Skip to main content
SpringerLink
Log in

Recurrent Pregnancy Loss

  • Conference paper
Book cover New Trends in Reproductive Medicine

  • 102 Accesses

Abstract

Spontaneous miscarriage itself is an extremely common disorder during pregnancy. About 15%–20% of clinically detected pregnancies result in spontaneous abortion prior to 20 weeks’ gestation (Warburton and Frazer 1964; Poland et al. 1977; Stray-Pedersen and Stray-Pedersen (1984). By using daily sensitive plasma and urine assays for human chorionic gonadotropin (hCG), 39% of the postimplantation pregnancies were reported to be lost (Wilcox et al. (1988). Also, it was concluded that 30% of embryos fail to implant and another 30% of early pregnancies could only be recognized by sensitive β-hCG assays (Chard 1991).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Ayers J, Peterson E et al (1982) Early therapy for the incompetent cervix in patients with habitual abortion. Fertil Steril 38:177–181

    PubMed  CAS  Google Scholar 

  • Bauman J (1981) Basal body temperature: unreliable method of ovulation detection. Fertil Steril 36:729–733

    PubMed  CAS  Google Scholar 

  • Beer A (1986) New horizons in the diagnosis, evaluation and therapy of recurrent spontaneous abortion. Clin Obstet Gynecol 13:115–124

    CAS  Google Scholar 

  • Bennett M (1987) Congenital abnormalities of the fundus. In: Bennett, Edmonds (eds) Spontaneous and recurrent abortion. Blackwell, London, pp 109–129

    Google Scholar 

  • Billington W (1992) The normal fetomaternal immune relationship. Baillieres Clin Obstet Gynaecol 6:417–438

    Article  PubMed  CAS  Google Scholar 

  • Boue J, Boue A et al (1975) Retrospective and prospective epidemiological studies of 1500 karyotyped spontaneous human abortions. Teratology 12:11–26

    Article  PubMed  CAS  Google Scholar 

  • Braekeleer M, Dao T (1990) Cytogenetic studies in couples experiencing repeated pregnancy losses. Hum Reprod 5:519–528

    PubMed  Google Scholar 

  • Cariou R, Tobelem G et al (1988) Effect of lupus anticoagulant of antithrombogenic properties of endothelial cells — inhibition of thrombomodulin dependent protein C activation. Thromb Haemost 60:54–58

    PubMed  CAS  Google Scholar 

  • Carp H, Toder V et al (1990) Recurrent miscarriage: a review of current concepts, immune mechanisms, and results of treatment. Obstet Gynecol Surv 45:657–669

    Article  PubMed  CAS  Google Scholar 

  • Carr D (1972) Cytogenetic aspects of induced and spontaneous abortions. Clin Obstet Gynecol 15:203–219

    Article  PubMed  CAS  Google Scholar 

  • Caucni M, Lim D et al (1991) Treatment of recurrent aborters by immunization with paternal cells-controlled trial. Am J Reprod Immunol 25:16–17

    Google Scholar 

  • Chard T (1991) Frequency of implantation and early pregnancy loss in natural cycles. Baillieres Clin Obstet Gynaecol 5:179–189

    Article  PubMed  CAS  Google Scholar 

  • Christiansen O, Mathieson O et al (1990) Idiopathic recurrent spontaneous abortion. Acta Obstet Gynecol Scand 69:597–601

    Article  PubMed  CAS  Google Scholar 

  • Clark D, Daya S (1991) Trials and tribulations in the treatment of recurrent spontaneous abortion. Am J reprod Immunol 25:18–24

    PubMed  CAS  Google Scholar 

  • Conley C, Hartman R (1952) Hemorrhagic disorder caused by circulating anticoagulant in patients with disseminated lupus erythematosus. J Clin Invest 31:621–622

    Google Scholar 

  • Corson S (1992) Operative hysteroscopy for infertility. Clin Obstet Gynecol 35:229–241

    Article  PubMed  CAS  Google Scholar 

  • Cosgriff T, Martin B (1981) Low functional and high antigenic antithrombin III level in a patient with the lupus anticoagulant and recurrent thrombosis. Arthritis Rheum 24:94–96

    Article  PubMed  CAS  Google Scholar 

  • Coulam C (1991) Epidemology for recurrent spontaneous abortion. Am J Reprod Immunol 26:23–27

