Despite doctors prescribing progesterone to their patients with a history of recurrent miscarriages to help them have a live birth, a recent study suggests that supplemental progesterone may not up odds of motherhood.
The recent findings challenge the widespread belief that progesterone supplementation in the first trimester may prevent miscarriages. Past studies had indeed shown that the hormone may lower risk of recurrent miscarriages.
But a new trial revealed that only 65.8 percent of women who took progesterone in the first trimester had a baby. By comparison, 63.3 percent of patients in the control group reached due date. Researchers said that the difference had no statistical significance.
The study, which was published in The New England Journal of Medicine, involved 800 pregnant women with a history of recurrent miscarriages. The women were either given supplemental progesterone or a placebo, but they had no idea whether they were in the control group because supplementation was done through vaginal suppositories.
“It’s an awfully good study, and the first well-designed study on this topic,”
said Dr. Samantha M. Pfeifer of the American Society for Reproductive Medicine who isn’t an author of the study.
Dr. Coomarasamy added that the findings may be a disappointment to many clinicians that use progesterone as a first-line solution against recurrent miscarriages. According to the studys background data, in the U.S. five percent of women experience two unexplained miscarriages, while one percent can experience even more.
The research also showed that progesterone supplementation does not trigger defects in the unborn baby. Dr. Arri Coomarasamy, lead author of the study and researcher with the University of Birmingham in the U.K., underscored that progesterone does not have a harmful action.
On the other hand, there are experts that argue that progesterone supplementation may prove beneficial if it were given earlier. Dr. Mary D. Stephenson, gynecology expert at the University of Illinois who was not associated with the study, believes that doctors should give patients progesterone after ovulation not just in the first trimester of pregnancy.
She expressed her concerns that healthcare providers may be starting the progesterone too late.
The exact cause of recurrent miscarriage is not fully understood. Researchers believe that it may be linked to chromosomal errors in babies that become more frequent as women age. This is why in the latest research the maximum enrollment age was 39.
Furthermore, some experts said that maybe the study could have been more accurate if it had allowed only women with miscarriages that were unrelated to chromosomal errors.
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