Women that have recurrent or unexplained miscarriages often respond to treatment with progesterone, and are able to maintain the next pregnancy. Prevent early miscarriage. Progesterone deficiency is not the cause of every miscarriage, but scientific research indicates that adequate amounts of progesterone are needed to support the early stages of pregnancy. Progesterone levels naturally increase during each menstrual cycle once ovulation has occurred. This allows for the uterine wall to thicken to provide support for the pregnancy. This is called the luteal phase. Once the released egg has been fertilized, the lining of the uterus provides protection for the egg as it begins to develop. After the first few weeks, the placenta takes over, producing the additional hormones and nutrients needed. Some women have naturally lower levels of progesterone. Some studies suggest that low levels during the first few weeks of pregnancy can cause the uterine lining to be inadequate to support the pregnancy, causing the miscarriage. Evidence for this is limited, however. Inadequate levels of progesterone needed to support the early stage of pregnancy are sometimes referred to as a luteal phase defect. Using progesterone vaginal inserts may help prevent early miscarriage, depending on the cause of the miscarriage. The scientific literature supports the use of vaginally applied progesterone, via inserts or suppositories, to help maintain the lining of the uterus to support the pregnancy. While other ways to administer progesterone are available, such as injections, oral dosing, and topical creams, for women with luteal phase defects and recurrent or unexplained miscarriages, this is the recommended method of delivery. ART helps to induce pregnancy by using procedures that remove the eggs from the woman, combine them with sperm in a laboratory setting, then return them to the woman's body, or to another woman's body. There are many methods that help couples to achieve pregnancy. ART is one only one method. Women that participate in ART require supplementation of hormones, like progesterone, to help their bodies create a healthy environment to maintain the pregnancy. Progesterone administered by either intramuscular injection or by vaginal products have been shown to be effective in establishing the initial higher levels of progesterone needed during ART. Injectable progesterone is sometimes used but carries additional risks for complications since progesterone is very rapidly absorbed and is quickly changed into other chemicals. By altering the delivery system of the injection, the active progesterone can remain in its desired chemical form as long as possible. This means altering the liquid, or vehicle, the active drug is placed in, by using oils, such as peanut oil. Do not use this form of progesterone if you are allergic to peanuts. Possible complications from progesterone injections include developing an allergy to the inactive ingredients, abscesses and pain at the site of injection, and unwanted bleeding into the muscle tissue. Vaginal delivery products produce lower systemic levels of progesterone, but higher levels in the endometrium, which is the goal. A product designed to deliver progesterone in this manner, and specifically in the group of women that are using ART, is a progesterone gel product currently marketed under the brand name of Crinone®️. Crinone®️ is available containing either 4% or 8% of progesterone. The 8% product is recommended for use in women participating in ART. Avoid using Crinone®️ in some situations. This product should not be used if you are allergic to any progesterone products, have unusual vaginal bleeding, have ever had liver problems, cancer of the breast or genital organs, or blood clots. If you have had a recent miscarriage, see your doctor first. Get emergency medical help if you have any signs of an allergic reaction. Signs of an allergic reaction include hives, difficulty breathing, and swelling in your face, mouth, or throat. Emergency medical care is also warranted if you experience pain in the calves or chest, sudden headache, numbness or weakness, especially if you notice this to be on only one side of your body, shortness of breath, difficulty breathing, or coughing up blood. Emergency care is also needed for problems with your vision or speaking, feeling dizzy, faint, or problems with balance, changes in vision or speech, chest pain, pain spreading to the arm or shoulder, weakness or numbness in an arm or leg, pain or swelling in the legs, nausea, vomiting, stomach pain, loss of appetite, low grade fever, or changes in your urine.
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One-sentence summary -- Talk with your gynecologist about increasing progesterone. Use progesterone vaginal inserts. Supplement progesterone during assisted reproductive technology, or ART. Use injectable or vaginally administered progesterone. Administer the progesterone by using a vaginal gel product. Seek immediate medical attention if severe side effects develop.

If you're giving a presentation, always include something physical for your participants to work with. Presentation handouts should summarize what you'll be saying in your presentation and include additional figures or visuals. Include additional resources in handouts that aren't in the presentation. For example, if your presentation was about fire safety, include a list of numbers that employees can call to report safety violations. Whether your training program is a manual, a presentation, or another medium, tell participants the goal of the program. That way, they can see how the information they're about to receive builds up to the ultimate goal of the training. Put this goal on one of the first pages of a manual or handout. Use an explicit statement like, "By the end of this program, you will know how to do " If there are multiple goals, break them up into A, B, and C for further clarity. Inform participants of the training plan so they know what to expect. If you're giving a presentation, put a schedule on the projector or in the handouts you provide. If you're writing a manual or module, make one of the first pages a table of contents. For long presentations, always schedule a break time. Your participants will zone out in meetings that last several hours. If you have to cover a lot of material, consider multiple sessions over a few days to hold your participants' attention. If your training program includes multiple goals, keep those goals separate so participants can focus on one skill at a time. If you try to cover different skills in the same section, your program will be messy and hard to follow. Look at all your training goals and if necessary, break them into small sections. This will make your program much easier for participants. Organize different sections logically. For example, don't make the first section "Interacting with Customers" and the second section "Answering the Phone." This doesn't make sense because "Answering the Phone" should come first. Build up to each skill by using an effective order of events. Training materials should be easy to read and refer back to. If you're putting together a manual, explain everything as simply and quickly as you can. The same goes for handouts. Use bullet points instead of paragraphs wherever possible. If you write in complete sentences, don't use long paragraphs or blocks of text. Skip a line every few sentences. Breaking up the text will allow the participants to skim the information more easily. If you aren't good at writing short, simple instructions, consider hiring a professional writer who is. Your training program will be much better and easier to follow. This advice can also apply to presentations. Don't put large blocks of text on the projector. Use very short, readable sentences and bullet points to keep your audience's attention. No matter what medium you use for your training materials, use visuals like charts, figures, and diagrams to help guide the participants along. It will make the information easier to follow, but more importantly, people often learn better when they see a visual representation. For a guide explaining how to use the office computers, for instance, include screenshots of each page and circle areas where employees should click. This conveys the point much better than explaining the location of each button.
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One-sentence summary --
Include handouts for all presentations. State the training goals clearly from the start. Draw up a table of contents or schedule. Dedicate separate sections to different learning goals. Use bullet points and short sentences for a manual and handouts. Include visuals in as many places as possible.