Diagnostic factors identified in 1020 women with two versus three or more recurrent pregnancy losses
Presented at the 62d Annual Meeting of the American Society for Reproductive Medicine, which was held in New Orleans, Louisiana, on October 21–25, 2006.
Received 18 September 2008; received in revised form 14 January 2009; accepted 30 January 2009. published online 31 March 2009.
Objective
To determine whether the frequency of abnormal results for evidence-based diagnostic tests differed among women with recurrent pregnancy loss (RPL) based on the number of prior losses (n = 2, 3, or ≥4) and to determine whether abnormal results for additional investigative diagnostic tests differed in prevalence among women with different numbers of pregnancy losses.
Design
Single-center, retrospective study.
Setting
Patients with RPL at a private practice.
Patient(s)
One thousand twenty women who had two or more consecutive spontaneous pregnancy losses with the same partner.
Intervention(s)
None.
Main Outcome Measure(s)
Frequencies of abnormal results for evidence-based diagnostic tests considered definite or probable causes of RPL (karyotyping for parental chromosomal abnormalities; pelvic sonohysterography, hysterosalpingogram, or hysteroscopy for uterine anomalies; immunological tests for lupus anticoagulant and anticardiolipin antibodies; thrombophilic tests for the factor V Leiden mutation; and blood tests for thyroid-stimulating hormone [TSH] and fasting blood glucose). We also measured the frequency of abnormal results for nine additional investigative tests in the same patients (antiphosphatidyl serine antibodies, microbial infection, midluteal P, PRL, functional protein C activity, functional protein S activity, antithrombin activity, fasting homocysteine and methylenetetrahydrofolate reductase polymorphisms, and factor II mutation).
Result(s)
The prevalence of abnormal results for evidence-based and investigative diagnostic tests did not differ among women with different numbers of pregnancy losses.
Conclusion(s)
Evaluation of all couples with two, three, or more consecutive miscarriages is recommended.
aDepartment of Biology, Rhodes College, University of Tennessee, Memphis, Tennessee
bDivision of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Tennessee, Memphis, Tennessee
cFertility Associates of Memphis, Memphis, Tennessee
Reprint requests: William H. Kutteh, M.D., Ph.D., Fertility Associates of Memphis, 80 Humphreys Center, No. 307, Memphis, Tennessee 38120 (FAX: 901-747-4446).
C.R.J. has nothing to disclose. J.L.C. has nothing to disclose. W.H.K. has nothing to disclose.
Supported by a Creative Advance Planning Sabbatical Grant from the Andrew W. Mellon Foundation and by the Frank Ling Research Grant in Obstetrics and Gynecology from the University of Tennessee Health Science Center, Memphis, Tennessee.
ABSTRACT