Kaya Burgess

The Times

Gerry Gajadharsingh writes:

“Progesterone supplementation is back on the agenda 8 years after NICE rejected it as part of treatment for recurrent miscarriage. In 2012 it decided that “the evidence was insufficient to recommend the use of progesterone” in such cases.

 However, this latest research suggests that it is being reconsidered for women who have had at least one miscarriage.

 Progesterone, a steroid hormone (made from cholesterol, sometimes cholesterol is not bad for you!), is important for maintaining the placenta after a fertilised egg has been implanted. Progesterone is released from the Corpus Luteum (the yellow hormone secreting body formed in the ovary during ovulation at the site of a matured follicle), the placenta and the adrenal glands. There is significant interaction between many hormones in the body and optimum hormone production is a very delicate and complex process.

 Dr Adam Devall, a fellow at the University of Birmingham and manager of Tommy’s National Centre for Miscarriage Research, the bodies that led the research, said the new studies showed a “small but positive treatment effect (of progesterone supplementation) depending on the number of previous miscarriages”.

Fertility is a complex process and adequate levels of progesterone just one part of that process.

 Idiopathic (medically unexplained) sub-fertility, affects at least 30% of couples trying to conceive.

 For further information on natural intervention to help sub-fertility please go to

https://www.thehealthequation.co.uk/fertility-treatments/”

More than 8,000 miscarriages a year could be prevented by treating high-risk women with a hormone, scientists have claimed.

Researchers said that women who have had at least one miscarriage should be given twice-daily doses of progesterone, a naturally-occurring hormone that can be taken at home if they show any signs of bleeding during the early stages of a pregnancy.

They estimate that this process would prevent 8,450 miscarriages per year and said it would cost just £240 per pregnancy, calling on the NHS to adopt it as policy.

National Institute for Health and Care Excellence (Nice), the regulator, said yesterday that it is re-examining its guidelines and will “consider new evidence on progesterone in treating threatened miscarriage”. In 2012 it decided that “the evidence was insufficient to recommend the use of progesterone” in such cases.

The NHS estimates that one in eight pregnancies ends in miscarriage, likely to be about 91,000 miscarriages in the UK each year. It recorded 36,154 miscarriages in 2018/19, but these are only cases that resulted in a hospital stay.

The results of two trials have been published today in the American Journal of Obstetrics and Gynecology looking at the effect of giving progesterone to women who experience “early pregnancy bleeding”.

The first, called Promise, examined 836 women with recurrent miscarriages at 45 British and Dutch hospitals and found that giving them progesterone led to a 3 per cent increase in live births. The second, called Prism, involved 4,153 women at 48 hospitals in the UK and found that giving progesterone to women who had had one or more previous miscarriage led to a 5 per cent increase in the number of babies compared with a group of similar women who were given a placebo. For women who had had three or more miscarriages, there was a 15 per cent increase in birth rate.

Dr Adam Devall, a fellow at the University of Birmingham and manager of Tommy’s National Centre for Miscarriage Research, the bodies that led the research, said the new studies showed a “small but positive treatment effect depending on the number of previous miscarriages”.

Dr Pat O’Brien, vice-president of the Royal College of Obstetricians and Gynaecologists, said the study did not show any benefit for women with no prior history of miscarriage, but said of women at high risk due to previous miscarriages: “This treatment offers an increased chance of a successful birth and appears to be cost effective for the NHS, so we hope NICE will consider this important research in their next update of the guidance.”

A Nice spokeswoman said: “We are currently updating our guideline on the diagnosis and initial management of ectopic pregnancy and miscarriage to consider new evidence on progesterone in treating threatened miscarriage.”

The Miscarriage Association said it would support the treatment for women who had had one or two miscarriages.