Department of Obstetrics & Gynecology, Sheba Medical Center, Tel Hashomer, Israel.
Gynecol Endocrinol. 2013 Feb;29(2):169-72. doi: 10.3109/09513590.2012.730582. Epub 2012 Nov 7.
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.
本研究旨在探讨是否对反复妊娠丢失(RPL)合并经前期综合征(PMS)的女性进行性激素脱敏治疗能改善其产科结局。本研究报告了一项为期 10 年的开放性前瞻性随访研究结果,共纳入 26 名年龄在 25-42 岁、有 3-8 次自然流产史且患有 PMS 的 RPL 女性,她们的皮肤试验显示对激素过敏。23 名女性的雌二醇皮肤试验阳性,20 名女性的孕酮皮肤试验阳性,17 名女性的雌二醇和孕酮皮肤试验均阳性。26 名患者中有 21 名在接受小剂量性激素皮内脱敏治疗后 PMS 症状(根据 VAS 评分)得到缓解。26 名患者中有 21 名在脱敏治疗后长期稳定地减轻了严重 PMS。5 名女性在皮肤试验前受孕。26 名女性中有 16 名(61%)随后有活产。5 名女性在随后的妊娠中再次有 2 次活产。无产科并发症发生。5 名女性有 2 次随后的妊娠并分娩活婴。纠正性激素过敏似乎伴随着持续 PMS 的缓解,可能对成功妊娠的机会产生积极影响。