Many women experience repeated miscarriages due to a lack of hormones. To treat this condition, expectant mothers need to use hormone-containing medications and visit their doctors for regular check-ups.
In healthy women, following ovulation, the remaining follicular structure in the ovaries transforms into a special endocrine gland known as the corpus luteum. The corpus luteum secretes progesterone (also referred to as the pregnancy hormone) and estrogen to facilitate implantation and the development of the embryo in the uterus.
If the ovum released during that menstrual cycle is not fertilized (the woman is not pregnant), the corpus luteum will regress by the 25th-26th day of the menstrual cycle, and 2-3 days later, the woman will have a new menstrual period. Conversely, if the ovum is fertilized, the embryo will implant in the uterus and develop there, leading to the corpus luteum being maintained and further developing to provide the necessary hormones for pregnancy; at this point, it is referred to as the “pregnancy corpus luteum.”
For the corpus luteum to persist, the trophoblast cells of the embryo, once they attach to the uterine lining, will secrete a special hormone known as HCG. This substance helps the corpus luteum continue to develop and secrete the hormones necessary for pregnancy during the first four months of gestation. By the fifth month, the placenta has developed and become an endocrine gland capable of providing sufficient pregnancy hormones, rendering the role of the corpus luteum unnecessary, at which point the pregnancy corpus luteum will regress.
Thus, if in the early stages of pregnancy, the corpus luteum does not secrete enough hormones or regresses too early, it may lead to a miscarriage. To diagnose miscarriage due to hormonal deficiency, complex hormonal quantitative tests are needed, which are difficult to perform in our country. Even if they can be done, the reliability is limited because the hormone levels required can vary for each individual and for each pregnancy. Therefore, in practice, obstetricians usually prescribe hormone medications to support the pregnancy.
The commonly used medication is progesterone – the pregnancy hormone from the corpus luteum, administered via intramuscular injection. The dosage, method of use, and duration will be determined by the obstetrician after examination. This is the main medication used for pregnancy support. Injectable medications can be replaced with oral progesterone options such as Duphaston or Utrogestan.
In addition to progesterone, the corpus luteum also secretes estrogen; hence, in the treatment of threatened miscarriage or to support pregnancy, this substance is also included. The previously used medication was diethylstilbestrol, which posed a risk of causing vaginal cancer in the patients’ daughters, so it has been discontinued. Currently, the medication commonly used is ethinyl estradiol (brand name Mikrofollin). The dosage and duration of use must be determined by the gynecologist after examination.
Another hormone used in cases of threatened miscarriage due to hormonal deficiency is the placental gonadotropin, which has an active ingredient similar to HCG secreted by the placenta to maintain the corpus luteum, with the brand name Pregnyl.
Dr. Phó Đức Nhuận, Health & Life
