Neelam Potdar1, Justin C Konje. 1. Reproductive Sciences Section, Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester Royal Infirmary, Leicester, UK.
Abstract
PURPOSE OF REVIEW: This review discusses the endocrinological aspects of recurrent miscarriage based on the literature from January 2004 to January 2005, elaborating on the advances in the field and their impact on diagnosis and management. RECENT FINDINGS: Endometrial luteal phase defect is associated with recurrent miscarriage. Fifty years have passed since the diagnostic criteria for dating the endometrial biopsy was established by Noyes et al. This has been the gold standard and last year its accuracy and clinical utility were critically analysed. A Cochrane review has shown a small but statistically significant difference in the live birth rate in the subgroup of women in which progestogen was used to prevent recurrent miscarriage. Endocannabinoids and fatty acid amide hydrolase have been found to have a potential role in signalling for implantation and maintenance of pregnancy. SUMMARY: Abnormal secretory endometrial changes may adversely affect the early pregnancy outcome. Other dating techniques using biochemical and molecular markers of endometrial function may prove useful in predicting outcome. Use of progestogens with or without estrogens for prevention of recurrent miscarriage needs to be investigated further in larger randomized controlled trials. The role of endocannabinoids and agents modulating their receptors are potentially very exciting areas to be explored further.
PURPOSE OF REVIEW: This review discusses the endocrinological aspects of recurrent miscarriage based on the literature from January 2004 to January 2005, elaborating on the advances in the field and their impact on diagnosis and management. RECENT FINDINGS: Endometrial luteal phase defect is associated with recurrent miscarriage. Fifty years have passed since the diagnostic criteria for dating the endometrial biopsy was established by Noyes et al. This has been the gold standard and last year its accuracy and clinical utility were critically analysed. A Cochrane review has shown a small but statistically significant difference in the live birth rate in the subgroup of women in which progestogen was used to prevent recurrent miscarriage. Endocannabinoids and fatty acid amide hydrolase have been found to have a potential role in signalling for implantation and maintenance of pregnancy. SUMMARY: Abnormal secretory endometrial changes may adversely affect the early pregnancy outcome. Other dating techniques using biochemical and molecular markers of endometrial function may prove useful in predicting outcome. Use of progestogens with or without estrogens for prevention of recurrent miscarriage needs to be investigated further in larger randomized controlled trials. The role of endocannabinoids and agents modulating their receptors are potentially very exciting areas to be explored further.
Authors: Mary A Andrews; Karen C Schliep; Jean Wactawski-Wende; Joseph B Stanford; Shvetha M Zarek; Rose G Radin; Lindsey A Sjaarda; Neil J Perkins; Robyn A Kalwerisky; Ahmad O Hammoud; Sunni L Mumford Journal: Hum Reprod Date: 2015-06-16 Impact factor: 6.918
Authors: Ariane Germeyer; Michael von Wolff; Julia Jauckus; Thomas Strowitzki; Tanuj Sharma; Anna T Grazul-Bilska Journal: Reprod Biol Endocrinol Date: 2010-06-21 Impact factor: 5.211
Authors: Marieke G M Braem; N Charlotte Onland-Moret; Leo J Schouten; Roy F P M Kruitwagen; Annekatrin Lukanova; Naomi E Allen; Petra A Wark; Anne Tjønneland; Louise Hansen; Christina Marie Braüner; Kim Overvad; Françoise Clavel-Chapelon; Nathalie Chabbert-Buffet; Birgit Teucher; Anna Floegel; Heiner Boeing; Antonia Trichopoulou; George Adarakis; Maria Plada; Sabina Rinaldi; Veronika Fedirko; Isabelle Romieu; Valeria Pala; Rocco Galasso; Carlotta Sacerdote; Domenico Palli; Rosario Tumino; H Bas Bueno-de-Mesquita; Inger Torhild Gram; Oxana Gavrilyuk; Eiliv Lund; Maria-José Sánchez; Catalina Bonet; Maria-Dolores Chirlaque; Nerea Larrañaga; Aurelio Barricarte Gurrea; Jose R Quirós; Annika Idahl; Nina Ohlson; Eva Lundin; Karin Jirström; Salma Butt; Konstantinos K Tsilidis; Kay-Tee Khaw; Nick Wareham; Elio Riboli; Rudolf Kaaks; Petra H M Peeters Journal: PLoS One Date: 2012-05-18 Impact factor: 3.240