Use of oral allylestrenol in women with recurrent spontaneous abortion: A retrospective clinical trial

Recurrent spontaneous abortion (RSA), defined as two or more clinically confirmed pregnancies that end before 20-24 weeks of gestation, encompasses both embryonic and fetal losses and is a significant clinical challenge. The aim of this study was to compare the efficacy of allylestrenol (AT) and progesterone in improving pregnancy outcomes in RSA. From June 2021 to June 2024, 480 participants were randomly assigned to an AT, Progesterone, or Control group. Key outcomes included early pregnancy rates, ongoing pregnancies with fetal heart activity, live birth rates after 24 weeks, and pregnancy loss before 24 weeks. Results indicated significantly higher pregnancy rates at 6-8 weeks in both the Allylestrenol (71.8%) and Progesterone groups (76.2%) compared to the Control group (57.5%). At 12 weeks, ongoing pregnancies with fetal heart activity were higher in the Allylestrenol (65%) and Progesterone groups (64%) versus the Control group (52.5%). Both treatment groups had higher live birth rates (60% and 60.6%) compared to the Control group (45%). Pregnancy loss before 24 weeks was lower in both treatment groups (31.8% and 33.1%) compared to the Control group (38.7%). No significant adverse reactions were observed, indicating good safety profiles for both treatments. These findings suggest that both treatments effectively improve pregnancy outcomes in cases of RSA with satisfactory safety, supporting their potential clinical use. However, further research is needed to explore their long-term effects and broader applicability in clinical settings.