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One study seems to support progesterone treatment to help prevent miscarriage in patients who suffer recurrent miscarriage, which may be caused by Luteal Phase Defect.
Though most treatments for miscarriage remain scientifically unproven, one study seems to support the benefits of progesterone supplementation for treating recurrent miscarriage. Progestogen for Preventing Miscarriage ,conducted by D.M. Haas and P.S Ramsey (Cochrane Database of Systematic Reviews. 2008. Issue 2), demonstrated an increase in the rate of successful pregnancies among the treated group of women who had suffered recurrent loss. Conditions Requiring Progesterone SupplementationHaas’s and Ramsey’s study suggests the support of progesterone treatment in women who suffer recurrent miscarriage. However, a woman who has not been diagnosed with recurrent loss may seek testing for certain conditions which are connected with repeated miscarriage. Some proposed conditions, such as embryo toxicity and natural killer cells, are unproven and controversial. The primary condition linked to progesterone supplementation is Luteal Phase Defect, a condition in which the endometrium is not sufficiently prepared for implantation and support of the embryo. Understanding Luteal Phase DefectThe Luteal Phase occurs between ovulation and menstruation. In a normal cycle:
During the luteal phase, which should last approximately 14 days, the corpus luteum secretes progesterone. Progesterone, along with estrogen, prepares the endometrium (the lining of the uterus) for the implantation of the embryo. In a woman with LPD, a problem may occur at any stage with the follicle, the developed corpus luteum, or the endometrium. Miscarriage, then, is presumably caused by the failure of the embryo to implant, improper implantation of the embryo or unsuitable nourishment of the growing embryo and fetus. Diagnosis of LPDSymptoms of LPD are generally disguised, since a woman with LPD can have regular menstrual cycles. It is during attempts at conception that most women discover the disorder. Inconsistent basal body temperatures after ovulation are one symptom linked to LPD. Women who do not chart basal body temperatures may not discover the condition until they have had repeated miscarriages. Testing for LPDThere are many ways doctors can test for LPD. A specialist may request
How and When Progesterone is TakenUpon the diagnosis of LPD, a patient may be given a prescription for progesterone supplementation, such as Crinone or Prometrium. Depending on the brand, the supplements may be taken orally or inserted vaginally. Miscarriage prevention seems to be unaffected by the brand or route of administration. However, it is essential that the supplementation begin at or just after ovulation and continue up to the 10th or 12th week of pregnancy. Additional Research NecessaryMany specialists have testimonies to support the success of progesterone treatment for miscarriage. The Haas and Ramsey study seems to support the benefits of this treatment. However, more studies need to be conducted before the scientific community will accept progesterone supplementation as a valid treatment for recurrent loss. In addition, more research needs to be conducted involving the causes of miscarriage, such as Luteal Phase Defect and the more controversial theories. Additional Resources on Luteal Phase Defect:
The copyright of the article Miscarriage Prevention in Fertility Treatment Types is owned by Kristen O'Hara. Permission to republish Miscarriage Prevention in print or online must be granted by the author in writing.
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