Swyer, G. I., & Daley, D. (1953). Progesterone implantation in habitual abortion. British Medical Journal, 1(4819), 1073-1077. https://doi.org/10.1136/bmj.1.4819.1073
Swyer GI, Daley D. Progesterone implantation in habitual abortion. Br Med J. 1953;1(4819):1073-1077. doi:10.1136/bmj.1.4819.1073
Swyer, G. I., and D. Daley. "Progesterone implantation in habitual abortion." British Medical Journal, vol. 1, no. 4819, 1953, pp. 1073-1077.
Live births occurred in 80% with progesterone implants and 75% without
In a 1953 controlled study of 113 women with repeated miscarriage, 80 out of 100 women given progesterone implants had live births. The comparison group received no specific therapy, and 75 out of 100 had live births.
Key Findings
Among 113 women with two or more consecutive miscarriages, live birth followed in 80% of 60 women given progesterone implants and 75% of 53 given no specific therapy (P>0.7).
Among 47 women with three or more consecutive miscarriages, live birth followed in 74% of 27 treated women and 55% of 20 controls, again not statistically significant (P>0.2).
The authors report that control-group rates of 75% and 55% were far higher than the calculations of Eastman and Malpas predicted, and they criticize those calculations.
Across 355 pregnanediol determinations, a urinary marker of progesterone metabolism, women with repeated miscarriage showed no evidence of lower output than unselected antenatal patients, or of higher output after implantation.
A late fall in pregnanediol output appeared in seven of 18 controls and six of 18 implanted women with serial assays, and many miscarriages occurred with apparently adequate output.
Interpretation
This controlled clinical series followed 113 women with repeated miscarriage at two hospitals. Women got progesterone implants or no specific therapy, assigned by alternation at one hospital and at random at the other. Women with a known cause, such as a uterine malformation, were excluded first. Progesterone was given as implanted pellets. The authors note that control women got no inert implant. The findings support larger studies of progesterone support in repeated miscarriage.
RRM Context
Restorative reproductive medicine looks for the cause of repeated miscarriage in each couple. In this study, miscarriages happened with and without signs of low progesterone. The authors named egg defects as another possible cause, and they concluded low progesterone was a likely cause of some losses. NaProTechnology, a restorative method, checks the luteal phase through cycle charting. It times progesterone support to the charted cycle.
Our editorial summary of this paper, not the article's abstract.
