The effect of low-dose ovarian stimulation with HMG plus progesterone on pregnancy outcome in women with history of recurrent pregnancy loss and secondary infertility: a retrospective cohort study

摘要

We assessed the outcome of pregnancy in women with a history of recurrent pregnancy loss (RPL) following treatment with low-dose human menopausal gonadotropin (HMG)+progesterone or progesterone alone. This single-center retrospective cohort study included data from women diagnosed with RPL and treated between February 2005 and December 2012 with one cycle of HMG+progesterone or progesterone alone. Primary endpoint was the rate of ongoing pregnancies and losses by treatment, age (38 vs.38years) and in the subgroup with unexplained RPL. Of 169 RPL patients, 35.5% (n=60) received HMG+progesterone and 64.5% (n=109) progesterone alone. Compared to progesterone alone, HMG+progesterone led to a lower, although not significant, frequency of losses (3.3% vs. 11.9%, p=.09) and a twofold higher rate of ongoing pregnancies (41.7% vs. 19.3%, p=.002). Similar results were obtained in the subgroup of patients with unexplained RPL (ongoing pregnancies: 48.1% upon HMG+progesterone vs. 21.3% upon progesterone, p=.03; losses: 0% vs. 8.5%, respectively, p=.29) and in those38years (ongoing pregnancies: 47.4% vs. 18.8%, respectively, p=.003; losses: 5.3% vs. 10.9% respectively, p=.47). These findings suggest that HMG in women with RPL may reduce the rate of miscarriages and increase that of live births regardless of RPL cause and in women aged38years.