; P = .05).
“There are very few evidence-based treatments available for women who are able to conceive, but unable to maintain pregnancy,” Stephenson told Endocrine Today. “This study is an important step forward in building the body of evidence-based clinical research which suggests that progesterone, which is safe and inexpensive, as a treatment option that physicians may consider for their patients with recurrent pregnancy loss, once an evaluation is completed. This study also demonstrates that molecular markers may have a potential role in identifying women who may benefit from progesterone treatment, and may be used for optimized dosing.” – by Amber Cox
For more information:
Mary D. Stephenson, MD, MSc, can be reached at the University of Illinois at Chicago, department of obstetrics and gynecology, (312)-996-7006.
Disclosure: Stephenson reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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