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Obstetrics and Gynegology2019№2
Use of micronized progesterone in...

Use of micronized progesterone in the prevention and therapy of miscarriage

DOI
https://dx.doi.org/10.18565/aig.2019.2.148-156

Ignatko I.V., Strizhakov A.N., Kuznetsov A.S., Churganova A.A., Lebedev V.A., Bogacheva N.A., Bogomazova I.M., Kardanov M.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow, Russia
The authors have carried out a systems analysis of the data available in the current literature on the features of different clinical situations and on the evaluation of the efficacy of micronized progesterone during pregravid preparation in pregnant women at high risk for reproductive losses and in those with recurrent miscarriage or threatened pregnancy termination. The current protocols using micronized progesterone have been investigated in women at high risk of preterm birth and in those with threatened early miscarriage, asymptomatic cervical shortening, or multiple pregnancy. Iprogine is one of the natural micronized progesterone preparations, which has been used to prevent early and late reproductive losses in European countries for over 20 years. The progesterone that is part of this drug is characterized by high bioavailability and proven efficacy irrespective of the route of administration (oral, intravaginal). Particular attention is paid to the neuroprotective effects of progesterone preparations in premature newborn infants; third-trimester therapy with micronized progesterone has been shown to play a role in preventing adverse neurological outcomes of preterm birth.

Keywords

recurrent miscarriage
pregravid preparation
preterm labor
neuroprotection
micronized progesterone
Full text (in Russian)

