In response to a reader's query about possible conflicts of interest relative to a Letter to the Editor published in the May issue of the Journal (O'Brien JM. 17-hydroxy progesterone caproate, progesterone, preterm birth prevention, and safety; who decides? Someone should. Am J Obstet Gynecol 2011;204:5.e16-7) Dr John O'Brien wishes to disclose the following:
        • (1)
          He was involved in studies of progesterone gel treatment for preterm birth prevention, financially supported by Columbia Laboratories, a maker of progesterone gel.
        • (2)
          He serves on Advisory Boards for Watson Pharmaceuticals, a company with a financial interest in marketing vaginal progesterone gel for preterm birth prophylaxis.
        • (3)
          He acknowledges that he and others are listed in the patent on the use of all progesterone compounds to prevent preterm birth (US Patent Number 7,884,093: Progesterone for the Treatment and Prevention of Spontaneous Preterm Birth).

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        • 17-hydroxyprogesterone caproate, progesterone, preterm birth prevention, and safety: who decides? Someone should
          American Journal of Obstetrics & GynecologyVol. 204Issue 5
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            The synthetic progestin 17-hydroxyprogesterone caproate (17-OHP-C) and natural progesterone differ remarkably in their structure and relative affinity for progesterone receptors (the binding affinity of 17OHP-C is only 26-30% of the binding affinity of progesterone).1 Furthermore, the synthetic is not metabolized into a naturally occurring compound.2 This varied biochemistry may elicit varied responses, which have been observed in laboratory experiments (some of which are negative regarding exposure to the synthetic).
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