ABSTRACT
Chapters 14 and 15 have debated whether progesterone supplementation should be used in RPL. The theoretical basis, diagnosis of luteal deficiency and immunological actions of progesterone have been discussed. However, there are numerous progestogens available, and the reader may be in a quandary over which progestogen to prescribe, if at all. This chapter will try to assess the different types of progesterone and the evidence (or lack) of effect. Progestogen supplementation is used as a treatment for a presumed maternal cause of pregnancy loss, that is, luteal deficiency. Chapters 3, 11, and 12 have described the embryonic causes of RPL. 40% of recurrent miscarriages are due to chromosomal aberrations which are incompatible with life. It is against this background that the effect of progesterone has to be assessed. The relative merits of the different progestogens should be based on efficacy data and possible maternal and fetal side effects.
