S W Trout1, D B Seifer. 1. Division of Reproductive Endocrinology and Infertility, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA. troutsw@umdnj.edu
Abstract
OBJECTIVE: To determine the potential role of diminished ovarian reserve in unexplained habitual abortion. DESIGN: Retrospective comparative analysis. SETTING: University-based practice. PATIENT(S): Fifty-seven women who presented for evaluation of recurrent pregnancy loss (RPL). INTERVENTION(S): The test group (n = 36) comprised women with unexplained RPL. The control group (n = 21) comprised women with a known cause of RPL. Mean age, parity, day 3 serum FSH and E(2) levels, and presence or absence of a history of infertility were compared between groups. MAIN OUTCOME MEASURE(S): Day 3 serum FSH and E(2) levels. RESULT(S): Both day 3 FSH and E(2) levels were elevated in the unexplained group compared with the control group. When combined, FSH or E(2) levels, or both, were elevated in 58% of the unexplained RPL group and 19% of the control group (odds ratio, 5.95 [95% CI, 1.7-21.3]; P<.004). Age, parity, and presence of infertility did not differ between groups. CONCLUSION(S): Women with unexplained RPL have a greater incidence of elevated day 3 serum FSH and E(2) levels than do women with a known cause of RPL. Therefore, diminished ovarian reserve may contribute to recurrent pregnancy loss and should be considered part of the work-up for RPL.
OBJECTIVE: To determine the potential role of diminished ovarian reserve in unexplained habitual abortion. DESIGN: Retrospective comparative analysis. SETTING: University-based practice. PATIENT(S): Fifty-seven women who presented for evaluation of recurrent pregnancy loss (RPL). INTERVENTION(S): The test group (n = 36) comprised women with unexplained RPL. The control group (n = 21) comprised women with a known cause of RPL. Mean age, parity, day 3 serum FSH and E(2) levels, and presence or absence of a history of infertility were compared between groups. MAIN OUTCOME MEASURE(S): Day 3 serum FSH and E(2) levels. RESULT(S): Both day 3 FSH and E(2) levels were elevated in the unexplained group compared with the control group. When combined, FSH or E(2) levels, or both, were elevated in 58% of the unexplained RPL group and 19% of the control group (odds ratio, 5.95 [95% CI, 1.7-21.3]; P<.004). Age, parity, and presence of infertility did not differ between groups. CONCLUSION(S): Women with unexplained RPL have a greater incidence of elevated day 3 serum FSH and E(2) levels than do women with a known cause of RPL. Therefore, diminished ovarian reserve may contribute to recurrent pregnancy loss and should be considered part of the work-up for RPL.
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