Recurrent pregnancy loss and inappropriate local immune response to sex hormones.
OBJECTIVE
The cause of recurrent miscarriage is often unknown. Recurrent miscarriage may be associated with inappropriate responses to progesterone and estrogen. We examined whether the condition may be diagnosed by skin testing.


METHODS
In a longitudinal prospective study, the weal and flare reaction after intradermal injection of estradiol and progesterone was compared in 29 women with recurrent miscarriage to the response in 10 healthy women. Reactions were evaluated after 20 min, 24, and 48 hr and 5 days later.


RESULTS
Estrogen hypersensitivity was found in 23 patients, and progesterone hypersensitivity in 20 patients. No patient in the control group demonstrated sex hormone hypersensitivity.


CONCLUSIONS
Recurrent pregnancy loss may be associated with inappropriate local immune responses to sex hormones. Further research is necessary into the mechanisms of hypersensitivity to estrogen and progesterone and their interactions with other systems.
Itsekson
Alek M
AM
Department of Obstetrics & Gynecology, Sheba Medical Center, Tel Hashomer, Israel. itsekson@netvision.net.il
Seidman
Daniel S
DS
Zolti
Matityahu
M
Lazarov
Anneta
A
Carp
Howard J A
HJ
D000026:Abortion, Habitual / Q000276:immunology* / Q000378:metabolism; D000328:Adult; D016022:Case-Control Studies; D004967:Estrogens / Q000378:metabolism; D005260:Female; D012739:Gonadal Steroid Hormones / Q000276:immunology*; D006801:Humans; D008137:Longitudinal Studies; D011374:Progesterone / Q000378:metabolism; D011446:Prospective Studies; D012882:Skin Tests
D004967:Estrogens; D012739:Gonadal Steroid Hormones; D011374:Progesterone