Reproductive Endocrinology · Ovarian Hormones

Changes in the level of fetoplacental complex hormones in pregnant women with miscarriage

Lisova KM, Kalinovska IV, Pryimak SH, Tokar PY, Varlas VN

Journal of medicine and life, 14(4), 487-491, 2021
DOI 10.25122/jml-2021-0089 PMID 34621371 PMC PMC8485377

RRM Academy Synopsis

Pregnant women with miscarriage had lower progesterone and estradiol

Pregnant women with miscarriage had lower pregnancy hormones in a small study from Ukraine. Progesterone ran about two-thirds lower at the embryonic and late fetal stages. The study compared 50 women with miscarriage and 50 with uncomplicated pregnancies.

Key Findings

  • Estradiol was 76.0% lower in the miscarriage group in the embryonic period and 65.5% lower in the late fetal period. The authors called the differences significant (p <0.05).
  • Progesterone was 67.4% lower in the embryonic period and 68.4% lower in the late fetal period than in the control group.
  • In the miscarriage group, chorionic gonadotropin (hCG) was 20.8% lower in the early fetal period, 43.0% lower in the middle fetal period and 35.4% lower in the late fetal period.
  • Placental lactogen was 39.1% lower in the embryonic period in the miscarriage group.

Interpretation

The study compared 50 women with miscarriage against 50 with uncomplicated pregnancies at one regional perinatal center in 2020 to 2021. Hormones were measured at four stages of pregnancy. In this sample, lower hormone levels went along with miscarriage. The paper does not describe how the groups were matched or how many pregnancies ended in loss. The authors read the pattern as placental dysfunction that starts early and progresses. The data cannot show whether the hormone shortfall came before the failing pregnancy or followed it. The study tested no treatment.

RRM Context

Progesterone rises after ovulation. A shortfall in pregnancy therefore raises a question about the ovulatory cycle before it. The authors cite luteal phase defect as a proposed cause of miscarriage in genetically normal pregnancies. Their measurements start after conception and include no earlier cycle charts. Restorative reproductive medicine treats that earlier cycle as part of the question of cause.

Abstract

The purpose of the study was TO analyze the fetoplacental complex hormone levels and changes in their dynamics in pregnant women with miscarriage and the impact of these features on the subsequent course of pregnancy. Hormone levels were determined at different stages of gestation in 50 healthy women with a physiological course of pregnancy (control group) and 50 pregnant women with a history of miscarriage (main group). The women of the main group had a significantly slower rate of increase in hormones and a lag in quantitative indicators than the control group. The estradiol level indicators were 4.1 times (76.0%) and 2.89 times (65.5%) lower in women with miscarriage in the embryonic and late fetal period, respectively, compared to healthy women. Indicators of the level of placental lactogen and chorionic gonadotropin in the embryonic period in women with miscarriage were lower by 39.1% and 50.9%, respectively, compared to healthy women. In the late fetal period, the level of these hormones was lower by 72.9% and 35.4%, respectively. In the embryonic and late fetal periods, progesterone levels were lower by 67.4% and 68.4%, respectively, compared to the control group. The data obtained are evidence of a pronounced hormonal abnormality of the placenta, and hence a marker of fetoplacental dysfunction, which on the background of miscarriage develops at the early stages and continues to progress with the course of pregnancy.

Topics

Related research

Reproductive Endocrinology › Ovarian Hormones › Progesterone · Diagnostics › Hormone Testing › Serum Panels · Pregnancy › Pregnancy Complications › Intrauterine Infection
Kateryna Mykolaivna Lisova, Iryna Valentynivna Kalinovska, Svitlana Hryhorivna Pryimak, Petro Yuriyovych Tokar, Valentin Nicolae Varlas
K Lisova, I Kalinovska, S Pryimak, P Tokar, V Varlas
PMID 34621371 34621371 DOI 10.25122/jml-2021-0089 10.25122/jml-2021-0089 Lisova et al. 2021, Lisova 2021