Tommy’s research helps inform national guidance around progesterone treatment to prevent early miscarriage

National guidelines will now include recommendations to use hormone progesterone in the treatment of miscarriage which could lead to 8,450 more births each year.

Today, we welcome the news that the National Institute for Health and Care Excellence (NICE) has recommended the use of progesterone to help prevent early miscarriage. 

The new guidance comes after researchers at our National Centre for Miscarriage Research published findings from their clinical trial, PRISM, in 2019. This study looked at using progesterone – a natural hormone produced during pregnancy that helps prepare the body for a growing baby – as a treatment to prevent miscarriage. 

One of the key findings showed how taking daily progesterone can help give those with early pregnancy bleeding and a history of miscarriage the best chance of carrying a baby to term.

PRISM studied 4,153 women who experienced early pregnancy bleeding at 48 hospitals in the UK. Of those, around half were given progesterone pessaries (400mg) to take until 16 weeks into their pregnancy, and the other half were given dummy tablets. The results found a 5% increase in the number of babies born to those given progesterone, who had previously had one or more miscarriages, compared to those given a placebo. The benefit was even greater for the women who had experienced recurrent miscarriages with a 15% increase in the live birth rate.

Until now, many families have found it difficult to get progesterone, despite our research and the evidence of its benefits to certain pregnant people. This is because healthcare professionals can be reluctant to prescribe treatments which aren’t recommended under national guidelines. We’re hopeful this new guidance from NICE, based on the findings of our research, will mean more parents get the help they need, when they need it. 

Professor Arri Coomarasamy, Director of Tommy’s National Centre for Miscarriage Research at the University of Birmingham, said:

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“The miscarriage care guidelines from NICE include a very welcome change, after many years researching the use of progesterone and working to make treatment more accessible. 

“Our research has shown that progesterone is a robust and effective treatment option, which could prevent 8,450 miscarriages a year in the UK – but we know it’s not yet reaching everyone who might benefit. This recommendation from NICE is an important step in tackling the current variation in miscarriage services across the country and preventing these losses wherever possible.”

Find out more about the ongoing work at our National Centre for Miscarriage Research.

UPDATE  19/09/2023: This research has led to NICE recommending progesterone for women who have had 1 or more previous miscarriages and are bleeding in early pregnancy. Read more here about how you can access progesterone if you are having bleeding.