Tom 8, Nr 2 (2023)
Wytyczne / stanowisko ekspertów
Opublikowany online: 2023-06-16
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Eksport do Mediów Społecznościowych

Eksport do Mediów Społecznościowych

Stanowisko Ekspertów Polskiego Towarzystwa Ginekologów i Położników dotyczące stosowania produktów leczniczych zawierających progesteron mikronizowany: Progesterone Besins 100 mg i 200 mg (stosowany doustnie) oraz Utrogestan 200 mg (stosowany dopochwowo)

Piotr Laudański123, Grzegorz Jakiel4, Rafał Kurzawa5, Robert Spaczyński6, Mariusz Zimmer7, Piotr Sieroszewski8
Ginekologia i Perinatologia Praktyczna 2023;8(2):129-135.



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  1. Norwitz ER, Schust DJ, Fisher SJ. Implantation and the survival of early pregnancy. N Engl J Med. 2001; 345(19): 1400–1408.
  2. Coomarasamy A, Gallos ID, Papadopoulou A, et al. Sporadic miscarriage: evidence to provide effective care. Lancet. 2021; 397(10285): 1668–1674.
  3. EPPPIC Group. Evaluating progestogens for preventing preterm birth international collaborative (EPPPIC): meta-analysis of individual participant data from randomized controlled trials. Obstetric Anesthesia Digest. 2022; 42(1): 36–37.
  4. Szekeres-Bartho J, Halasz M, Palkovics T. Progesterone in pregnancy; receptor-ligand interaction and signaling pathways. J Reprod Immunol. 2009; 83(1-2): 60–64.
  5. Czajkowski K, Sienko J, Mogilinski M, et al. Uteroplacental circulation in early pregnancy complicated by threatened abortion supplemented with vaginal micronized progesterone or oral dydrogesterone. Fertil Steril. 2007; 87(3): 613–618.
  6. Piette PCM. The pharmacodynamics and safety of progesterone. Best Pract Res Clin Obstet Gynaecol. 2020; 69: 13–29.
  7. Piette P. The history of natural progesterone, the never-ending story. Climacteric. 2018; 21(4): 308–314.
  8. Schindler AE, Campagnoli C, Druckmann R, et al. Classification and pharmacology of progestins. Maturitas. 2003; 46 Suppl 1: S7–SS16.
  9. Stanczyk FZ, Hapgood JP, Winer S, et al. Progestogens used in postmenopausal hormone therapy: differences in their pharmacological properties, intracellular actions, and clinical effects. Endocr Rev. 2013; 34(2): 171–208.
  10. Romero R, Stanczyk FZ. Progesterone is not the same as 17α-hydroxyprogesterone caproate: implications for obstetrical practice. Am J Obstet Gynecol. 2013; 208(6): 421–426.
  11. Laudański P. Poronienie. In: Bręborowicz GH. ed. Położnictwo i ginekologia. T. 1. PZWL, Warszawa 2020: 81–88.
  12. Larsen EC, Christiansen OB, Kolte AM, et al. New insights into mechanisms behind miscarriage. BMC Med. 2013; 11: 154.
  13. Coomarasamy A, Devall AJ, Brosens JJ, et al. Micronized vaginal progesterone to prevent miscarriage: a critical evaluation of randomized evidence. Am J Obstet Gynecol. 2020; 223(2): 167–176.
  14. Gameiro S, Sousa-Leite M, Vermeulen N, et al. ESHRE Guideline Group on RPL. ESHRE guideline: recurrent pregnancy loss. Hum Reprod Open. 2018; 2018(2): hoy004.
  15. Quenby S, Gallos ID, Dhillon-Smith RK, et al. Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss. Lancet. 2021; 397(10285): 1658–1667.
  16. van Oppenraaij RHF, Jauniaux E, Christiansen OB, et al. ESHRE Special Interest Group for Early Pregnancy (SIGEP). Predicting adverse obstetric outcome after early pregnancy events and complications: a review. Hum Reprod Update. 2009; 15(4): 409–421.
