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The lack of local guidelines and variations in recommendations by existing guidelines result in inconsistent management of these conditions in Thailand. The Thai interest group aims to provide recommendations to healthcare providers for the use of progesterone supplementation in women experiencing threatened miscarriage and unexplained RPL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Existing guidelines and relevant studies were reviewed to explore the role of oral, vaginal, and injectable progestogens. In the present evidence\u2010based recommendations, the Thai interest group delineated effective diagnostic and therapeutic strategies for managing patients with threatened miscarriages and unexplained RPL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Treatment initiation for unexplained RPL is recommended after experiencing two or more pregnancy losses, regardless of consecutive occurrences. Oral progestogen (dydrogesterone) is recommended for the management of both threatened miscarriage and unexplained RPL. Exceeding 200\u2009mg of micronized vaginal progesterone (MVP) per intake is not advisable for threatened miscarriage or preventing recurrent miscarriage because of luteal phase insufficiency. Treatment with intramuscular injection progestin should be continued at a dosage of 250\u2009mg twice weekly for several weeks. Additionally, patient experiences and safety concerns related to MVP and injectable progestogens are discussed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These inaugural evidence\u2010based Thai recommendations can be applied in regional healthcare settings for improved outcomes in threatened miscarriage and unexplained RPL. Further research is needed to better understand the epidemiology and etiology of these conditions in Thailand.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70038","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T03:55:41Z","timestamp":1755057341000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Progestogen therapy in threatened miscarriage and unexplained recurrent pregnancy loss: Recommendations by the Thai interest group"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5062-7328","authenticated-orcid":false,"given":"Kiattisak","family":"Kongwattanakul","sequence":"first","affiliation":[{"name":"Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology Faculty of Medicine, Khon Kaen University  Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phudit","family":"Jatavan","sequence":"additional","affiliation":[{"name":"Maternal and Fetal Medicine Unit, Department of Obstetrics and Gynecology Faculty of Medicine, Chiang Mai University  Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olarik","family":"Musigavong","sequence":"additional","affiliation":[{"name":"Chaophya Abhaibhubejhr Hospital  Prachinburi Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savitree","family":"Pranpanus","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Medicine, Prince of Songkla University  Hat Yai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6101-5589","authenticated-orcid":false,"given":"Lingling","family":"Salang","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Unit, Obstetrics and Gynecology Department Faculty of Medicine, Khon Kaen University  Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chonthicha","family":"Satirapod","sequence":"additional","affiliation":[{"name":"Reproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynecology Faculty of Medicine, Ramathibodi Hospital, Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Somsin","family":"Petyim","sequence":"additional","affiliation":[{"name":"Reproductive Biology and Infertility Unit, Department of Obstetrics and Gynecology Faculty of Medicine Siriraj Hospital, Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5956-8262","authenticated-orcid":false,"given":"Boonchai","family":"Uerpairojkit","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Faculty of Medicine, Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.11622\/smedj.2013148"},{"issue":"8","key":"e_1_2_9_3_1","article-title":"Progestogen for treating threatened miscarriage","volume":"8","author":"Wahabi HA","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.4274\/tjod.galenos.2023.66789"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1083746"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2009.11.016"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.18203\/2320-1770.ijrcog20161292"},{"issue":"2","key":"e_1_2_9_8_1","first-page":"76","article-title":"Recurrent pregnancy loss: etiology, diagnosis, and therapy","volume":"2","author":"Ford HB","year":"2009","journal-title":"Rev Obstet Gynecol"},{"key":"e_1_2_9_9_1","unstructured":"European Society of Human Reproduction and Embryology (ESHRE) guideline development group.Recurrent pregnancy loss. 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