Recurrent Miscarriages and Progesterone Deficiency
Having one miscarriage can be a tragic event for a couple to experience. Currently, 3 miscarriages must occur for the woman to be diagnosed with recurrent miscarriages, and a proper work up is completed. This is a tragedy in and of itself. What other medical condition requires 3 major events before a proper assessment is initiated?
I have now been been working with couples struggling to conceive or to maintain pregnancies for the past 19 years. I will initiate a comprehensive work up for my patients even after their first miscarriage.
There are many factors to consider when assessing recurrent miscarriages. For example, the inadequate secretion of progesterone in early pregnancy has been proposed as a cause of recurrent miscarriages.
Progesterone maintains early pregnancy, and is mainly secreted by the corpus luteum during pregnancy.1,2 Insufficient progesterone secretion and delayed endometrial development at the time of implantation, or during early pregnancy, may occur naturally or due to luteal phase defect. This deficiency of progesterone has been implicated as a cause of sporadic and recurrent miscarriages. 3,4,5
As with most complex medical issues, the data concerning the role of progesterone in miscarriage patients is conflicting. However in my clinical experience, it’s evaluation and therapeutic use when indicated, has aided many women complete healthy pregnancies to term.
- Arredondo F, Noble LS. Endocrinology of recurrent pregnancy loss. Semin Reprod Med. 2006;24:33–9. [PubMed]
- Di Renzo GC, Mattei A, Gojnic M, Gerli S. Progesterone and pregnancy. Curr Opin Obstet Gynecol. 2005;17:589–600. [PubMed]
- Insler V. Corpus luteum defects. Curr Opin Obstet Gynecol. 1992;4:203–11. [PubMed]
- Daya S. Issues in the etiology of recurrent spontaneous abortion. Curr Opin Obstet Gynecol. 1994;6:153–9. [PubMed]
- Daya S. Efficacy of progesterone support for pregnancy in women with recurrent miscarriage. A meta-analysis of controlled trials. Br J Obstet Gynaecol. 1989;96:275–80. [PubMed]