References

  1. Стрижаков А.Н., Тимохина Е.В., Игнатко И.В., Белоцерковцева Л.Д. Физиология и патология плода и плаценты. Шевченко О.С., ред. М.: ГЭОТАР-Медиа; 2015. 176с. [Strizhakov A.N., Ignatko I.V., Timokhina E.V., Belotserkovtseva L.D. M. Physiology and pathology of the fetus and placenta. M: GEOTAR-Media; 2015. 176 p. (In Russian)]
  2. Радзинский В.Е., Ордиянц И.М., Побединская О.С., Зыков Е.В. Прогестерон и репродуктивные потери. Акушерство и гинекология. 2017; 8: 109-14. http://dx.doi.org/10.18565/aig.2017.8.109-14 [Radzinsky V.E., Ordiyants I.M., Pobedinskaya O.S., Zykov E.V. Progesterone and reproductive losses. Obstetrics and gynecology. 2017; 8: 109-14. http://dx.doi.org/10.18565/aig.2017.8.109-14 (In Russian)]
  3. Стрижаков А.Н., Игнатко И.В., Федюнина И.А., Попова Ю.Ю. Прегравидарная подготовка и ведение беременности у женщин с антенатальной гибелью плода в анамнезе. Акушерство и гинекология. 2016; 4: 36-43. [Strizhakov A.N., Ignatko I.V., Fedyunina I.A., Popova Yu.Yu. Pregravid preparation and pregnancy management in women with a history of antenatal fetal death. Akusherstvo i ginekologiya/Obstetrics and Gynecology. 2016; (4): 36-43. (in Russian)] http://dx.doi.org/10.18565/aig.2016.4.36-43.
  4. Савельева Г.М., Аксененко В.А., Андреева М.Д., Базина М.И., Башмакова Н.В., Боровкова Л.В., Брюхина Е.В., Буштырева И.О., Волков В.Г., Гурьев Д.Л., Данькова И.В., Доброхотова Ю.Э., Егорова А.Т., Иванова Т.В., Константинова О.Д., Коротких И.Н., Кравченко Е.Н.,Крамарский В.А., Кулешов В.М., Лебеденко Е.Ю., Мальцева Л.И., Манухин И.Б., Мартиросян С.В., Михельсон А.Ф., Олина А.А., Пашов А.И., Рогожина И.Е., Сахаутдинова И.В., Селихова М.С., Серова О.Ф., Синчинхин С.П., Сичинава Л.Г., Тапильская Н.И., Цхай В.Б., Ярмолинская М.И.Терапия привычного выкидыша микронизированым прогестероном (результаты многоцентрового исследования ТРИСТАН-1). Акушерство и гинекология. 2017; 11: 44-55. https://dx.doi.org/10.18565/aig.2017.11.44-55. [Saveleva G.M., Aksenenko V.A., Andreeva M.D. et al. Micronized progesterone therapy of recurrent pregnancy loss (results of multicenter TRISTAN-1 study). Obstetrics and Gynecology. 2017; (11): 44-55. https://dx.doi.org/10.18565/aig.2017.11.44-55. (in Russian)]
  5. Palomba S., Santagni S., La Sala G.B. Progesterone administration for luteal phase deficiency in human reproduction: an old or new issue? J. Ovarian Res. 2015; 8: 77.
  6. Ismail A.M., Abbas A.M., Ali M.K., Amin A.F. Peri-conceptional progesterone treatment in women with unexplained recurrent miscarriage: a randomized double-blind placebo-controlled trial. J. Matern. Fetal Neonatal Med. 2018; 31(3): 388-94. https://dx.doi.org/10.1080/14767058.2017.1286315.
  7. Stephenson M.D., McQueen D., Winter M., Kliman H.J. Luteal start vaginal micronized progesterone improves pregnancy success in women with recurrent pregnancy loss. Fertil. Steril. 2016; 107(3): 684-90. e2. https://dx.doi.org/10.1016/j.fertnstert.2016.11.029.
  8. Practice Committee of the American Society for Reproductive Medicine. Current clinical irrelevance of luteal phase deficiency: a committee opinion. Fertil. Steril. 2015; 103(4): e27-32. https://dx.doi.org/10.1016/j.fertnstert.2014.12.128.
  9. Di Renzo G.C., Cabero Roura L., Facchinetti F., Helmer H., Hubinont C., Jacobsson B. et al. Preterm labor and birth management: recommendations from the European Association of Perinatal Medicine. J. Matern. Fetal Neonatal Med. 2017; 30(17): 2011-30. https://dx.doi.org/10.1080/14767058.2017.1323860.
  10. Краснопольская К.В., Горская О.С., Кабанова Д.И., Крстич Е.В. Роль гестагенов в лечении бесплодия и невынашивания беременности. Акушерство и гинекология. 2011; 2: 21-3. [Krasnopolskaya K.V., Gorskaya OS, Kabanova D.I., Krstic E.V. The role of progestin in the treatment of infertility and miscarriage. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2011;2:21-24. (in Russian)]
  11. Coomarasamy A., Williams H., Truchanowicz E., Seed P.T., Small R., Quenby S. A randomized trial of progesterone in women with recurrent miscarriages. N. Engl. J. Med. 2015; 373(22): 2141-8.
