“…Progesterone—which rises throughout human pregnancy before dipping slightly prior to parturition—is a keystone pacemaker for pregnancy [ 51 , 125 , 185 ]. Progesterone influences the pregnancy timeline through its immunomodulatory activity, which is mediated via four main mechanisms: (1) direct communication with immune cells via its nuclear receptors, progesterone receptor (PR)-B and PR-A, (2) signaling through its membrane progesterone receptors (mPR), (3) promiscuous binding to the glucocorticoid receptor, and/or (4) inducing transcription of the paracrine hormone Progesterone Induced Blocking Factor (PIBF) [ 10 , 12 , 14 , 15 , 92 , 122 , 132 , 172 ]. Although progesterone’s role in the immune system remains an area of investigation, the general consensus is that, at least up until the time of parturition, progesterone is a critical factor in the maintenance of an immunotolerant state and of myometrial quiescence.…”