It is human nature to have a child after marriage, and everyone wants to have a healthy child without any problems, but in reality about 10% of pregnant women have to miscarry off. Miscarriages are sometimes the result of superiority and inferiority, for example, the fetus has various malformations, mainly due to chromosomal abnormalities in number and structure that cannot survive, so of course it is good that it is naturally aborted. But sometimes it is an avoidable transient disorder, such as endocrine factors such as luteal insufficiency. The corpus luteum secretes luteinizing hormone, which is an important hormone to maintain sufficient blood supply to the endometrium for embryo implantation and not to be rejected. It has been reported that luteal failure in early pregnancy accounts for 15% to 20% of habitual miscarriages, and some experts report that this figure is as high as 30%. Once the vaginal redness and other aura of miscarriage, the doctor often can not find the exact cause, but the progesterone to protect the fetus. In recent years, some books and journals have introduced that treatment with progesterone in early pregnancy may lead to fetal malformations, mainly masculinization of the external genitalia of female fetuses, so it is listed as a contraindication, thus causing controversy over the safety of progesterone for fetal preservation. Here we would like to share some of our views. The sperm-egg meeting road is bumpy, begging along the way to ensure survival The common egg is the ovum or fertilized egg (already fertilized). Break it up and take a look: the fertilized egg is like a bean sprout, while the very large yolk part is for the embryo to prepare sufficient nutrition. The human sperm, egg and fertilized egg are unrecognizable to the naked eye, small in form and lacking sufficient nutrient storage, and the journey from fertilization at the woman’s fallopian tube to planting in the uterine cavity takes a week, during which nutrients must be constantly drawn from the surrounding body fluids. “The quality of the uterine milk is closely related to the secretion of luteinizing hormone, which makes it difficult for the embryo to survive if the corpus luteum does not function well. The corpus luteum is responsible for the formation of the corpus luteum during the menstrual cycle after ovulation, with a diameter of 1 to 2 cm and a yellow color like a wild chrysanthemum, which can secrete progesterone (mainly progesterone) and estrogen. Once the corpus luteum is not healthy, luteinizing hormone secretion will be insufficient and the endometrium will not be supported, which will not only reduce the secretion of uterine milk, but also cause the embryo planted in the endometrium to wither due to insufficient blood supply, leading to miscarriage. In addition, progesterone has an anti-rejection effect because half of the embryo comes from the father’s side and is a foreign body to the pregnant woman. In addition, it also has an inhibitory effect on uterine contractions, which ensures that the embryo develops unharmed in the uterus. Research Facts Good Point The safety of progestogen for fetal preservation during pregnancy has aroused the concern of obstetricians and gynecologists. In 1994, the latest fourth edition of “Medications for Pregnancy and Lactation” in the United States, Briggs, a famous scholar, listed 265 cases who had used oral hydroxyprogesterone 20-30 mg/day or intramuscular progesterone 500 mg/week, or both, for miscarriage bleeding in early pregnancy in 1985, compared with the control group 1,146 cases were compared with the control group, and the results did not differ between the two groups in terms of malformation rate (12.00% and 12. 39%, respectively). Progesterone is a natural endocrine hormone and would be safer. In addition, there were 988 cases of maternal use of various progestins, mainly progesterone and 17 hydroxyprogesterone, or progestins in the middle and late stages of pregnancy in 1985, and no increase in malformation rate was observed. Progesterone has been used in clinical practice since 1934, and synthetic products have been available since the 1950s, which not only have stronger effects but can also be taken orally. Synthetic products can be divided into two categories, one is made from testosterone drugs after processing, such as women’s health tablets (norethindrone), in addition to the strong progesterone effect also has some testosterone effect. This type of progesterone is prohibited for birth control because testosterone can masculinize the external genitalia of the female fetus. The other type of progesterone is made by processing progesterone drugs, such as gynecological tablets (methoprene) and progesterone (methoprene). These progesterones, in addition to their possible luteolytic effect, may cause glandular dysplasia of the endometrium and insufficient secretion of uterine milk, thus also limiting their use in fetal preservation. In addition, for the use of menopausal gonadotropin (hMG) or the preservation of fetus in patients with ovarian hyperstimulation syndrome (OHSS) often complicated by IVF superovulation, chorionic gonadotropin (hCG) should not be used again, so as not to aggravate the symptoms of OHSS, and progesterone should be used for the preservation of fetus. Usually the fetus is preserved until 10 weeks of pregnancy (counting from the last menstruation), after which the progesterone is produced by the placenta, which is large and vigorous, and there is no worry about insufficient secretion. Progesterone injections for injection are 10 mg, 20 mg and 50 mg. The first two small doses are commonly used for supplementary fetal preservation, while 50 mg or even 100 mg are only used for replacement therapy without luteal function. For example, in our hospital last year, a 57-year-old woman who had been menopausal for 3 years was able to conceive and deliver a healthy baby boy through IVF with borrowed eggs. Because she was menopausal, her ovaries did not ovulate, so of course she had no luteal function, so she received 100 mg/day of domestic progesterone treatment and used it continuously for nearly 3 months. In recent years, progesterone suppositories have been used both at home and abroad to treat luteal failure and pre-eclampsia, with 25 mg per suppository inserted vaginally once in the morning and once in the evening. Experiments have shown that 1/4 of the suppositories used can be absorbed vaginally and enter the body circulation directly without going through the liver, avoiding the decreasing effect of the liver and the pain and possible infection of intramuscular injection. It can be seen that the clinical application of natural progesterone injections or suppositories is reasonable and safe.