2nd Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Ulloi ut 78/a, Budapest 1082, Hungary.
Arch Gynecol Obstet. 2012 Nov;286(5):1299-305. doi: 10.1007/s00404-012-2433-0. Epub 2012 Jun 29.
To re-evaluate the role of folliculo-luteal function (FLF) in recurrent miscarriage (RM) on the basis of new hormonal diagnostic criteria.
A prospective, randomized, single-blinded, placebo-controlled study was carried out at 110 apparently healthy patients with three or more miscarriages not related to any presumable predisposing factors of RM were investigated. In the treatment group FLF was normalized preconceptionally. Women in the control group received placebo. FLF was regarded as physiological when the mean of three progesterone (P) values measured every second day between the 4th and 9th day after ovulation or before menstruation was 21.0 ± 2.0 ng/ml.
A significant difference (p < 0.001) was found between the physiological and placebo groups in the occurrence of live births: 93 versus 56 %, pregnancy losses: 7 versus 44 %; premature delivery per births: 10 versus 57 %. Luteal mean P and estradiol values were significantly (p < 0.001) different in cases of spontaneous abortions and premature and mature deliveries, respectively (P: 14.6 ± 2.2, 20.2 ± 2.7, 27.6 ± 3.9 ng/ml). A strong and significant correlation (p < 0.001) was found between luteal mean P values and the duration of pregnancy (r = 0.85), as well as between the P means measured in the luteal phase and different parameters of the newborns: weight (r = 0.89), weight percentile (0.86) and length (0.73). Retrospective analysis of our data suggests that a luteal P mean value of 29.3 ± 2.9 ng/ml characterising patients with singular, mature, eutroph newborns seems to be the most favorable P value for successful reproduction in RM.
Determining the oocyte quality and placentation, FLF quantitatively determines the outcome of pregnancy: its duration and different characteristics of the newborns in RM.
根据新的激素诊断标准，重新评估卵泡黄体功能（FLF）在复发性流产（RM）中的作用。
在 110 名显然健康的患者中进行了一项前瞻性、随机、单盲、安慰剂对照研究，这些患者有三次或更多与 RM 任何假定的易患因素无关的流产史。在治疗组中，在受孕前使 FLF 正常化。对照组患者接受安慰剂。当在排卵后第 4 天至第 9 天或月经前每两天测量一次的孕激素（P）值的平均值为 21.0±2.0ng/ml 时，FLF 被认为是生理性的。
在活产率方面，生理性组和安慰剂组之间存在显著差异（p<0.001）：93%对 56%；妊娠丢失率：7%对 44%；早产率：10%对 57%。自发性流产、早产和足月分娩的黄体平均 P 和雌二醇值差异显著（p<0.001）（P：14.6±2.2、20.2±2.7、27.6±3.9ng/ml）。黄体平均 P 值与妊娠持续时间（r=0.85）以及黄体期测量的 P 值与新生儿的不同参数（体重、体重百分位数和长度）之间存在很强的显著相关性（p<0.001）。对我们数据的回顾性分析表明，黄体 P 值为 29.3±2.9ng/ml 的患者具有单个、成熟、营养良好的新生儿，这似乎是 RM 中成功繁殖的最有利的 P 值。
FLF 定量确定了妊娠的结局：其持续时间和 RM 中新生儿的不同特征。
