Delgado, G., & Davenport, M. L. (2012). Progesterone use to reverse the effects of mifepristone. The Annals of Pharmacotherapy, 46(12), e36. https://doi.org/10.1345/aph.1R252
Delgado G, Davenport ML. Progesterone use to reverse the effects of mifepristone. Ann Pharmacother. 2012;46(12):e36. doi:10.1345/aph.1R252
Delgado, George, and Mary L. Davenport. "Progesterone use to reverse the effects of mifepristone." The Annals of Pharmacotherapy, vol. 46, no. 12, 2012, pp. e36.
Progesterone after mifepristone preceded 4 term births in 6 women
Four of 6 women who took mifepristone and then received progesterone delivered healthy term newborns. All six had asked for reversal. Physicians trained in NaProTECHNOLOGY gave the progesterone. None had taken misoprostol when progesterone began.
Study at a glance, case series of six women: Four of 6 women given progesterone after mifepristone delivered term newborns. Source: Delgado G et al., 2012, PMID 23191936.
Key Findings
Six women who took mifepristone and then sought reversal received progesterone. A seventh patient was lost to follow-up.
Four of the 6 women delivered healthy term newborns. In those four, the authors noted no untoward effects of progesterone and no birth defects.
Two abortions occurred: one soon after the first progesterone dose, with incomplete data, and one in a woman whose live embryo was not documented.
No woman had taken misoprostol when progesterone began. In the four who delivered, the first progesterone dose came 30 to 72 hours after mifepristone, at 7 to 11 weeks of gestation.
A PubMed search from 1996 to May 2012 found no trials or case studies on progesterone to reverse mifepristone.
Interpretation
This case series followed six women who took mifepristone, then asked for reversal and received progesterone. Four of the six went on to deliver healthy term newborns, with no untoward effects or birth defects noted in those pregnancies. The findings support larger studies of progesterone reversal after mifepristone.
RRM Context
The treating physicians trained in NaProTECHNOLOGY at the Pope Paul VI Institute. Their rationale is receptor biology: progesterone competes with mifepristone at the progesterone receptor. The paper cites FDA trials in which an ongoing living embryo after mifepristone ranged from less than 1% before 49 days to 9% at 57-63 days.
Our editorial summary of this paper, not the article's abstract.
Abstract
Objective
To present a series of cases demonstrating successful reversal of mifepristone effects in women who chose to reverse the medical abortion process.
Case Report
Four of 6 women who took mifepristone were able to carry their pregnancies to term after receiving intramuscular progesterone 200 mg.
Discussion
Mifepristone has been available in the US since 2000. By 2008, approximately 25% of abortions prior to 9 weeks were accomplished with mifepristone. Some women who take mifepristone wish to reverse the medical abortion process. Progesterone competes with mifepristone for the progesterone receptor and may reverse the effects of mifepristone. A PubMed literature search from 1996 to May 2012 did not reveal any trials or case studies evaluating the efficacy of progesterone use to reverse the effects of mifepristone.
Conclusions
Health care professionals should be aware of the possible use of progesterone to reverse mifepristone in women who have begun the medical abortion process by taking mifepristone and then change their minds.
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