Endocrine basis for recurrent pregnancy loss

Obstet Gynecol Clin North Am. 2014 Mar;41(1):103-12. doi: 10.1016/j.ogc.2013.10.003. Epub 2013 Dec 5.

Abstract

Common endocrinopathies are a frequent contributor to spontaneous and recurrent miscarriage. Although the diagnostic criteria for luteal phase defect (LPD) is still controversial, treatment of patients with both recurrent pregnancy loss and LPD using progestogen in early pregnancy seems beneficial. For patients who are hypothyroid, thyroid hormone replacement therapy along with careful monitoring in the preconceptual and early pregnancy period is associated with improved outcome. Women with polycystic ovary syndrome (PCOS) have an increased risk of pregnancy loss. Management of PCOS with normalization of weight or metformin seems to reduce the risk of pregnancy loss.

Keywords: Hyperprolactinemia; Luteal phase defect; Polycystic ovary syndrome; Recurrent pregnancy loss; Thyroid antibodies; Thyroid disease.

Publication types

  • Review

MeSH terms

  • Abortion, Habitual / etiology*
  • Abortion, Habitual / metabolism
  • Abortion, Habitual / prevention & control
  • Female
  • Humans
  • Hyperinsulinism / complications*
  • Hyperinsulinism / metabolism
  • Hyperinsulinism / therapy
  • Hyperprolactinemia / complications*
  • Hyperprolactinemia / metabolism
  • Hyperprolactinemia / therapy
  • Hypoglycemic Agents / therapeutic use
  • Luteinizing Hormone / metabolism
  • Metformin / therapeutic use
  • Obesity / complications*
  • Obesity / metabolism
  • Polycystic Ovary Syndrome / complications*
  • Polycystic Ovary Syndrome / metabolism
  • Polycystic Ovary Syndrome / therapy
  • Pregnancy
  • Prevalence
  • Progestins / therapeutic use
  • Thyroid Diseases / complications*
  • Thyroid Diseases / metabolism
  • Thyroid Diseases / therapy
  • Weight Loss

Substances

  • Hypoglycemic Agents
  • Progestins
  • Luteinizing Hormone
  • Metformin