Progestagen therapy for recurrent miscarriage

Abstract

Standardized laboratory protocols for identifying potential targets of progestogen treatment as well as implementation of well-designed randomized studies are needed to establish the usefulness of progesterone supplementation in the treatment of RM.

Recurrent miscarriages: What is the role of cytokines?

“…Recurrent miscarriage is defined as three or more consecutive miscarriages before 20 weeks of gestation [1,2]. This condition is a frequent reproductive problem worldwide, affecting up to 1% of couples [3,4].…”

“…Maternal underlying mechanisms include uterine pathology, endocrine dysfunction, thrombophilias and antiphospholipid syndrome [7]. Genetic or developmental abnormalities in the fetus can also contribute to recurrent miscarriage [1]. However, up to 50% of cases are idiopathic [1].…”

“…Genetic or developmental abnormalities in the fetus can also contribute to recurrent miscarriage [1]. However, up to 50% of cases are idiopathic [1].…”

Recurrent pregnancy loss

“…Progesteron endometriumda morfolojik ve fizyolojik değişiklikleri başlatarak, implantasyonun pencere döneminde (LH surge'nden 5-10 gün sonra) embiryonun implantasyonu için uygun bir ortam sağlamış olur. Ayrıca progesteron stromal hücre fonksiyonunun regülasyonunda plasentalmaternal yüzeyde çeşitli sitokin, mediatör ve proteinlerin de regülasyonunda rol oynamaktadır (11,12). Progestron gebelikte corpus luteumdan salgılanmaya başlar ve gebeliğin ilerleyen dönemlerinde plasenta bu görevi üstlenir.…”

Hormonal causes of recurrent pregnancy loss (RPL)

“…6 There is evidence that Th2 cytokines favour normal pregnancy, while an excess of Th1 cytokines leads to pregnancy termination. 7 In particular, in the presence of progesterone, the lymphocytes of pregnant women release a 35 kD protein named the progesterone-induced blocking factor (PIBF), which in turn alters the profile of cytokine secretion of activated lymphocytes shifting the balance towards Th2 dominance.…”