Endocrinological and endometrial factors in recurrent miscarriage.

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.

The value of biochemical and ultrasound measurements in predicting pregnancy outcome in women with a history of recurrent miscarriage.

In this study, the potential prognostic value of serial ultrasonographic, endocrinological and biochemical measurements in the early pregnancy of women with a history of unexplained recurrent miscarriage was examined. A total of 113 pregnancies among 93 women were studied, of which 77 (68%) resulted in live birth, whereas 36 (32%) ended in a miscarriage. The normal range (5-95th centile) of various measurements was derived from pregnancies which resulted in a live birth.

Hyperhomocysteinemia: a risk factor for placental abruption or infarction.

Objective: To establish the prevalence of hyperhomocysteinemia in women with placental abruption or infarction.

Design: Forty-six women with normal pregnancy outcome (controls) and 84 women with placental abruption or infarction (study group) were selected, and studied in the non-pregnant state. Homocysteine metabolism was investigated by a standardized oral methionine loading test.

Early endometriosis invades the extracellular matrix.

Objectives: To investigate whether the aminoterminal propeptides of type III procollagen are increased in patients with early endometriosis and to demonstrate that the subtle lesion of endometriosis is an active stage of the disease.

Design: Aminoterminal propeptide of type III procollagen was determined in serum and peritoneal fluid (PF) of 100 consecutive patients undergoing laparoscopy.

Setting: Academisch Ziekenhuis Maastricht, The Netherlands, a tertiary care center.