Polycystic ovaries and levels of gonadotrophins and androgens in recurrent miscarriage: prospective study in 50 women

Abstract

Objective To compare the serum levels of gonadotrophins and androgens, as well as ovarian morphology, in 50 women with a history of recurrent miscarriage and in 20 healthy controls. Design Prospective study on women with a history of at least three consecutive miscarriages in Department I and II of Obstetrics and Gynecology, University Central Hospital of Helsinki, Finland. Results The recurrent miscarriage group as a whole exhibited gonadotrophin and androgen levels comparable to those seen in the controls. Ultrasound examination revealed polycystic ovaries (PCO) in 22 patients (44%) and in four control women (20%, P=0.06) but no differences in the levels of gonadotrophins and androgens emerged between the patients with or without PCO. During follow up, 33 (66%) women with a history of recurrent miscarriage who became pregnant; 16 miscarried again (48.5%), whereas 17 (51.5%) succeeded. The presence of PCO did not predict miscarriage, but the patients who miscarried had higher levels of total testosterone, free testosterone and dehydroepiandrosterone sulphate than RSA women with continuing pregnancies. Conclusions PCO and hyperandrogenism may be associated with repeated miscarriage.

Dissociation of oocyte nuclear and cytoplasmic maturation by the addition of insulin in cultured bovine antral follicles

“…This decrease in IGF-I receptor reduced glucose uptake and triggered apoptosis. In addition, women with polycystic ovary syndrome exhibit elevated concentrations of insulin and IGF-I and experience increased pregnancy losses (Tulppala et al 1993, Zephne et al 2004, Dumesic et al 2005. A threshold may exist at which the level of growth hormone, IGF-I or insulin goes from being beneficial to detrimental on oocyte and embryo development.…”

The Pathophysiology of Miscarriage in Women with Polycystic Ovary Syndrome. Review and Proposed Hypothesis of Mechanisms Involved

“…An earlier study 41 described an association between elevated androgen concentrations and miscarriage. A more recent study 42 supported these findings, reporting that plasma concentrations of androgens were significantly higher in women with PCOS who had recurrent miscarriages compared with normal controls.…”

Lifestyle Risk Factors Associated with Threatened Miscarriage: A Case-Control Study

“…The association between a past history of regular menses and lower risk of threatened miscarriage that we found may simply reflect the association of irregular menstrual cycles with underlying infertility or other conditions such as Polycystic Ovarian Syndrome, which confers an increased risk of miscarriage [28,29].…”