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Progestogens and Recurrent Miscarriage

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Progestogens in Obstetrics and Gynecology

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Abstract

The loss of three or more consecutive pregnancies, known as recurrent miscarriage (RM), affects approximately 1 % of couples. Aetiology can be varied but in up to 50 % of the cases the cause remains unexplained. Progestogen supplementation has been used for more than half a century for the treatment of recurrent miscarriage in different doses and routes of administration. Progesterone activity is mediated via specific progesterone receptors, and is considered crucial for the development of an endometrial environment suitable for implantation. Progesterone regulates endometrial receptivity, and induces uterine quiescence. In addition, the immunomodulatory properties of progesterone, controlled by progesterone induced blocking factor (PIBF), seem to be also important for the maintenance of early pregnancy. In women with RM there may be a degree of immunological intolerance, progesterone may benefit these women by altering the immune response to the embryo. Despite favourable meta-analyses on the use of progestogens in RM, the evidence is not considered to be solid and data from ongoing research are awaited.

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Authors and Affiliations

  1. Reproductive Health Group, Centre for Reproductive Health, Daresbury Park, Daresbury, WA4 4GE, Cheshire, UK

    Luciano G. Nardo M.D., M.R.C.O.G.

  2. Centre for Reproductive Medicine, Kenton & Lucas Wing, St Bartholomew’s Hospital, London, EC1A 7BE, UK

    Spyridon Chouliaras M.D., M.R.C.O.G.

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  1. Luciano G. Nardo M.D., M.R.C.O.G.
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  2. Spyridon Chouliaras M.D., M.R.C.O.G.
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Correspondence to Luciano G. Nardo M.D., M.R.C.O.G. .

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  1. Tel Aviv University, Tel Aviv, Tel Aviv, Israel

    Howard J.A. Carp

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Nardo, L.G., Chouliaras, S. (2015). Progestogens and Recurrent Miscarriage. In: Carp, H. (eds) Progestogens in Obstetrics and Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-319-14385-9_5

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