    PubMed  CAS  Google Scholar 

  • Cowchock F, Reece A et al (1992) Repeated fetal losses associated with antiphospholipid antibodies: a collaborative randomized trial comparing prednisone with lowdose heparin treatment. Am J Obstet Gynecol 166:1318–1323

    PubMed  CAS  Google Scholar 

  • Daya S, Clark D (1992) Alloimmunity. Principles and practice of medical therapy in pregnancy. Appleton, Norwalk, pp 407–413

    Google Scholar 

  • Derksen R, Hasselaar P et al (1988) Coagulation screen is more specific than the anticardiolipin antibody ELISA in defining a thrombotic subset of lupus patients. Ann Rheum Dis 47:364–371

    Article  PubMed  CAS  Google Scholar 

  • Desoye G, Dohr G et al (1988) Lack of HLA class I and class II antigens on the human preimplantation embryos. J Immunol 140:4157–4159

    PubMed  CAS  Google Scholar 

  • Dewald G, Michels V (1986) Recurrent miscarriages: cytogenetic causes and genetic counseling of affected families. Clin Obstet Gynecol 29:865–885

    Article  PubMed  CAS  Google Scholar 

  • Downs K, Gibson M (1983) Basal body temperature graph and the luteal phase defect. Fertil Steril 40:466–468

    PubMed  CAS  Google Scholar 

  • Drugan AFK III et al (1990) Prenatal genetic diagnosis following recurrent early pregnancy loss. Obstet Gynecol 75:381–384

    PubMed  CAS  Google Scholar 

  • Dudley D, Branch D (1991) Antiphospholipid syndrome. A model for autoimmune pregnancy loss. Infertil Reprod Med Clin North Am 2:149–164

    Google Scholar 

  • Ecker J, Laufer M et al (1993) Measurement of embryotoxic factors is predictive of pregnancy outcome in women with a history of recurrent abortion. Obstet Gynecol 81:84–87

    PubMed  CAS  Google Scholar 

  • Filicori M, Butler J et al (1984) Neuroendocrine regulation of the corpus luteum in the human. Evidence for pulsatile progesterone secretion. J Clin Invest 73:1638–1647

    Article  PubMed  CAS  Google Scholar 

  • Fishman P, Falach-Vaknine E et al (1993) Prevention of fetal loss in experimental antiphospholipid syndrome by in vivo administration of recombinant interleukin-3. J Clin Invest 91:1834–1837

    Article  PubMed  CAS  Google Scholar 

  • Fraser E, Grimes D et al (1993) Immunization as therapy for recurrent spontaneous abortion: a review and meta-analysis. Obstet Gynecol 82:854–859

    PubMed  CAS  Google Scholar 

  • Fritz M (1988) Inadequate luteal function and recurrent abortion: diagnosis and treatment of luteal phase deficiency. Semin Reprod Endocrinol 6:129–143

    Article  Google Scholar 

  • Geisler M, Kleinebrecht J (1978) Cytogenetic and histologic analyses of spontaneous abortions. Hum Genet 45:239–251

    Article  PubMed  CAS  Google Scholar 

  • Glass R, Golbus M (1994) Recurrent abortion. Maternal-fetal medicien, principles and practice. Saunders, Philadelphia, 3rd edn., pp 445–451

    Google Scholar 

  • Gleicher N, Harlow L et al (1992) Regulatory effect of antiphospholipid antibodies on signal transduction: a possible model for autoantibody-induced reproductive failure. Am J Obstet Gynecol 167:637–642

    PubMed  CAS  Google Scholar 

  • Goldzieher J, Benigno B (1958) The treatment of threatened and recurrent abortion: a critical review. Am J Obstet Gynecol 75:1202–1214

    PubMed  CAS  Google Scholar 

  • Guerneri S, Bettio D et al (1987) Prevalence and distribution of chromosome abnormalities in a sample of first trimester internal abortions. Hum Reprod 2:735–739

    PubMed  CAS  Google Scholar 

  • Hamilton-Fairley D, Kiddy D et al (1991) Low-dose gonadotropin therapy for induction of ovulation in 100 women with polycystic ovary syndrome. Hum Reprod 6:1095–1099

    PubMed  CAS  Google Scholar 

  • Harger J, Archer D et al (1983) Etiology of recurrent pregnancy losses and outcome of subsequent pregnancies. Obstet Gynecol 62:574–581

