Progesterone and Luteal Phase Deficiency: Endocrinological Insights into Recurrent Pregnancy Loss
DOI:
https://doi.org/10.64105/h9zw0280Keywords:
Recurrent Pregnancy Loss; Progesterone; Luteal Phase Deficiency; Endocrine Dysfunction; Prolactin; Thyroid Function.Abstract
Background: Recurrent pregnancy loss (RPL) is a complicated conceptual conceptional reproduction illness in which endocrine malfunctions particularly the malfunctioning of luteal phase that is increasingly becoming an issue of speculation as factors which can be modified. The role of progesterone in endometrial receptivity, implantation and maintenance of early pregnancy is a major topic, yet its clinical role in RPL has been under-valued.
Objective: To determine the luteal phase features and mid-luteal hormonal levels in women of recurrent pregnancy loss and to determine independent endocrine predictors of pregnancy loss.
Methods: It was an analytical case-control study involving 60 women who had recurrent pregnancy loss and 60 women who had healthy fertility. Luteal phase length was measured and mid-luteal follicle-stimulating hormone, prolactin, progesterone, luteinizing hormone, estradiol, and thyroid-stimulating hormone were measured. Univariate analysis was done to measure the associations between luteal phase parameters and RPL, and multivariate logistic regression was used to determine independent predictors.
Results: Compared to controls, RPL women had a high short luteal phases and low mid-luteal progesterone levels. The low concentration of progesterone (less than 10 ng/mL) and short luteal phase (less than 10 days) were found to be strongly related to the risk of RPL. The higher levels of prolactin and thyroid malfunction were also very high in the RPL group. Multivariate analysis has revealed that progesterone insufficiency, a short luteal phase, increased body mass index, and thyroid dysfunction were still independent predictors of recurrent pregnancy loss.
Conclusion: Repeated pregnancy loss is closely linked with progesterone deficiency and functional luteal phase inadequacy, which is usually accompanied by other endocrine disorders. A thorough assessment of the luteal phase activity and specific endocrine screening could enhance the process of risk stratification and personal approach to treatment in women with recurrent pregnancy loss.
