Endocrine factors associated with recurrent spontaneous abortion

Area of Science:

• Reproductive Endocrinology
• Human Reproduction
• Obstetrics and Gynecology

Background:

• Recurrent spontaneous abortion (RSA) etiology is debated, with endocrine factors like diabetes mellitus and thyroid disease not proving significant risk factors.
• The role and diagnosis of luteal-phase defect (LPD) in RSA are controversial, lacking accurate diagnostic methods and evidence of treatment efficacy.
• The corpus luteum is crucial for mammalian reproduction, but its function in humans and impact on fertility remain subjects of debate.

Purpose of the Study:

• To review the controversial role of endocrine factors and luteal function in recurrent spontaneous abortion.
• To discuss the limitations in diagnosing and treating luteal-phase defects.
• To explore potential markers for uterine receptivity and their correlation with pregnancy outcomes.

Main Methods:

• Review of existing literature on endocrine factors, luteal function, and recurrent pregnancy loss.
• Analysis of findings from donor egg recipient models in assisted reproductive technology (ART).
• Evaluation of diagnostic methods for uterine receptivity, including endometrial proteins and ultrasonography.

Main Results:

• Diabetes mellitus and thyroid disease are not significant risk factors for recurrent pregnancy loss.
• The donor egg model demonstrates that corpus luteum function can be substituted by estrogen and progesterone.
• Endometrial proteins are candidate markers for uterine receptivity, while ultrasonography shows high sensitivity but low specificity.

Conclusions:

• Current evidence does not support endocrine factors like diabetes or thyroid disease as major causes of recurrent pregnancy loss.
• The luteal-phase defect's role and effective treatment remain uncertain due to diagnostic and study limitations.
• Further research is needed to validate endometrial markers for uterine receptivity and improve diagnostic accuracy for successful implantation.