The relationship of recurrent spontaneous miscarriage with reproductive failure.
OBJECTIVE
To investigate the reproductive performance of non-pregnant women with recurrent spontaneous miscarriage (RSM) and the association between RSM and polycystic ovary syndrome (PCOS) in reproductive failure.


METHODS
Fifty non-pregnant women with 3 or more consecutive RSM attending our RSM clinic were evaluated prospectively. Detailed history and physical examination were completed. Extensive laboratory investigations, ultrasonographic, radiological and specialized procedures/tests were performed. Those patients who did not achieve pregnancy within the first 6 months of follow-up had appropriate treatment options implemented. The outcome of any subsequent pregnancies was analyzed.


RESULTS
The mean age of the patients was 33.8 +/- 4.6 years (range 22-43 years). The aetiological factors associated with RSM were chromosome anomaly, uterine abnormality, antiphospholipid syndrome, PCOS and infections; 40% were 'unexplained'. Thirty patients (60%) were able to achieve viable pregnancies which progressed to term, resulting in live births. Fourteen of the other 20 patients had high body mass index (BMI) >30 and evidence of PCOS. Of these 20 patients, 13 eventually achieved pregnancies which ended again in first-second-trimester abortions (cause undetermined). The remaining 7 patients (4 with high BMI) who had a combination of male factor/protracted PCOS/ovarian failure did not achieve pregnancies.


CONCLUSIONS
The association of RSM with PCOS resulted in poor reproductive performance, which may progress to reproductive failure.
Diejomaoh
Michael
M
Department of Obstetrics and Gynaecology, Faculty of Medicine, Kuwait University, Kuwait. michael@hsc.kuniv.edu.kw
Jirous
Jiri
J
Al-Azemi
Magda
M
Baig
Saba
S
Gupta
Madhu
M
Tallat
Alaa
A
D000026:Abortion, Habitual / Q000209:etiology*; D000328:Adult; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors