Recurrent Miscarriage – does progesterone improve outcomes?
The researchers sought to determine if 400 mg progesterone vaginal capsules, given twice a day could increase live births beyond 24 weeks when compared to placebo, when administered to women with history of recurrent miscarriage (3 or more first trimester losses). Results showed that:
The live birth rate in the progesterone group was 65.8% compared to 63.3% in the placebo group, which was not a statistically significant difference (p=0.45)
There were no differences in secondary outcomes which included clinical pregnancy between 6 to 8 weeks, ongoing pregnancy at 12 weeks, ectopic rate and stillbirths, neonatal survival rates or congenital anomalies
Progesterone is required for a healthy pregnancy and progesterone has been used to treat women with recurrent pregnancy loss. This multi-centered randomized controlled trial sought to determine if providing vaginal progesterone in the first trimester would improve live birth rates by at least 10%. The vaginal capsules were administered from the date of randomization (no later than 6 weeks gestation) until 12 completed weeks of gestation.
Progesterone administered in the first trimester, using the dosage and route in this study, did not improve live births nor secondary outcomes in women who had a history of unexplained first trimester losses
This study does not address administration of progesterone prior to conception
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