title: Correlation between thrombophilia and recurrent pregnancy loss in patients with polycystic ovary syndrome: a comparative study.
abstract: BACKGROUND
  Patients with polycystic ovary syndrome (PCOS) have an increased prevalence of thrombophilia, leading to higher rates of pregnancy loss. The aim of this study was to determine the association between thrombophilia and recurrent pregnancy loss (RPL) in patients with and without PCOS.
  
  
  METHODS
  In this comparative case-control study, we included 60 patients with RPL (≥3 consecutive pregnancy losses at <20 weeks of gestation) and PCOS (Group 1), 60 patients with PCOS and without RPL (Group 2), 60 patients with RPL and without PCOS (Group 3), and 60 healthy individuals (Group 4). These four study groups were compared regarding serum levels of testosterone, fasting insulin, homocysteine (Hcy), plasminogen activator inhibitor activity (PAI-Fx), protein C, protein S, antithrombin III, activated protein C ratio (APCR), factor V Leiden, prothrombin G20210A, and methylene tetrahydrofolate reductase gene mutations.
  
  
  RESULTS
  Patients in Group 1 had significantly higher levels of testosterone (p = 0.026), dehydroepiandrosterone sulfate (p = 0.035), fasting insulin (p = 0.015), Hcy (p = 0.036), and PAI-Fx (p = 0.008) compared to Group 3. They also had higher proportions of APCR (p = 0.009) and a higher prevalence of factor V Leiden mutations compared to Group 3 (p = 0.001). However, there was no significant difference in protein C (p = 0.088), protein S (p = 0.514), or antithrombin III (p = 0.627) between the four study groups.
  
  
  CONCLUSIONS
  Hyperinsulinemia, hyperandrogenemia, hypofibrinolysis, and hyperhomocysteinemia as well as APCR and factor V Leiden mutations are associated with RPL in patients with PCOS.
authors.affiliation: Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Talieh
authors.initials: T
authors.lastname: Kazerooni
authors.forename: Fariborz
authors.initials: F
authors.lastname: Ghaffarpasand
authors.forename: Nasrin
authors.initials: N
authors.lastname: Asadi
authors.forename: Zahra
authors.initials: Z
authors.lastname: Dehkhoda
authors.forename: Maryam
authors.initials: M
authors.lastname: Dehghankhalili
authors.forename: Yasaman
authors.initials: Y
authors.lastname: Kazerooni
mesh_terms: D000026:Abortion, Habitual / Q000209:etiology*; D000328:Adult; D016022:Case-Control Studies; D005165:Factor V / Q000235:genetics; D005260:Female; D006801:Humans; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000235:genetics; D011247:Pregnancy; D000090822:Ribosomal Protein L3; D019851:Thrombophilia / Q000209:etiology*
chemical_list: C000716547:RPL3 protein, human; D000090822:Ribosomal Protein L3; C095381:factor V Leiden; D005165:Factor V; D042965:Methylenetetrahydrofolate Reductase (NADPH2)