Defining recurrent pregnancy loss: associated factors and prognosis in couples with two versus three or more pregnancy losses

Youssef, Angelos; Lashley, Lisa E.E.L.O.; Dieben, Sandra; Verburg, Harjo; Hoorn, Marie-Louise van der

doi:10.1016/j.rbmo.2020.05.016

Cited by 18 publications

(16 citation statements)

References 19 publications

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“…Further, it should not be forgotten that couples with RPL have a high rate of healthy pregnancies. Youssef et al [38] found no cause in 71.5 % of women with RPL experience in their study. Although the chance of having a healthy pregnancy decreases with the increasing number of pregnancy losses, they found this possibility as 75 % even in those who had ≥ 4 pregnancy loss.…”

Section: Discussionmentioning

confidence: 62%

Telomere Length in Idiopathic Recurrent Pregnancy Loss

Onat

Çaltekin

Başer

et al. 2021

Z Geburtshilfe Neonatol

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Objective Telomere length is used as an indicator of biological aging. It is well known that one of the most remarkable risk factors of recurrent pregnancy losses is advanced maternal age. The objective of this study was to investigate the correlation between idiopathic recurrent pregnancy loss and telomere length. Method The study group included 40 women, while the control group consisted of 41 healthy women whose age and body mass index were matched. A venous blood sample was taken from all participants into EDTA tubes in the early follicular phase, and telomere length was measured through the qPCR technique. Results When the mean TL of the groups was compared, it was determined that TL was significantly shorter among the iRPL group (7763.89±924.58 base pair) compared to the control group (8398.84±1102.95 base pair) (p<0.006). Whereas FSH and E2 were higher in the iRPL group, TAFC was lower (p<0.001). When the correlation between telomere length and endocrine parameters was statistically tested in the iRPL group, a negative correlation was found between FSH and telomere length (r=-0.437; p<0.001). Conclusion Shortened telomere length might play a role in the etiology of iRPL. We are of the opinion that patients with RPL should be screened for the presence of cardiovascular diseases and other chronic diseases, as is the case for POF.

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Section: Discussionmentioning

confidence: 62%

Telomere Length in Idiopathic Recurrent Pregnancy Loss

Onat

Çaltekin

Başer

et al. 2021

Z Geburtshilfe Neonatol

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“…We retrospectively searched patient's files referred to our thrombophilia unit from 2003 to 2018. Inclusion criteria were (1) women referred to our unit after at least one prior event of RF (early or late PL), (2) screened for thrombophilia, and (3) followed during their next pregnancy in our thrombophilia unit. We identified 175 women fitting our inclusion criteria.…”

Section: Study Populationmentioning

confidence: 99%

“…Reproductive failure (RF), defined as failure to carry pregnancy in term, is a frustrating event for childbearing aged women [1]. In most cases, etiological factors cannot be detected, and women are referred to hematology units for thrombophilia screen [2].…”

Section: Introductionmentioning

confidence: 99%

Reproductive Failure and Thrombophilia: Not Enough Evidence for a Tight Bond

et al. 2021

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Objectives: The role of hereditary thrombophilia in reproductive failure (RF) is strongly debatable. In this retrospective single-center study, we analyzed pregnancy outcome in 175 women screened for thrombophilia after at least one event of RF. Results: The prevalence of thrombophilia in our cohort was 33.4%. Pregnancy survival curves were not different according to severity (log-rank, p = 0.302) or type of thrombophilia (log-rank, p = 0.532). In total, 81.7% of 175 subsequent pregnancies were proceeded with LMWH. Concomitant use of ASA was prescribed in 75 pregnancies according to physician choice. The primary endpoint was live birth rate (LBR) that succeeded in 152/175 next pregnancies (86.8%) and late obstetric complications (LOBC) which occurred in 17/175 next pregnancies (9.8%). In logistic regression analysis, neither the severity nor the type of thrombophilia was important for any pregnancy outcome (LBR or LOBC). Considering therapeutic interventions, the use of LMWH ± ASA was not related to LBR or LOBC. The only factor inversely related to LBR was age above the cutoff value of 35.5 years (p = 0.049). Conclusions: Incidence of thrombophilia is increased among women with RF, but the severity or type of thrombophilia is not related to pregnancy outcome.

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“…Despite extensive diagnostic workup offered to couples with RPL, underlying risk factors can be identified in only 25%–40% of couples 7 8. Limited understanding of mechanisms underlying RPL has the consequence that effective treatment options are often lacking.…”

Section: Introductionmentioning

confidence: 99%

Development of the OPAL prediction model for prediction of live birth in couples with recurrent pregnancy loss: protocol for a prospective and retrospective cohort study in the Netherlands

et al. 2022

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IntroductionRecurrent pregnancy loss (RPL) is defined as the loss of two or more conceptions before 24 weeks gestation. Despite extensive diagnostic workup, in only 25%–40% an underlying cause is identified. Several factors may increase the risk for miscarriage, but the chance of a successful pregnancy is still high. Prognostic counselling plays a significant role in supportive care. The main limitation in current prediction models is the lack of a sufficiently large cohort, adjustment for relevant risk factors, and separation between cumulative live birth rate and the success chance in the next conception. In this project, we aim to make an individualised prognosis for the future chance of pregnancy success, which could lead to improved well-being and the ability managing reproductive choices.Methods and analysisIn this multicentre study, we will include both a prospective and a retrospective cohort of at least 931 and 1000 couples with RPL, respectively. Couples who have visited one of the three participating university hospitals in the Netherlands for intake are eligible for the study participation, with a follow-up duration of 5 years. General medical and obstetric history and reports of pregnancies after the initial consultation will be collected. Multiple imputation will be performed to cope for missing data. A Cox proportional hazards model for time to pregnancy will be developed to estimate the cumulative chance of a live birth within 3 years after intake. To dynamically estimate the chance of an ongoing pregnancy, given the outcome of earlier pregnancies after intake, a logistic regression model will be developed.Ethics and disseminationThe Medical Ethical Research Committee of the Leiden University Medical Center approved this study protocol (N22.025). There are no risks or burden associated with this study. Participant written informed consent is required for both cohorts. Findings will be published in peer-reviewed journals and presentations at international conferences.Trial registration numberNCT05167812.

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Defining recurrent pregnancy loss: associated factors and prognosis in couples with two versus three or more pregnancy losses

Abstract: Center (LUMC) in the Netherlands, with recurrent pregnancy loss as his focus area. He obtained his Doctor of Medicine degree in 2020. As a medical student he has performed studies on his focus area of recurrent pregnancy loss.

Cited by 18 publications

References 19 publications

Telomere Length in Idiopathic Recurrent Pregnancy Loss

Telomere Length in Idiopathic Recurrent Pregnancy Loss

Reproductive Failure and Thrombophilia: Not Enough Evidence for a Tight Bond

Development of the OPAL prediction model for prediction of live birth in couples with recurrent pregnancy loss: protocol for a prospective and retrospective cohort study in the Netherlands

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