    PubMed  CAS  Google Scholar 

  • Harris E (1987) Syndrome of the black swan. Br J Rheumatol 26:324–326

    Article  PubMed  CAS  Google Scholar 

  • Harris E, Ghavari A et al (1985) Anticardiolipin antibodies in autoimmune thrombocytopenic purpura. Br J Haematol 59:231–234

    Article  PubMed  CAS  Google Scholar 

  • Hassold T, Chen N et al (1980) A cytogenetic study of 1000 spontaneous abortions. Ann Hum Genet 44:151–178

    Article  PubMed  CAS  Google Scholar 

  • Hill J (1991) The rationale for leukocyte immunization in women with recurrent spontaneous abortion: fact or fiction? Colloque INSERM Libbey Eurotext, Paris, pp 263–269 Cellular and molecular biology of the maternofetal relationship

    Google Scholar 

  • Hill J (1992) Immunological contributions to recurrent pregnancy loss. Baillieres Clin Obstet Gynecol 6:489–505

    Article  CAS  Google Scholar 

  • Hill J, Polgar K et al (1992) Evidence of embryo-and trophoblast-toxic cellular immune response(s) in women with recurrent spontaneous abortion. Am J Obstet Gynecol 166:1044–1052

    PubMed  CAS  Google Scholar 

  • Ho H, Gill TI et al (1990) Sharing of human leukocyte antigens in primary and secondary recurrent spontaneous abortions. Am J Obste Gynecol 163:178–188

    CAS  Google Scholar 

  • Ho H, Gill TI et al (1991) Immunotherapy for recurrent spontaneous abortions in a Chinese population. Am J Reprod Immunol 25:10–15

    PubMed  CAS  Google Scholar 

  • Hwang J, Ho H et al (1992) The role of blocking factors and antipaternal lymphocytotoxic antibodies in the success of pregnancy in patients with recurrent spontaneous abortion. Fertil Steril 58:691–696

    PubMed  CAS  Google Scholar 

  • Infante-Rivard C, David M et al (1991) Lupus anticoagulants, anticardiolipin antibodies and fetal loss. A case-control study. N Engl J Med 325:1063–1066

    CAS  Google Scholar 

  • Jacobs H, Hombourg R (1990) The endocrinology of conception. Baillieres Clin Endocrinol Metab 4:195–205

    Article  PubMed  CAS  Google Scholar 

  • Johnson P, Ramsden G et al (1991) A combined randomised double-blind and open study of trophoblast membrane infusion (TMI) in unexplained recurrent miscarriage. In: Cellular and molecular biology of the materno-fetal relationship. Colloque INSERM/Libbey Eurotext, Paris, pp 277–284

    Google Scholar 

  • Kalter H (1987) Diabetes and spontaneous abortion: a historical review. Am J Obstet Gynecol 156:1243–1253

    PubMed  CAS  Google Scholar 

  • Kats I, Fisch B et al (1992) Cutaneous graft-versus-host-like reaction after paternal lymphocyte immunization for prevention of recurrent abortion. Fertil Steril 57:927–929

    Google Scholar 

  • Knudsen U, Hansen V et al (1991) Prognosis of a new pregnancy following previous spontaneous abortions. Eur J Obstet Gynecol Reprod Biol 39:31–36

    Article  PubMed  CAS  Google Scholar 

  • Kovats S, Main E et al (1990) A class I antigen, HLA-G, expressed in human trophoblast. Science 248:220–223

    Article  PubMed  CAS  Google Scholar 

  • Kutteh W, Carr B (1993) Recurrent pregnancy loss. Textbook of reproductive medicine. Appleton and Lange, Norwalk, pp 559–570

    Google Scholar 

  • Lanzavecchia A (1990) Receptor mediated antigen uptake and its effect on antigen presentation to class II-restricted T lymphocytes. Annu Rev Immunol 8:773–793

    Article  PubMed  CAS  Google Scholar 

  • Laurell A, Nilsson I (1957) Hypergammaglobulinemia, circulating anticoagulant and biologic false-positive Wasserman reaction. J Lab Clin Med 49:694

    PubMed  CAS  Google Scholar 

  • Lenton E, Landgreen B et al (1984) Normal variation in the length of the luteal phase of the menstrual cycle: identification of the short luteal phase. Br J Obstet Gynaecol 91:685–689

    Article  PubMed  CAS  Google Scholar 

  • Li T, Rogers A et al (1987) A comparison between two methods of chronological dating of human endometrial biopsies during the luteal phase, and their correlation with histological dating. Fertil Steril 48:928–932

