Progesterone is known to play an important role in maintaining pregnancy, especially in the early stages. Treatment of pregnant women at risk of idiopathic recurrent miscarriage or threatened is critical and complex. Therefore, a group of Saudi Arabia obstetricians and gynecologists gathered to update Saudi Arabia’s 2014 Guidelines on Threatened and Recurrent miscarriage management. In preparation, a literature review was conducted to investigate the role of oral, vagina, and injection progestogens: It served as the basis for developing position statements to guide and correct practice across Saudi Arabia. The Role of Hormones In Pregnancy: Pregnancy is a hormone-mediated physiological condition that includes an increase in uterine blood flow and a decrease in uterine vascular tone. Progesterone and estrogen are two major hormones that remain elevated during pregnancy and play significant roles in causing anatomical adjustments in the uterus to create an environment conducive to fetal growth. Progesterone, rightly referred to as the “pregnancy hormone”, is critical in maintaining pregnancy as it is involved in modulating maternal immune response, reducing uterine contraction, suppressing inflammatory response, improving uterine and the luteal stage and placental flow. Especially at the beginning of pregnancy, progesterone is responsible for preparing the endometrium