Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology

Haas, David M.; Hathaway, T.; Ramsey, Patrick S.

doi:10.1002/14651858.cd003511.pub5

Cited by 70 publications

(86 citation statements)

References 54 publications

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“…In RM, standard investigations (parental karyotypes, uterine cavity exploration, screening for antiphospholipid [aPL] antibodies) fail to reveal an apparent cause for RM in ~50% of women. However, on the basis of animal models and clinical studies, several hypotheses have been proposed: an altered ovarian reserve, a progesterone defect, thrombotic and/or endothelial dysfunction, immunological disturbances, and chronic endometritis . Some of these possible mechanisms may be occur simultaneously in the same patient, e.g., in obese women at high risk for RM …”

Section: Pathophysiology Of Recurrent Miscarriagementioning

confidence: 99%

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Hydroxychloroquine may be beneficial in preeclampsia and recurrent miscarriage

Moreuil

Alavi

Pasquier

2019

Brit J Clinical Pharma

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Recurrent miscarriage (RM) and vasculoplacental disorders, such as preeclampsia (PE), affect women of childbearing age worldwide. Vascular endothelial dysfunction and immunological impairment are associated with both RM and PE. To date, there is no effective or optimal therapeutic approach for these conditions. Notably, aspirin use is only partially effective in the prevention of PE. Hydroxychloroquine (HCQ) has demonstrated beneficial effects on disease flares, pregnancy outcomes and cardiovascular impairment in systemic erythaematosus lupus (SLE) through its immunomodulatory, vasculoprotective and antithrombotic properties. Here, in the context of the underlying physiological dysregulation associated with PE and RM, the beneficial properties and potential therapeutic efficacy of HCQ are reviewed in anticipation of the results of current and future trials. Two related trials addressing RM in the absence of maternal autoimmune disease are ongoing. Other trials addressing pregnancy outcomes in the presence of maternal autoimmune disease are forthcoming. In this review, we hypothesise that the immunological and endothelial effects of HCQ may be beneficial in the context of PE and RM, regardless of the maternal autoimmune status. K E Y W O R D S hydroxychloroquine, pregnancy, preeclampsia, recurrent miscarriage

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Section: Pathophysiology Of Recurrent Miscarriagementioning

confidence: 99%

“…Consequently, a variety of therapeutics, targeting haemostasis (LMWH, aspirin), immune mechanisms (polyvalent immunoglobulins, small doses of corticosteroids), or endocrine mechanisms (e.g., progesterone), have been tested . To date, no treatment seems to be effective.…”

Section: Pathophysiology Of Recurrent Miscarriagementioning

confidence: 99%

Hydroxychloroquine may be beneficial in preeclampsia and recurrent miscarriage

Moreuil

Alavi

Pasquier

2019

Brit J Clinical Pharma

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“…Orally administered progesterone has been shown to reduce the rate of spontaneous miscarriages and to improve fertility among women who have experienced bleeding in early pregnancy and recurrent miscarriages ( Haas et al. 2019 ).…”

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confidence: 99%

The Neandertal Progesterone Receptor

Zeberg

Kelso

Pääbo

2020

Molecular Biology and Evolution

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The hormone progesterone is important for preparing the uterine lining for egg implantation and for maintaining the early stages of pregnancy. The gene encoding the progesterone receptor (PGR) carries introgressed Neandertal haplotypes with two missense substitutions and a mobile Alu element. These Neandertal gene variants have reached nearly 20% frequency in non-Africans and have been associated with preterm birth. Here, we show that one of the missense substitutions appears fixed in Neandertals, while the other substitution as well as the Alu insertion were polymorphic among Neandertals. We show that two Neandertal haplotypes carrying the PGR gene entered the modern human population and that present-day carriers of the Neandertal haplotypes express higher levels of the receptor. In a cohort of present-day Britons, these carriers have more siblings, fewer miscarriages, and less bleeding during early pregnancy suggesting that the Neandertal progesterone receptor alleles promote fertility. This may explain their high frequency in modern human populations.

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“…Miscarriage is more prevalent in women older than 40 years, [39][40][41] and women with previous induced abortion have an increased risk of miscarriage. 42,43 Our results indicate no difference in the rate of rs3803662 polymorphism in different age groups, and there were also no significant correlations between the rs3803662 C>T polymorphism and the number of prior abortions in stratified analysis. According to the results of this study, the rs3803662 polymorphism may not be a biomarker for miscarriage.…”

Section: Discussionmentioning

confidence: 50%

Association between the TOX3 rs3803662 C>T polymorphism and recurrent miscarriage in a southern Chinese population

Huang¹,

Zhou

Li³

et al. 2019

Clinical Laboratory Analysis

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Background Studies have shown that some genetic polymorphisms associated with breast cancer susceptibility may also be associated with abortion. The TOX3 gene plays a key role during the onset of breast cancer, and reproductive factors such as abortion are risk factors for breast cancer. However, there is currently no study describing the relationship between the TOX3 rs3803662 C>T polymorphism and the risk of recurrent miscarriage. Therefore, we investigated whether the TOX3 rs3803662 C>T polymorphism is associated with recurrent miscarriage susceptibility in this case‐control study. Methods We recruited 248 recurrent miscarriage patients and 392 healthy controls from the southern Chinese population and performed genotyping using the TaqMan method. Results The results showed no evidence that TOX3 rs3803662 C>T is associated with recurrent miscarriage (CT and CC: corrected OR = 1.038, 95% CI = 0.737‐1.461, P = .8321; TT and CC: adjusted OR = 0.989, 95% CI = 0.591‐1.656, P = .9659; dominant model: adjusted OR = 1.027, 95% CI = 0.742‐1.423, P = .8712; recessive model: adjusted OR = 0.969, 95% CI = 0.600‐1.566, P = .8975). Conclusion According to this study, the TOX3 rs3803662 C>T polymorphism may not be associated with recurrent miscarriage in the southern Chinese population. A larger multicenter study is needed to confirm the results.

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Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology

Cited by 70 publications

References 54 publications

Hydroxychloroquine may be beneficial in preeclampsia and recurrent miscarriage

Hydroxychloroquine may be beneficial in preeclampsia and recurrent miscarriage

The Neandertal Progesterone Receptor

Association between the TOX3 rs3803662 C>T polymorphism and recurrent miscarriage in a southern Chinese population

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