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Prophylactic measure in women with early recurrent pregnancy loss, polycystic ovary syndrome, and hyperhomocysteinemia

2022; Medknow; Volume: 35; Issue: 2 Linguagem: Inglês

10.4103/mmj.mmj_147_21

2314-6788

SamiaM Ghonim, MohamedS Gad, AbdEL-Hamid E. Shahin,

Reproductive Biology and Fertility

ObjectiveThis work aims to evaluate prophylactic measures against early recurrent pregnancy loss (RPL) in women with polycystic ovary syndrome (PCOS) and hyperhomocysteinemia.BackgroundPCOS is the most common endocrine disorder in females; hyperhomocysteinemia is frequently associated with PCO. Mild-to-moderate hyperhomocysteinemia increases the risk of RPL through augmentation of hypercoagulable state of pregnancy and thrombosis in maternal and fetal circulation.Patients and methodsThe study was a randomized prospective comparative study. Patients in this study were 60 patients aged between 20 and 35 years with PCOS that was diagnosed according to the Rotterdam criteria if at least two of the following criteria is present: oligoamenorrhea/amenorrhea, clinical or biochemical hyperandrogenism and PCO on ultrasonography, hyperhomocysteinemia, and a history of early recurrent abortion. Patients were randomly classified into three groups by simple randomization (number generation by computer): group 1 included 20 patients with PCOS, hyperhomocysteinemia, and a history of early recurrent abortion, treated with folic acid 5 mg/day and low-dose aspirin (LDA) 81 mg/day until 20 weeks of pregnancy. Group 2 included 20 patients with PCOS, hyperhomocysteinemia, and a history of early recurrent abortion, treated with folic acid 5 mg/day and low-molecular weight heparin (LMWH) 40 mg/day until 20 weeks of pregnancy and group 3 included 20 patients with PCOS, hyperhomocysteinemia, and a history of early recurrent abortion treated with LDA 81 mg/day, LMWH 40 mg/day, and folic acid 5 mg/day until 20 weeks of pregnancy.ResultsRPL is common in women with PCOS and hyperhomocysteinemia. It was found that combined treatment with folic acid' aspirin, and LMWH in women with PCO and hyperhomocysteinemia improved successful pregnancy rates.ConclusionAdministration of folic acid and LMWH or folic acid, LMWH, and LDA decreases the rate of early RPL in women with PCO and hyperhomocysteinemia better than folic acid and LDA alone.