Progesterone supplements do not reduce risk of recurrent miscarriage, study showsBMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h6359 (Published 26 November 2015) Cite this as: BMJ 2015;351:h6359
Progesterone supplements in the first trimester of pregnancy do not improve the rate of live births in women who have unexplained recurrent miscarriages, shows a large study published in the New England Journal of Medicine.1
The study selected 826 women who were trying to conceive naturally after three or more recurrent losses of pregnancy in the first trimester and randomised them to twice daily treatment with vaginal suppositories containing 400 mg of micronised progesterone or matched placebo. They started treatment soon after having a positive pregnancy test and continued it to 12 weeks of gestation.
Progesterone is essential to achieving and maintaining a healthy pregnancy, and previous research has shown that treatment with this hormone may reduce the risk of recurrent miscarriage.
The new study found that around two thirds of women in both groups went on to give birth to a live baby after 24 weeks of gestation. The rate of live births was 65.8% (262 of 398) in women treated with progesterone and 63.3% (271 of 428) in the placebo group (relative rate 1.04 (95% confidence interval 0.94 to 1.15)). No significant difference was seen in the rate of adverse events between the two groups.
“We had hoped, like many people, that this research would confirm progesterone as an effective treatment,” said the lead author, Arri Coomarasamy, professor of gynaecology at the University of Birmingham, UK. “Though disappointing, it does address a question that has remained unanswered since progesterone was first proposed as a treatment back in 1953.”
He continued, “Fortunately, there are a number of other positives that we can take from the trial as a whole.” Results showed no negative effects of progesterone treatment on the women taking part in the trial or on their babies. This is important for women who take progesterone for reasons other than miscarriage, such as treatment for infertility.
Coomarasamy said that progesterone supplements may have other uses, such as preventing miscarriage in women with early pregnancy bleeding. He added that the trial, which was supported by the UK National Institute for Health Research, created a solid network of doctors, nurses, and midwives across the United Kingdom and beyond, all committed to miscarriage research.
“That wealth of expertise and information will be invaluable as we continue to explore and test other treatments that really can reduce the risk of miscarriage,” he said.
Cite this as: BMJ 2015;351:h6359