In summarizing their well-executed randomized trial, Progesterone in Recurrent Miscarriages (PROMISE), Coomarasamy et al. (Nov. 26 issue)1 state that there is no evidence of benefit from progesterone supplementation “in the first trimester” of pregnancy among women who have had three or more miscarriages.
Infertility is usually a consequence of multiple chronic conditions rather than a single acute condition. We propose that it is erroneous to apply acute medical interventions to a condition that is chronic in nature.
We evaluated outcomes in couples treated for infertility with natural procreative technology (NaProTechnology, NPT), a systematic medical approach for optimizing physiologic conditions for conception in vivo, from an Irish general practice.