    PubMed  CAS  Google Scholar 

  • Lockshin M, Druzin M (1985) Antibody to cardiolipin as a predictor of fetal distress or death in pregnant patients with systemic lupus erythematosus. N Engl J Med 313:152–156

    Article  PubMed  CAS  Google Scholar 

  • Lockwood C, Rand J (1994) The immunobiology and obstetrical consequences of antiphospholipid antibodies. Obstet Gynecol Surv 49:432–441

    Article  PubMed  CAS  Google Scholar 

  • Lubbe W, Liggins G (1985) Lupus anticoagulant and pregnancy. Am J Obstet Gynecol 153:322–327

    PubMed  CAS  Google Scholar 

  • Lubbe W, Butler W et al (1984) Lupus anticoagulant in pregnancy. Br J Obstet Gynaecol 91:357–363

    Article  PubMed  CAS  Google Scholar 

  • Malpas P (1938) Study of abortion sequences. J Obstet Gynaecol Br Emb 45:932–949

    Article  CAS  Google Scholar 

  • McDonough P (1988) The role of molecular mutation in recurrent euploidic abortion. Semin Reprod Endocrinol 6:155–164

    Article  Google Scholar 

  • McIntyre J, Faulk W et al (1983) Human trophoblast-lymphocyte cross-reactive (TLX) antigens define a new alloantigen system. Science 222:1135–1137

    Article  PubMed  CAS  Google Scholar 

  • McWilliams R, Gibbons W (1991) Müllerian anomalies and recurrent pregnancy loss. Infertil Reprod Med Clin North Am 2:55–74

    Google Scholar 

  • Mowbray J, Gibbings C et al (1985) Controlled trial of treatment of recurrent spontaneous abortion by immunisation with paternal cells. Lancet i:941–943

    Article  Google Scholar 

  • Ninia J (1994) Recurrent pregnancy loss. The Female Patient 19:26–32

    Google Scholar 

  • Parazzini F, Bocciolone L et al (1991) Risk factors for spontaneous abortion. Int J Epidemiol 20:157–161

    Article  PubMed  CAS  Google Scholar 

  • Peaceman A, Silver R et al (1992) Interlaboratory variation in antiphospholipid antibody testing. Am J Obstet Gynecol 166:1780–1787

    PubMed  CAS  Google Scholar 

  • Poland B, Miller J et al (1977) Reproductive counselling in patients who have had a spontaneous abortion. Am J Obstet Gynecol 127:685–691

    PubMed  CAS  Google Scholar 

  • Portnoi M-F, Joye N et al (1988) Karyotypes of 1142 couples with recurrent abortion. Obstet Gynecol 72:31–34

    PubMed  CAS  Google Scholar 

  • Rae R, Smith I et al (1994) Chlamydial serologic studies and recurrent spontaneous abortion. Am J Obstet Gynecol 170:782–785

    PubMed  CAS  Google Scholar 

  • Regan L (1992) Recurrent early pregnancy failure. Curr Opin Obstet Gynecol 4:220–228

    PubMed  CAS  Google Scholar 

  • Regan L, Braude P et al (1989) Influence of past reproductive performance on risk of spontanenous abortion. Br Med J 299:541–546

    Article  CAS  Google Scholar 

  • Regan L, Owen E et al (1990) Hypersecretion of luteinising hormone, infertility and miscarriage. Lancet 336:1141–1144

    Article  PubMed  CAS  Google Scholar 

  • Regan L, Braude P et al (1991) A prospective study of the incidence, time of appearance and significance of anti-paternal lymphocytotoxic antibodies in human pregnancy. Hum Reprod 6:294–298

    PubMed  CAS  Google Scholar 

  • Rein M (1991) Luteal phase defect and recurrent pregnancy loss. Reprod Med Clin North Am 2:121–136

    Google Scholar 

  • Roberts J, Taylor C et al (1992) Expression of the CD46 antigen and the absence of class I MHC antigen on the human oocyte and preimplantation blastocyst. Immunology 75:202–205

    PubMed  CAS  Google Scholar 

  • Roman E (1984) Fetal loss rates and their relation to pregnancy order. J Epidemiol Commun Health 38:29–35

    Article  CAS  Google Scholar 

  • Rosenbusch B, Sterzik K (1991) Sperm chromosomes and habitual abortion. Fertil Steril 56:370–372

    PubMed  CAS  Google Scholar 

  • Shangold M, Berkeley A, et al (1983) Both midluteal serum progesterone levels and late endometrial histology should be assessed in all in infertile women. Fertil Steril 40:627–630

