Restoration of serum estradiol and reduced incidence of miscarriage in patients with low serum estradiol during pregnancy: a retrospective cohort study using a multifactorial protocol including DHEA.
| Autor: | Boyle P; International Institute for Restorative Reproductive Medicine, London, United Kingdom.; NeoFertility Clinic, Dublin, Ireland., Andralojc K; NeoFertility Clinic, Dublin, Ireland.; Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands., van der Velden S; Kath. Karl-Leisner-Klinikum, Kleve, Germany., Najmabadi S; Office of Cooperative Reproductive Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, United States., de Groot T; NeoFertility Clinic, Dublin, Ireland.; Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, Netherlands., Turczynski C; NeoFertility Clinic, Dublin, Ireland.; Billings Ovulation Method Association-USA, Saint Cloud, MN, United States., Stanford JB; International Institute for Restorative Reproductive Medicine, London, United Kingdom.; Office of Cooperative Reproductive Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, United States. |
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| Jazyk: | angličtina |
| Zdroj: | Frontiers in reproductive health [Front Reprod Health] 2024 Jan 04; Vol. 5, pp. 1321284. Date of Electronic Publication: 2024 Jan 04 (Print Publication: 2023). |
| DOI: | 10.3389/frph.2023.1321284 |
| Abstrakt: | Background: Low serum estradiol in early pregnancy is associated with an elevated risk of miscarriage. We sought to determine whether efforts to restore low blood estradiol via estradiol or dehydroepiandrosterone (DHEA) supplementation would reduce the risk of miscarriage as part of a multifactorial symptom-based treatment protocol. Methods: This retrospective cohort study included women with low serum estradiol levels in early pregnancy, defined as ≤50% of reference levels by gestational age. Estradiol or DHEA were administered orally, and the primary outcome measure was serum estradiol level, in reference to gestational age. The secondary outcome measures included miscarriage, birth weight, and gestational age at birth. Results: We found no significant effect of estradiol supplementation on serum estradiol levels referenced to gestational age, while DHEA supplementation strongly increased estradiol levels. For pregnancies with low estradiol, the miscarriage rate in the non-supplemented group was 45.5%, while miscarriage rate in the estradiol and DHEA supplemented groups were 21.2% ( p = 0.067) and 17.5% ( p = 0.038), respectively. Birth weight, size, gestational age, and preterm deliveries were not significantly different. No sexual abnormalities were reported in children ( n = 29) of DHEA-supplemented patients after 5-7 years follow-up. Conclusions: In conclusion, DHEA supplementation restored serum estradiol levels, and when included in the treatment protocol, there was a statistically significant reduction in miscarriage. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2024 Boyle, Andralojc, van der Velden, Najmabadi, de Groot, Turczynski and Stanford.) |
| Databáze: | MEDLINE |
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