Progesterone: No Help for Recurrent Miscarriage

Progesterone therapy may not improve unexplained recurrent miscarriage outcomes

/ Author:  / Reviewed by: Jennifer Gershman, PharmD, CPh

(RxWiki News) In the search for an effective treatment for recurrent miscarriage, one option appears to have fallen short.

In one of the first studies to provide an answer to more than 60 years of uncertainty, a team of researchers from the UK found that progesterone therapy did not improve outcomes for women with unexplained recurrent miscarriage (URM). URM is a condition in which a woman has three or more clinical pregnancy losses (miscarriages) before she completes her first trimester.

Although the results of the PROMISE trial may be disappointing to many, this finding may allow researchers to direct their efforts toward exploring more helpful treatment options for URM.

"We had hoped, like many people, that this research would confirm progesterone as an effective treatment," said lead study author Arri Coomarasamy, MD, a professor of gynecological studies at the University of Birmingham, in a press release. "Though disappointing, it does address a question that has remained unanswered since progesterone was first proposed as a treatment back in 1953. Fortunately, there are a number of other positives that we can take from the trial as a whole."

Progesterone (brand name Prometrium and others) is a hormone produced in the ovaries that plays a role in maintaining pregnancy.

For this study, Dr. Coomarasamy and team looked at 836 women with a history of URM who conceived naturally within one year of the study's start. These women were randomly assigned to receive either progesterone or a placebo.

These researchers found that the women given progesterone in their first trimester were no less likely to miscarry than those given placebo. This was true regardless of age, ethnicity, and medical and pregnancy history.

Nearly two-thirds of these women did have babies, however. The rate of live births was 65.8 percent in the progesterone group and 63.3 percent in the placebo group.

No significant differences in the rate of adverse events was found between the two groups.

This study was published Nov. 25 in The New England Journal of Medicine.

The National Institute for Health Research funded this research. Information on conflicts of interest was not available at the time of publication.

Review Date: 
November 24, 2015
Last Updated:
November 30, 2015