  12. Saccone G., Schoen C., Franasiak J.M., Scott R.T. Jr., Berghella V. Supplementation with progestogens in the first trimester of pregnancy to prevent miscarriage in women with unexplained recurrent miscarriage: a systematic review and meta-analysis of randomized, controlled trials. Fertil. Steril. 2017; 107(2): 430-8. e3. https://dx.doi.org/10.1016/j.fertnstert.2016.10.031.
  13. Piette P. The history of natural progesterone, the never-ending story. Climacteric. 2018; 21(4): 308-14. https://dx.doi.org/10.1080/13697137.2018.1462792.
  14. Сухих Г.Т., Баранов И.И., Мельниченко Г.А., Башмакова Н.В., Блокилл К., Гризингер Г., Ломакина А.А., Пексман-Фейз К. Lotus I: Рандомизированное III фазы контролируемое исследование сравнения пероральной формы дидрогестерона и вагинальной формы микронизированного прогестерона для поддержки лютеиновой фазы в циклах экстракорпорального оплодотворения, фокус на субанализ российской популяции. Акушерство и гинекология. 2017; 7: 75-95. [Sukhikh G.T., Baranov I.I., Melnichenko G.A., Bashmakova N.V., Blockeel C., Griesinger G., Lomakina A.A., Pexman-Fieth C. Lotus I: A Phase III randomized controlled trial of oral dydrogesterone versus micronized vaginal progesterone for luteal support in in vitro fertilization, with focus on the Russian subpopulation. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (7): 75-95. (in Russian)]
  15. Редакция. Микронизированный прогестерон в терапии невынашивания беременности. Заключение Рабочего совещания группы экспертов в рамках регионального форума «Мать и дитя». 28 июня 2017г. Проблемы репродукции. 2017; 23(3): 32-4. [Redaktsiia. Vaginal micronized progesterone in the therapy of pregnancy loss. The regional forum «Mother and child» consensus workshop, June 28, 2017. Russian Journal of Human Reproduction = Problemy reproduktsii. 2017;23(3):32-34. (in Russian)] https://doi.org/10.17116/repro201723332-34.
  16. Berghella V. Obstetrics evidence based guidelines, 2017. 3rd ed. CRC Press; 2017. 381p.
  17. FIGO Working Group On Best Practice In Maternal-Fetal Medicine; International Federation of Gynecology and Obstetrics. Best practice in maternal-fetal medicine. Int. J. Gynecol. Obstet. 2015; 128(1): 80-2. https://dx.doi.org/10.1016/j.ijgo.2014.10.011.
  18. SMFM clinical guidelines. Progesterone and preterm birth prevention: translating clinical trials data into clinical practice. Am. J. Obstet. Gynecol. 2012; 206(5): 376-86. https://dx.doi.org/10.1016/j.ajog.2012.03.010.
  19. Turgal M., Aydin E., Ozyuncu O. Effect of micronized progesterone on fetal-placental volume in first-trimester threatened abortion. J. Clin. Ultrasound. 2017; 45(1): 14-9. https://dx.doi.org/10.1002/jcu.22384.
  20. Савельева Г.М., Аксененко В.А., Андреева М.Д., Базина М.И., Башмакова Н.В.,Боровкова Л.В., Брюхина Е.В., Буштырева И.О., Волков В.Г., Гурьев Д.Л., Данькова И.В., Доброхотова Ю.Э., Егорова А.Т., Иванова Т.В., Константинова О.Д., Коротких И.Н., Кравченко Е.Н., Крамарский В.А., Кулешов В.М., Лебеденко Е.Ю., Мальцева Л.И., Манухин И.Б., Мартиросян С.В., Михельсон А.Ф., Олина А.А., Пашов А.И., Рогожина Е.И., Сахаутдинова И.В., Селихова М.С., Серова О.Ф., Синчихин С.П., Сичинава Л.Г., Тапильская Н.И., Цхай В.Б., Ярмолинская М.И. Исходы второй половины беременности у пациенток с привычным выкидышем в анамнезе (результаты многоцентрового исследования ТРИСТАН-2). Акушерство и гинекология. 2018; 8: 111-21. https://dx.doi.org/10.18565/aig.2018.8.111-121. [Savelieva G.M., Aksenenko V.A., Andreeva M.D. at al. Outcomes of the second half of pregnancy in patients with a habitual miscarriage in history (results of a multicenter study TRISTAN-2). Obstetrics and gynecology. 2018; 8: 111-21. https://dx.doi.org/10.18565/aig.2018.8.111-121. (In Russian)].
  21. Малышкина А.И., Назаров С.Б., Семененко С.С., Козелкова Е.В. Сравнительная оценка эффективности и безопасности препаратов микронизированного прогестерона в программах вспомогательных репродуктивных технологий. Акушерство и гинекология. 2018; 5: 122-6. [Malyshkina A.I., Nazarov S.B., Semenenko S.S., Kozelkova E.V. Comparative evaluation of the efficacy and safety of micronized progesterone formulations in assisted reproductive technology programs. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (5): 122-6. (in Russian)] https://dx.doi.org/10.18565/aig.2018.5.122-126.
