Semin Reprod Med 2006; 24: 033-039 DOI: 10.1055/s-2006-931799
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
Endocrinology of Recurrent Pregnancy Loss
Francisco Arredondo1, Luis S. Noble2
1 Assistant Professor, Division of Reproductive Endocrinology and Infertility Case Western Reserve University, Cleveland Ohio 2 Associate Clinical Professor, Department of Obstetrics and Gynecology, Texas Tech University Medical Center, and Medical Director of Southwest Center for Reproductive Health, El Paso, Texas

ABSTRACT

Following implantation, the maintenance of the pregnancy is dependent on a multitude of endocrinological events that will eventually aid in the successful growth and development of the fetus. Although the great majority of pregnant women have no pre-existing endocrine abnormalities, a small number of women can have certain endocrine alterations that could potentially lead to recurrent pregnancy losses. It is estimated that approximately 8 to 12% of all pregnancy losses are the result of endocrine factors. During the preimplantation period, the uterus undergoes important developmental changes stimulated by estrogen, and more importantly, progesterone. Progesterone is essential for the successful implantation and maintenance of pregnancy. Therefore, disorders related to inadequate progesterone secretion by the corpus luteum are likely to affect the outcome of the pregnancy. Luteal phase deficiency, hyperprolactinemia, and polycystic ovarian syndrome are some examples. Several other endocrinological abnormalities such as thyroid disease, hypoparathyroidism, uncontrolled diabetes, and decreased ovarian reserve have been implicated as etiologic factors for recurrent pregnancy loss.

KEYWORDS

Recurrent pregnancy loss - endocrine factors - prolactin - thyroid - luteal phase - ovarian reserve