Novel approaches to the management of recurrent pregnancy loss: The OPTIMUM (OPtimization of Thyroid function, Thrombophilia, Immunity, and Uterine Milieu) treatment strategy
| Autor: | Keiji Kuroda, Yuko Ikemoto, Takashi Horikawa, Azusa Moriyama, Yuko Ojiro, Satoru Takamizawa, Toyoyoshi Uchida, Shuko Nojiri, Koji Nakagawa, Rikikazu Sugiyama |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | Reproductive Medicine and Biology, Vol 20, Iss 4, Pp 524-536 (2021) |
| Druh dokumentu: | article |
| ISSN: | 1447-0578 1445-5781 |
| DOI: | 10.1002/rmb2.12412 |
| Popis: | Abstract Purpose Does the OPtimization of Thyroid function, Thrombophilia, Immunity, and Uterine Milieu (OPTIMUM) treatment strategy, developed for treating repeated implantation failure (RIF), contribute to improving pregnancy outcomes in patients with a history of recurrent pregnancy loss (RPL)? Methods Between 2018 and 2019, women with RPL after two or more clinical pregnancy losses underwent RPL testing. We treated chronic endometritis with antibiotics, high Th1/Th2 cell ratios with vitamin D and/or tacrolimus, overt/subclinical hypothyroidism with levothyroxine, and thrombophilia with low‐dose aspirin. Of 168 consecutive women aged ≤43 years, 115 underwent RPL testing. We compared 100 pregnancies (90 women) and 46 pregnancies (41 women) with and without the OPTIMUM treatment strategy, respectively. Results RPL testing identified intrauterine abnormalities in 66 (57.4%), elevated Th1/Th2 cell ratios in 50 (43.5%), thyroid dysfunction in 33 (28.7%), and thrombophilia in 33 (28.7%). The live birth rate in the OPTIMUM group was significantly higher than that in the control group among women aged |
| Databáze: | Directory of Open Access Journals |
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