  17. Coomarasamy A, Williams H, Truchanowicz E, et al. A Randomized Trial of Progesterone in Women with Recurrent Miscarriages. N Engl J Med. 2015; 373(22): 2141–2148.
  18. Coomarasamy A, Devall AJ, Cheed V, et al. A randomized trial of progesterone in women with bleeding in early pregnancy. N Engl J Med. 2019; 380(19): 1815–1824.
  19. Okeke Ogwulu CB, Goranitis I, Devall AJ, et al. The cost-effectiveness of progesterone in preventing miscarriages in women with early pregnancy bleeding: an economic evaluation based on the PRISM trial. BJOG. 2020; 127(6): 757–767.
  20. Devall AJ, Papadopoulou A, Podesek M, et al. Progestogens for preventing miscarriage: a network meta-analysis. Cochrane Database Syst Rev. 2021; 4(4): CD013792.
  21. Devall AJ, Coomarasamy A. Sporadic pregnancy loss and recurrent miscarriage. Best Pract Res Clin Obstet Gynaecol. 2020; 69: 30–39.
  22. Devall AJ, Papadopoulou A, Podesek M, et al. Progestogens for preventing miscarriage: a network meta-analysis. Cochrane Database Syst Rev. 2021; 4(4): CD013792.
  23. Stephenson MD, McQueen D, Winter M, et al. Luteal start vaginal micronized progesterone improves pregnancy success in women with recurrent pregnancy loss. Fertil Steril. 2017; 107(3): 684–690.e2.
  24. Haas DM, Hathaway TJ, Ramsey PS. Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology. Cochrane Database Syst Rev. 2018; 10(10): CD003511.
  25. Coomarasamy A, Dhillon-Smith RK, Papadopoulou A, et al. Recurrent miscarriage: evidence to accelerate action. Lancet. 2021; 397(10285): 1675–1682.
  26. Bosch E, Broer S, Griesinger G, et al. The Eshre Guideline Group On Ovarian Stimulation. ESHRE guideline: ovarian stimulation for IVF/ICSI†. Human Reproduction Open. 2020; 2020(2).
  27. van der Linden M, Buckingham K, Farquhar C, et al. Luteal phase support for assisted reproduction cycles. Cochrane Database Syst Rev. 2015; 2015(7): CD009154.
  28. Vaisbuch E, de Ziegler D, Leong M, et al. Luteal-phase support in assisted reproduction treatment: real-life practices reported worldwide by an updated website-based survey. Reprod Biomed Online. 2014; 28(3): 330–335.
  29. Shoham G, Leong M, Weissman A. A 10-year follow-up on the practice of luteal phase support using worldwide web-based surveys. Reprod Biol Endocrinol. 2021; 19(1): 15.
  30. Di Guardo F, Midassi H, Racca A, et al. Luteal phase support in IVF: comparison between evidence-based medicine and real-life practices. Front Endocrinol (Lausanne). 2020; 11: 500.
  31. Labarta E, Rodríguez C. Progesterone use in assisted reproductive technology. Best Pract Res Clin Obstet Gynaecol. 2020; 69: 74–84.
  32. Mohammed A, Woad KJ, Mann GE, et al. Evaluation of progestogen supplementation for luteal phase support in fresh in vitro fertilization cycles. Fertil Steril. 2019; 112(3): 491–502.e3.
  33. Figo Working Group On Best Practice In Maternal-Fetal Medicine, International Federation of Gynecology and Obstetrics. Best practice in maternal-fetal medicine. Int J Gynaecol Obstet. 2015; 128(1): 80–82.
  34. Romero R, Conde-Agudelo A, Fonseca EDa, et al. Vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix: a meta-analysis of patient data. Am J Obstet Gynecol. 2018; 218(2): 161–180.
  35. Jarde A, Lutsiv O, Beyene J, et al. Vaginal progesterone, oral progesterone, 17-OHPC, cerclage, and pessary for preventing preterm birth in at-risk singleton pregnancies: an updated systematic review and network meta-analysis. BJOG. 2019; 126(5): 556–567.
