Endocrinological and endometrial factors in recurrent miscarriage.

Abstract

OBJECTIVE:

To investigate the endocrinological and endometrial factors in women with unexplained recurrent miscarriage

DESIGN:

Prospective, case study

SETTING:

Recurrent miscarriage clinic, Jessop Hospital for Women, Sheffield

PARTICIPANTS:

One hundred and forty-four women with unexplained recurrent (> or =3) miscarriages

METHODS:

A blood sample was obtained in early follicular phase (day 3-5) to measure follicle stimulating hormone, luteinising hormone, prolactin, androgens and thyroid function; daily blood/urine samples were obtained from mid-follicular phase to measure luteinising hormone until the luteinising hormone surge was identified; endometrial biopsy and a further blood sample for progesterone measurement were obtained in the mid-luteal phase. A transvaginal ultrasonography was performed to evaluate ovarian morphology.

RESULTS:

Hypersecretion of luteinising hormone or ultrasonographic features of polycystic ovarian disease was present in 8% and 7.8% of women, respectively. The free androgen index was elevated in 14.6% of subjects. In the mid-luteal phase, low progesterone level was found in 17.4% and delayed endometrial development was noted in 27.1% of women. Although women with recurrent miscarriage women and delayed endometrium had significantly lower progesterone levels than those with normal endometrial development, only 8/24 had mid-luteal progesterone levels below 30 nmol/L. Recurrent miscarriage was not associated with hyperprolactinaemia or abnormal thyroid function test.

CONCLUSIONS:

Endocrinological and endometrial abnormalities are present in about a quarter of women with unexplained recurrent miscarriage.

• Authors: T C Li, M D Spuijbroek, E Tuckerman, B Anstie, M Loxley, S Laird
• Journal: BJOG : an international journal of obstetrics and gynaecology (BJOG) Vol. 107 Issue 12 Pg. 1471-9 (Dec 2000) ISSN: 1470-0328 [Print] England
• PMID: 11192102 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Sex Hormone-Binding Globulin
• Testosterone
• Androstenedione
• Progesterone
• Estradiol
• Prolactin
• Luteinizing Hormone
• Follicle Stimulating Hormone

Topics

• Abortion, Habitual (blood, etiology)
• Adult
• Androstenedione (blood)
• Endocrine System Diseases (blood, complications)
• Endometrium
• Estradiol (blood)
• Female
• Follicle Stimulating Hormone (blood)
• Humans
• Luteinizing Hormone (blood, urine)
• Pregnancy
• Progesterone (blood)
• Prolactin (blood)
• Prospective Studies
• Sex Hormone-Binding Globulin (metabolism)
• Testosterone (blood)