Luteal phase HCG support for unexplained recurrent pregnancy loss – a low hanging fruit?

Fox, Chelsea; Azores-Gococo, Denise; Swart, Linda; Holoch, K.; Savaris, Ricardo Francalacci; Likes, C.E.; Miller, P. L.; Forstein, David A.; Lessey, Bruce A.

doi:10.1016/j.rbmo.2016.11.016

Cited by 12 publications

(10 citation statements)

References 41 publications

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“…There is also no consensus on the proposed management of LPD. Besides treating the underlying cause, several therapeutic regimens have been used: ovulation induction, supplemental progesterone, supplemental progesterone and estrogen, and human chorionic gonadotropin 75–78. Progesterone supplementation is the most widely used treatment because of its availability, ease of administration, and tolerability.…”

Section: Etiologiesmentioning

confidence: 99%

Recurrent pregnancy loss: current perspectives

Hachem

Crepaux

May‐Panloup

et al. 2017

IJWH

339

209

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Recurrent pregnancy loss is an important reproductive health issue, affecting 2%–5% of couples. Common established causes include uterine anomalies, antiphospholipid syndrome, hormonal and metabolic disorders, and cytogenetic abnormalities. Other etiologies have been proposed but are still considered controversial, such as chronic endometritis, inherited thrombophilias, luteal phase deficiency, and high sperm DNA fragmentation levels. Over the years, evidence-based treatments such as surgical correction of uterine anomalies or aspirin and heparin for antiphospholipid syndrome have improved the outcomes for couples with recurrent pregnancy loss. However, almost half of the cases remain unexplained and are empirically treated using progesterone supplementation, anticoagulation, and/or immunomodulatory treatments. Regardless of the cause, the long-term prognosis of couples with recurrent pregnancy loss is good, and most eventually achieve a healthy live birth. However, multiple pregnancy losses can have a significant psychological toll on affected couples, and many efforts are being made to improve treatments and decrease the time needed to achieve a successful pregnancy. This article reviews the established and controversial etiologies, and the recommended therapeutic strategies, with a special focus on unexplained recurrent pregnancy losses and the empiric treatments used nowadays. It also discusses the current role of preimplantation genetic testing in the management of recurrent pregnancy loss.

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Section: Etiologiesmentioning

confidence: 99%

Recurrent pregnancy loss: current perspectives

Hachem

Crepaux

May‐Panloup

et al. 2017

IJWH

339

209

View full text Add to dashboard Cite

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“…One of the most egregious cases of research misconduct in the UK was exposed earlier in the 1990s when the distinguished gynaecologist Malcolm Pearce of St. George's Hospital in London fabricated a report describing the transplantation of an ectopic pregnancy into a patient's uterus to result in a live birth, as well as falsifying a clinical trial on 191 women with polycystic ovarian syndrome suffering from recurrent miscarriage [17]. Despite the high profile nature of Pearce's case at the time and a formal statement from the respective journal declaring that both publications should be withdrawn, the clinical trial report's abstract remained intact on the journal's website for several years and the paper was subsequently cited in several papers as an example of fertility treatment [18][19][20][21][22][23][24][25].…”

Section: Historical Contextmentioning

confidence: 99%

Dishonesty and research misconduct within the medical profession

Rahman

Ankier²

2020

BMC Med Ethics

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While there has been much discussion of how the scientific establishment's culture can engender research misconduct and scientific irreproducibility, this has been discussed much less frequently with respect to the medical profession. Here the authors posit that a lack of self-criticism, an encouragement of novel scientific research generated by the recruitment policies of the UK Royal Training Colleges along with insufficient training in the sciences are core reasons as to why research misconduct and dishonesty prevail within the medical community. Furthermore, the UK General Medical Council's own data demonstrates a historic inattentiveness to the ease with which doctors can engage in research misconduct. Suggestions are made as to how these issues can be investigated and alternative incentives for career advancement are adumbrated.

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“…Embryonic trophoblast cells secrete human chorionic gonadotropin (hCG), which maintains the corpus luteum function in early pregnancy and plays a key role in implantation and endometrial receptivity [88]. A retrospective cohort study reported that miscarriage rate and time to pregnancy decreased in the 45 pregnant women who underwent 135 monitored cycles without hCG support, compared to 53 pregnant women who underwent 142 cycles with a single injection of mid-luteal hCG [89].…”

Section: Endocrine Effects On Recurrent Pregnancy Lossmentioning

confidence: 99%

Pathogenetic factors involved in recurrent pregnancy loss from multiple aspects

2019

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Recurrent pregnancy loss (RPL) is a common complication in obstetrics, affecting about 5% of women of childbearing age. An increase in the number of abortions results in escalation in the risk of miscarriage. Although concentrated research has identified numerous causes for RPL, about 50% of them remain unexplained. Pregnancy is a complex process, comprising fertilization, implantation, organ and tissue differentiation, and fetal growth, which is effectively controlled by a number of both maternal and fetal factors. An example is the immune response, in which T cells and natural killer cells participate, and inflammation mediated by tumor necrosis factor or colony-stimulating factor, which hinders embryo implantation. Furthermore, vitamin D affects glucose metabolism and inhibits embryonic development, whereas microRNA has a negative effect on the gene expression of embryo implantation and development. This review examines the causes of RPL from multiple perspectives, and focuses on the numerous factors that may result in RPL.

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Luteal phase HCG support for unexplained recurrent pregnancy loss – a low hanging fruit?

Cited by 12 publications

References 41 publications

Recurrent pregnancy loss: current perspectives

Recurrent pregnancy loss: current perspectives

Dishonesty and research misconduct within the medical profession

Pathogenetic factors involved in recurrent pregnancy loss from multiple aspects

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