Using progesterone before pregnancy may help prevent miscarriage

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 Photo: Getty Images

Lauren was 27 when she had her first miscarriage. Over the next few years, she went on to have two more miscarriages.

"My third was the hardest," says the 31-year-old from NSW.

"I was devastated and depressed that I couldn't do the number one thing my body was built to do."

Now new research, published in Fertility and Sterility online in January this year, may provide hope for women like Lauren who've suffered recurrent miscarriages.

The research found that 2/3 of women who used the hormone progesterone before getting pregnant went on to successfully deliver babies – despite these women having had at least two previous miscarriages.

This topic has been explored before, says obstetrician Dr Joseph Sgroi, from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG).

He says the biggest study on the topic involved 15 trials and over 2000 women, and showed that the risk of miscarriage wasn't reduced if progesterone was commenced at the start of pregnancy.

This study is different, though, because the women started progesterone soon after they ovulated – so even before they were pregnant.

Dr Sgroi says there might be compelling reasons to start progesterone at that time, as it may affect your immune system and allow pregnancy tissue to more easily go into the uterus.

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"Therefore the possibility exists that if progesterone is commenced early enough it may prevent miscarriage – but only if this is the primary reason why miscarriages are occurring."

And therein lies the key.

While some women may benefit from progesterone, Dr Sgroi says the difficulty is understanding which women they are.

That's because there is no standard test that can determine who will benefit from its use.

So should you ask your doctor if you should try it?

That depends, says Dr Sgroi.

While he says it's devastating to suffer a miscarriage, those who have had one miscarriage don't need further investigations or treatment.

He says miscarriages are unfortunately very common, and that most of them occur as "nature's way of preventing a pregnancy that would not continue to term, often as a result of major chromosomal abnormalities".

So if you've had one miscarriage, he says the best thing you can do is to simply start trying again (as soon as you and your partner are ready).

In fact, he says a recent study showed a 70 per cent increased chance of having a successful pregnancy if you conceive within three months of a miscarriage.

But if you've had two or more miscarriages, Dr Sgroi recommends seeking advice to see if there's a reason why they happened.

Those reasons could include structural abnormalities of the uterus (such as fibroids, or a uterine septum), genetic abnormalities, hormonal, clotting or immune issues.

You could also then talk to your doctor about using progesterone.

"There is no doubt further evidence will become available as more research is done in this important area," Dr Sgroi notes.

As for Lauren, she was referred to a fertility specialist after her third miscarriage.

While her doctor didn't recommend progesterone, Lauren fell pregnant again and is thrilled to report she is currently 16 weeks along and her doctor says everything's "looking good".

Had she been offered it, Lauren says she would have gladly used progesterone in the hopes it may have spared her the "heartbreak" she's been through.

She hopes this new research may prevent other mums from going through the same pain she experienced.

"I would not wish a miscarriage on anyone."