  22. Choi S.J. Use of progesterone supplement therapy for prevention of preterm birth: review of literatures. Obstet. Gynecol. Sci. 2017; 60(5): 405-20.https://dx.doi.org/10.5468/ogs.2017.60.5.405.
  23. Trotter A., Steinmacher J., Kron M., Pohlandt F. Neurodevelopmental follow-up at five years corrected age of extremely low birth weight infants after postnatal replacement of 17-β-estradiol and progesterone. J. Clin. Endocrinol. Metab. 2012; 97(3): 1041-7.
  24. Norman J.E., Mackenzie F., Owen P., Mactier H., Hanretty K., Cooper S. et al. Progesterone for the prevention of preterm birth in twin pregnancy (STOPPIT): a randomised, double-blind, placebo-controlled study and meta-analysis. Lancet. 2009; 373(9680): 2034-40. https://dx.doi.org/10.1016/S0140-6736(09)60947-8.
  25. Cetingoz E., Cam C., Sakalli M., Karateke A., Celik C., Sancak A. Progesterone effects on preterm birth in high-risk pregnancies: a randomized placebo-controlled trial. Arch. Gynecol. Obstet. 2011; 283(3): 423-9. https://dx.doi.org/10.1007/s00404-009-1351-2.
  26. Norman J.E., Marlow N., Messow C.M., Shennan A., Bennett P.R., Thornton S. et al. Does progesterone prophylaxis to prevent preterm labour improve outcome? A randomised double-blind placebo-controlled trial (OPPTIMUM). Health Technol. Assess. 2018; 22(35): 1-304. https://dx.doi.org/10.3310/hta22350.
  27. Joshi J.T. Review on micronization techniques. J. Pharm. Sci. Technol. 2011; 3(7): 651-81.
  28. Conde-Agudelo A., Romero R., Da Fonseca E., O’Brien J.M., Cetingoz E., Creasy G.W. et al. Vaginal progesterone is as effective as cervical cerclage to prevent preterm birth in women with a singleton gestation, previous spontaneous preterm birth, and a short cervix: updated indirect comparison meta-analysis. Am. J. Obstet. Gynecol. 2018; 219(1): 10-25. https://dx.doi.org/10.1016/j.ajog.2018.03.028.
  29. O’Brien J.M., Adair C.D., Lewis D.F., Hall D.R., Defranco E.A., Fusey S. et al. Progesterone vaginal gel for the reduction of recurrent preterm birth: primary results from a randomized, double-blind, placebo-controlled trial. Ultrasound Obstet. Gynecol. 2007; 30(5): 687-96.
  30. Wood S., Ross S., Tang S., Miller L., Sauve R., Brant R. Vaginal progesterone to prevent preterm birth in multiple pregnancy: a randomized controlled trial. J. Perinat. Med. 2012; 40(6): 593-9. https://dx.doi.org/10.1515/jpm-2012-0057.
  31. Schuit E., Stock S., Rode L., Rouse D.J., Lim A.C., Norman J.E. et al. Effectiveness of progestogens to improve perinatal outcome in twin pregnancies: an individual participant data meta-analysis. BJOG. 2014;122(1): 27-37.
  32. El-refaie W., Abdelhafez M.S., Badawy A. Vaginal progesterone for prevention of preterm labor in asymptomatic twin pregnancies with sonographic short cervix: a randomized clinical trial of efficacy and safety. Arch. Gynecol. Obstet. 2015; 293(1): 61-7.
  33. Suhag A., Berghella V. What’s new in the multiple gestations literature? J. Perinat. Med. 2018; 46(8): 823-24. https://dx.doi.org/10.1515/jpm-2018-0304.
  34. Ashoush S., El-Kady O., Al-Hawwary G., Othman A. The value of oral micronized progesterone in the prevention of recurrent spontaneous preterm birth: a randomized controlled trial. Acta Obstet. Gynecol. Scand. 2017; 96(12): 1460-6. https://dx.doi.org/10.1111/aogs.13236.
  35. Whitaker-Azmitia P.M., Lobel M., Moyer A. Low maternal progesterone may contribute to both obstetrical complications and autism. Med. Hypotheses. 2014; 82(3): 313-8.
  36. Dodds L., Fell D.B., Shea S., Armson B.A., Allen A.C., Bryson S. The role of prenatal, obstetric and neonatal factors in the development of autism. J. Autism Dev. Disord. 2011; 41(7): 891-902.
  37. Tomic V., Tomic J., Klaic D.Z., Kasum M., Kuna K. Oral dydrogesterone versus vaginal progesterone gel in the luteal phase support: randomized controlled trial. Eur. J. Obstet. Gynecol. Reprod. Biol. 2015; 186: 49-53. https://dx.doi.org/10.1016/j.ejogrb.2014.11.002.

