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A prospective study of early pregnancy loss in humans.

Vitzthum VJ, Spielvogel H, Thornburg J, West B

Anthropology Department, Indiana University, Bloomington, Indiana 47405, USA. Vitzthum@indiana.edu

OBJECTIVE: To test two hypotheses: In spontaneous conceptions, early pregnancy loss (EPL) is associated with [1] inadequate luteal (ovarian) P, and/or [2] elevated follicular (adrenal) P. DESIGN: A population-based prospective study. SETTING: Thirty rural Bolivian communities. PATIENT(S): Women volunteers (n = 191), 19-40 years old, in stable sexual unions and not using contraception. INTERVENTION(S): Collection of serial saliva samples throughout sequential ovarian cycles and urine samples during late luteal phases. Collections continued throughout pregnancy for each detected conception. MAIN OUTCOME MEASURE(S): Occurrence of spontaneous conceptions and subsequent outcomes. Salivary concentrations of P. Test for elevated urinary human chorionic gonadotropin (hCG). RESULT(S): Luteal (through implantation) P levels were similar in pregnancies lost within 5 weeks after conception (EPL; n = 8) and those pregnancies that were maintained longer (sustained conceptions, SC; n = 32). Follicular P was significantly higher in EPL than in SC. CONCLUSION(S): [1] Elevated follicular P was associated with EPL in natural conceptions in healthy women. [2] Early pregnancy loss exhibits absolute luteal P levels comparable to SC, but lower luteal/follicular P ratios.

Published 2 August 2006 in Fertil Steril, 86(2): 373-9.
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