Do women with unexplained recurrent pregnancy loss have higher day 3 serum FSH and estradiol values?

To determine the potential role of diminished ovarian reserve in unexplained habitual abortion.

Retrospective comparative analysis.

University-based practice.

Fifty-seven women who presented for evaluation of recurrent pregnancy loss (RPL).

The test group (n = 36) comprised women with unexplained RPL. The control group (n = 21) comprised women with a known cause of RPL. Mean age, parity, day 3 serum FSH and E(2) levels, and presence or absence of a history of infertility were compared between groups.

Day 3 serum FSH and E(2) levels.

Both day 3 FSH and E(2) levels were elevated in the unexplained group compared with the control group. When combined, FSH or E(2) levels, or both, were elevated in 58% of the unexplained RPL group and 19% of the control group (odds ratio, 5.95 [95% CI, 1.7-21.3]; P<.004). Age, parity, and presence of infertility did not differ between groups.

Women with unexplained RPL have a greater incidence of elevated day 3 serum FSH and E(2) levels than do women with a known cause of RPL. Therefore, diminished ovarian reserve may contribute to recurrent pregnancy loss and should be considered part of the work-up for RPL.