    PubMed  CAS  Google Scholar 

  • Silver RK, MacGregor S et al (1993) Comparative trial of prednisone plus aspirin versus aspirin alone in the treatment of anticardiolipin antibody-positive obstetric patients. Am J Obstet Gynecol 169:1411–1417

    PubMed  CAS  Google Scholar 

  • Simpson J, Golbus M (1992) Genetics of pregnancy losses. In: Genetics in obstetrics and gynecology, 2nd edn. Saunders, Philadelphia, pp 181–200

    Google Scholar 

  • Simpson J, Elias S et al (1981) Parental chromosomal rearrangements associated with repetitive spontaneous abortions. Fertil Steril 36:584–590

    PubMed  CAS  Google Scholar 

  • Simpson J, Meyers C et al (1989) Translocations are infrequent among couples having repeated spontaneous abortions but no other abnormal pregnancies. Fertil Steril 51:811–814

    PubMed  CAS  Google Scholar 

  • Stray-Pedersen B, Stray-Pedersen S (1984) Etiological factors and subsequent reproductive performance in 195 couples with a prior history of habitual abortion. Am J Obstet Gynecol 148:140–146

    PubMed  CAS  Google Scholar 

  • Talal N (1979) Sex factors, steroid hormones and the host response. Proceedings of the Kroc Foundation Conference. Arthritis Rheum 22:1153

    Article  Google Scholar 

  • Thiagarajan P, Shapiro S et al (1980) Monoclonal immunoglobulin M coagulation inhibitor with phospholipid specifity. J Clin Invest 66:397–405

    Article  PubMed  CAS  Google Scholar 

  • Tho P, Byrd J et al (1979) Etiologies and subsequent reproductive performance of 100 couples with recurrent abortion. Fertil Steril 32:389–395

    Google Scholar 

  • Triplett D (1989) Screening for the lupus anticoagulant. Res Clin Lab 19:379–389

    CAS  Google Scholar 

  • Triplett D (1992) Obstetrical implications of antiphospholipid antibodies. Baillieres Clin Obstet Gynaecol 6:507–518

    Article  PubMed  CAS  Google Scholar 

  • Viaanderen W, Treffers P (1987) Prognosis of subsequent pregnancies after recurrent spontaneous abortion in first trimester. Br Med J 295:92–93

    Article  Google Scholar 

  • Warburton D (1987) Chromosomal causes of fetal death. Clin Obstet Gynecol 30:268–277

    Article  PubMed  CAS  Google Scholar 

  • Warburton D, Frazer F (1964) Spontaneous abortion risk in man: data from reproductive histories collected in a medical genetics unit. Am J Hum Genet 16:1–25

    PubMed  CAS  Google Scholar 

  • Wilcox A, Weinberg C et al (1988) Incidence of early loss of pregnancy. N Engl J Med 319:189–194

    Article  PubMed  CAS  Google Scholar 

  • Wolf FD, Carreras L et al (1982) Decidual vasculopathy and extensive placental infarction in a patient with repeated thromboembolic accidents, recurrent fetal loss, and a lupus anticoagulant. Am J Obstet Gynecol 142:829–834

    PubMed  Google Scholar 

  • Xu L, Chang V et al (1990) Antinuclear antibodies in sera of patients with recurrent pregnancy wastage. Am J Obstet Gynecol 163:1493–1497

    PubMed  CAS  Google Scholar 

  • Yamada H, Polgar K et al (1994) Cell-mediated immunity to trophoblast antigens in women with recurrent spontaneous abortion. Am J Obstet Gynecol 170:1339–1344

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. A. Arici
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. O. Bukulmez
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Chefarzt Frauenklinik Krankenhaus Porz am Rhein, Akademisches Lehrkrankenhaus der Universität Köln, Urbacher Weg 19, 51149, Köln, Germany

    Karl Heinz Broer

  2. Dürener Straße 209, 50931, Köln, Germany

    Ismet Turanli (Frauenarzt) (Frauenarzt)

Rights and permissions

Reprints and permissions

Copyright information

© 1996 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Arici, A., Bukulmez, O. (1996). Recurrent Pregnancy Loss. In: Broer, K.H., Turanli, I. (eds) New Trends in Reproductive Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60961-9_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-60961-9_12

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-64630-0

  • Online ISBN: 978-3-642-60961-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation