Women with pregnancy losses may benefit from progesterone

NEW HAVEN » The hormone progesterone, given shortly after ovulation, could result in a successful birth for women who have suffered multiple losses in early pregnancy, according to research at the Yale School of Medicine and the University of Illinois at Chicago.

As many as one in four women suffer a first-trimester loss at least once, but the study focused on women who lose their fetus during every pregnancy, according to a press release.

An endometrial function test, created by study co-author Dr. Harvey J. Kliman, was used to determine whether the lining of the uterus, called the endometrium, is healthy enough to support a pregnancy.

“The endometrium feeds the baby up until the eighth week of pregnancy. Then at nine to 10 weeks the mother’s blood takes over to feed the embryo,” Kliman said in the release. He is director of the Reproductive and Placental Research Unit in the medical school’s Department of Obstetrics, Gynecology and Reproductive Sciences.

An abnormal endometrial function test predicts a pregnancy loss, showing that the fetus is not getting the nutrients it needs to develop. In the study, 116 women who had had two or more pregnancy losses were given progesterone derived from plants, the release said.

“In this subset of women experiencing multiple early miscarriages, we assume that their embryos were literally starving to death,” Kliman said. “They attached, but they were not getting enough food. When we give progesterone back to these women, the endometrium makes more nutrients and prevents their pregnancy loss.”

“We are very pleased to find that these results reinforce the evidence that progesterone could be a very beneficial, inexpensive, and safe treatment for many women with a history of recurrent pregnancy loss,” said the lead author, Dr. Mary Stephenson, director of the University of Illinois Recurrent Pregnancy Loss Program.

“The positive results show us that next we need to study progesterone as a treatment for recurrent pregnancy loss with a prospective randomized trial to validate the findings,” she said in the release.

The study was published Monday in Fertility & Sterility, the international journal of the American Society for Reproductive Medicine.