title: Intradermal sex hormone desensitization for relief of premenstrual symptoms may improve the obstetric outcome of women with recurrent pregnancy loss.
abstract: The aim of this study was to determine whether women with recurrent pregnancy loss (RPL) and concurrent premenstrual syndrome (PMS) who underwent desensitization with sex hormones had an improved obstetric outcome. This manuscript summarizes a 10 year open label prospective follow up study of 26 women with RPL, aged 25-42 with 3-8 previous miscarriages and PMS, who had hormone hypersensitivity on skin testing. Skin testing was positive to estradiol in 23 women, progesterone in 20 women and to both estrogen and progesterone in 17 women. Amelioration of the symptoms of PMS (according to the VAS) was seen in 21 of 26 patients after desensitization with small doses of sex hormones intradermally. There was long term and stable reduction of severe PMS in 21 of 26 patients after desensitization. Five women conceived after skin testing, prior to desensitization. Sixteen of 26 women (61%) had subsequent live births. Five women had two subsequent live births in the subsequent pregnancy. There were no obstetric complications. Five women had two subsequent pregnancies with live births. It seems that correction of sex hormone hypersensitivity was accompanied by relief of persistent PMS, may have a positive effect on the chances of a successful pregnancy.
authors.affiliation: Department of Obstetrics & Gynecology, Sheba Medical Center, Tel Hashomer, Israel. itsekson@netvision.net.il
authors.forename: Alek M
authors.initials: AM
authors.lastname: Itsekson
authors.forename: David
authors.initials: D
authors.lastname: Soriano
authors.forename: Mattityahu
authors.initials: M
authors.lastname: Zolti
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Seidman
authors.forename: Howard J A
authors.initials: HJ
authors.lastname: Carp
mesh_terms: D000026:Abortion, Habitual / Q000209:etiology / Q000517:prevention & control*; D000328:Adult; D001327:Autoimmune Diseases / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D015331:Cohort Studies; D003888:Desensitization, Immunologic; D020964:Embryo Loss / Q000209:etiology / Q000517:prevention & control*; D004958:Estradiol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D004967:Estrogens / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007271:Injections, Intradermal; D050498:Live Birth; D008137:Longitudinal Studies; D011247:Pregnancy; D011293:Premenstrual Syndrome / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D011374:Progesterone / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D055502:Secondary Prevention; D012720:Severity of Illness Index
chemical_list: D004967:Estrogens; D011374:Progesterone; D004958:Estradiol