The Endocrinology of Recurrent Pregnancy Loss

A randomized control trial of 64 hyperprolactinemic women with Recurrent Pregnancy Loss (RPL) treated with bromocriptine showed a higher incidence of live births, while PRL levels were significantly higher in women who miscarried. Progesterone is essential for successful implantation and maintenance of a normal pregnancy. Therefore, disorders related to inadequate progesterone secretion by the corpus luteum may affect the outcome of the pregnancy. One plausible explanation for the relationship between hypothyroidism and pregnancy loss is luteal phase defect linked to a hypofunctioning thyroid. Untreated hypothyroidism in pregnancy is associated with a greater risk for adverse pregnancy complications, such as miscarriage, premature birth, low birth weight, and detrimental effects on fetal neurocognitive development. Treatment of endometriosis has been shown to be beneficial for future fertility and improved pregnancy outcomes. Studies from in vitro fertilization have documented decreased pregnancy rates that can be improved with gonadotropin-releasing hormone agonist suppression, surgery, or aromatase inhibitor therapy.