  36. Rode L, Klein K, Nicolaides KH, et al. PREDICT Group. Prevention of preterm delivery in twin gestations (PREDICT): a multicenter, randomized, placebo-controlled trial on the effect of vaginal micronized progesterone. Ultrasound Obstet Gynecol. 2011; 38(3): 272–280.
  37. Fonseca EB, Celik E, Parra M, et al. Fetal Medicine Foundation Second Trimester Screening Group. Progesterone and the risk of preterm birth among women with a short cervix. N Engl J Med. 2007; 357(5): 462–469.
  38. Norman JE, Marlow N, Messow CM, et al. OPPTIMUM study group. Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM study): a multicentre, randomised, double-blind trial. Lancet. 2016; 387(10033): 2106–2116.
  39. Rehal A, Benkő Z, De Paco Matallana C, et al. Early vaginal progesterone versus placebo in twin pregnancies for the prevention of spontaneous preterm birth: a randomized, double-blind trial. Am J Obstet Gynecol. 2021; 224(1): 86.e1–86.e19.
  40. Stute P, Neulen J, Wildt L. The impact of micronized progesterone on the endometrium: a systematic review. Climacteric. 2016; 19(4): 316–328.
  41. Lobo RA, Archer DF, Kagan R, et al. A 17β-Estradiol-Progesterone Oral Capsule for Vasomotor Symptoms in Postmenopausal Women: A Randomized Controlled Trial. Obstet Gynecol. 2018; 132(1): 161–170.
  42. Davis SR, Dempster G, Bell RJ. The use of micronised progesterone for menopausal hormone therapy, a clinical practice audit. Aust N Z J Obstet Gynaecol. 2016; 56(3): 323–325.
  43. Canonico M, Oger E, Plu-Bureau G, et al. Estrogen and Thromboembolism Risk (ESTHER) Study Group. Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens: the ESTHER study. Circulation. 2007; 115(7): 840–845.
  44. Canonico M, Fournier A, Carcaillon L, et al. Postmenopausal hormone therapy and risk of idiopathic venous thromboembolism: results from the E3N cohort study. Arterioscler Thromb Vasc Biol. 2010; 30(2): 340–345.
  45. Scarabin PY. Postmenopausal hormone therapy and risk of venous thromboembolism: what about progesterone? BMJ. 2019; 364: l601.
  46. Stute P, Wildt L, Neulen J. The impact of micronized progesterone on breast cancer risk: a systematic review. Climacteric. 2018; 21(2): 111–122.
  47. Fournier A, Berrino F, Clavel-Chapelon F. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. Breast Cancer Res Treat. 2008; 107(1): 103–111.
  48. Fournier A, Fabre A, Mesrine S, et al. Use of different postmenopausal hormone therapies and risk of histology- and hormone receptor-defined invasive breast cancer. J Clin Oncol. 2008; 26(8): 1260–1268.
  49. Asi N, Mohammed K, Haydour Q, et al. Progesterone vs. synthetic progestins and the risk of breast cancer: a systematic review and meta-analysis. Syst Rev. 2016; 5(1): 121.
  50. Cobin RH, Goodman NF. AACE Reproductive Endocrinology Scientific Committee. American Association of Clinical Endocrinologists and American College of Endocrinology position statement on menopause-2017 update. Endocr Pract. 2017; 23(7): 869–880.
  51. Baber RJ, Panay N, Fenton A, et al. IMS Writing Group. 2016 IMS Recommendations on women's midlife health and menopause hormone therapy. Climacteric. 2016; 19(2): 109–150.
  52. Stevenson JC, Rozenberg S, Maffei S, et al. Progestogens as a component of menopausal hormone therapy: the right molecule makes the difference. Drugs Context. 2020; 9.

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