Received 15.02.2019

Accepted 22.02.2019

About the Authors

Ignatko, Irina V., MD, corresponding member of the Russian Academy of Sciences, professor of the Russian Academy of Sciences, professor of the Department of Obstetrics, Gynecology and Perinatology, Faculty of Medicine, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation
(Sechenov University). 119991, Russia, Moscow, Trubetskaya str. 8-2. Tel.: +74997823045. E-mail: iradocent@mail.ru
Strizhakov, Alexander N., MD, academician of the Russian Academy of Sciences, professor, head of the Department of Obstetrics, Gynecology and Perinatology,
Faculty of Medicine, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University).
119991, Russia, Moscow, Trubetskaya street, 8-2. Tel.: +74997823045. E-mail: kafedra-agp@mail.ru
Kuznetsov, Anton S., post-graduate student of the Department of Obstetrics, Gynecology and Perinatology, Faculty of Medicine, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University).
119991, Russia, Moscow, Trubetskaya street, 8-2. Tel.: +74997823045. E-mail: kafedra-agp@mail.ru
Churganova, Anastasia A., PhD, assistant professor of the Department of Obstetrics, Gynecology and Perinatology, Faculty of Medicine, I.M. Sechenov First Moscow
State Medical University of the Ministry of Health of the Russian Federation (Sechenov University).
119991, Russia, Moscow, Trubetskaya str. 8-2. Tel.: +74997823045. E-mail: kafedra-agp@mail.ru
Lebedev, Vladimir A., MD, professor of the Department of Obstetrics, Gynecology and Perinatology, Faculty of Medicine, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University). 119991, Russia, Moscow, Trubetskaya str. 8-2. Tel.: +74997823045. E-mail: iradocent@mail.ru
Bogacheva, Natalia A., PhD, assistant Professor of the Department of Obstetrics, Gynecology and Perinatology, Faculty of Medicine, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University).
119991, Russia, Moscow, Trubetskaya str. 8-2. Tel.: +74997823045. E-mail: kafedra-agp@mail.ru
Bogomazova, Irina M., PhD, docent of the Department of Obstetrics, Gynecology and Perinatology, Faculty of Medicine, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University). 119991, Russia, Moscow, Trubetskaya str. 8-2. Tel.: +74997823045. E-mail: kafedra-agp@mail.ru
Kardanova, Madina A., PhD, assistant Professor of the Department of Obstetrics, Gynecology and Perinatology, Faculty of Medicine, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University).
119991, Russia, Moscow, Trubetskaya str. 8-2. Tel.: +74997823045. E-mail: kafedra-agp@mail.ru

For citations: Ignatko I.V., Strizhakov A.N., Kuznetsov A.S., Churganova A.A., Lebedev V.A., Bogacheva N.A., Bogomazova I.M., Kardanova M.A. Use of micronized progesterone in the prevention and therapy of miscarriage. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2019; (2): 148-56. (in Russian)
http://dx.doi.org/10.18565/aig.2019.2.148-156

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