Recurrent Spontaneous Miscarriage Research Articles

Polymorphisms in the vascular endothelial growth factor gene associated with recurrent spontaneous miscarriage

Objective: To evaluate the association between the vascular endothelial growth factor (VEGF) polymorphism and the risk of recurrent spontaneous miscarriage (RSM).Methods: The participants enrolled included 227 RSM patients and 232 women with normal fertility. We examined the potential association between RSM and 13 single nucleotide polymorphisms (rs699947, rs1570360, rs2010963, rs833068, rs833069, rs3024997, rs3024998, rs3025000, rs3025006, rs3025010, rs3025020, rs3025030 and rs3025039) of VEGF gene using the MassARRAY system.Results: The results showed that rs3025020 located at intron 6 of VEGF gene was significantly associated with RSM (χ2 = 12.6385, p = 0.0004, odds ratio (OR) = 1.6109, 95% confidence interval (CI) = 1.2377–2.0967). Another significant association was observed for rs3025039 located in the 3′-untranslated region of VEGF gene (χ2 = 9.7256, p = 0.0018, OR = 1.6492, 95% CI = 1.2023–2.2622). Furthermore, strong linkage disequilibrium was observed in three blocks (D′ > 0.9), and significantly more T–G–C haplotypes (p = 0.0286) and fewer C–G–C haplotypes (p = 0.0006 after Bonferroni correction) residing in block 3 were found in RSM patients.Conclusion: These findings point to a role for VEGF gene polymorphisms in RSM, and may be informative for future genetic or neurobiological studies on RSM.

Dos and don'ts in diagnosing antiphospholipid syndrome

Abstract Antiphospholipid syndrome (APS) is an acquired autoimmune thrombotic tendency that is identified by the presence of abnormal antiphospholipid laboratory tests in patients who have a history of vascular thrombosis and/or pregnancy complications including recurrent spontaneous miscarriages and a group of other complications due to placental insufficiency. Diagnostic testing for APS is often problematic because of many misconceptions regarding these empirically derived assays. This chapter is intended to provide hematology-oncology consultants with practical information about the uses and limitations of assays used to diagnose APS.

Comparison of Blastocyst Development and Cycle Outcome in Patients with eSET Using Either Conventional or Time Lapse Incubators. A Prospective Study of Good Prognosis Patients

The aim of this study is to compare blastocyst development and cycle outcomes of good prognosis elective single embryo transfer patients using conventional or time lapse incubators. A randomized study was designed to evaluate embryo development until the blastocyst stage in either conventional or time-lapse incubators in good prognosis patients. Furthermore cycle outcomes of the patients were evaluated. The study involved 64 patients (33 for time-lapse and 31 for conventional incubation) in their first or second treatment cycle, with no recurrent spontaneous miscarriages, age<35 years, body mass index <28 kg/m2 and ≥8 oocytes retrieved. The primary outcome was the proportion of good and top quality blastocysts on day 5 and the secondary outcome was the implantation and pregnancy rates after elective single embryo transfer in good prognosis patients. The analysis performed revealed no statistical difference between both groups for blastocyst development, implantation and clinical pregnancy rates. In a selected good prognosis elective single embryo transfer population, similar rates of good and top quality blastocysts and comparable implantation and pregnancy rates were achieved. However, the stable culture conditions provided by time-lapse incubators and the use of morphokinetic parameters may allow the selection of the best available embryos with high developmental capacity, especially in poor prognosis patients.

Contribution of JAK2 and STAT3 Variants to the Genetic Susceptibility of Recurrent Spontaneous Miscarriage in a Tunisian Population

Th1 and Th2 balance is crucial for maintenance of pregnancy, and intracellular JAK and STAT proteins significantly contribute to it. In view of evidence linking JAK2 and STAT3 variants with recurrent spontaneous miscarriage (RSM), here we investigated the association of JAK2 (rs2230724) and STAT3 (rs1053023 and rs1053004) to RSM susceptibility in Tunisians. A retrospective case-control study. Subjects comprised 235 RSM cases and 235 control subjects. JAK2 and STAT3 were genotyped by the allelic discrimination method. STAT3 rs1053023 and, to a lower extent, rs1053004 were significantly associated with RSM under the additive and dominant, but not recessive models. This remained significant after adjustment for the covariates age, smoking, and gravida. In contrast to STAT3 variants, JAK2 rs2230724 was not associated with RSM under any of the genetic models tested. Two-locus STAT3 (rs1053023/rs1053004) haplotype analysis revealed increased frequency of the C/G haplotype in patients with RSM. Multivariate regression analysis confirmed the association of C/G haplotype with RSM (p=0.001; odds ratio=2.01; 95% confidence interval=1.32-3.07), thus conferring RSM susceptibility nature. These differences remained significant after applying the Bonferroni correction for multiple testing (Pc=0.004). STAT3 rs1053023, more so than the STAT3 rs1053004 or JAK2 rs2230724 polymorphisms, is associated with RSM risk.

O655 SELENIUM IN RECURRENT SPONTANEOUS MISCARRIAGE

International Journal of Gynecology & ObstetricsVolume 119, Issue S3 p. S491-S491 Free communication (oral) presentations O655 SELENIUM IN RECURRENT SPONTANEOUS MISCARRIAGE E.M. Stefanidou, E.M. StefanidouSearch for more papers by this authorL. Caramellino, L. CaramellinoSearch for more papers by this authorG. Gallone, G. GalloneSearch for more papers by this authorA. Patriarca, A. PatriarcaSearch for more papers by this authorG. Menato, G. MenatoSearch for more papers by this author E.M. Stefanidou, E.M. StefanidouSearch for more papers by this authorL. Caramellino, L. CaramellinoSearch for more papers by this authorG. Gallone, G. GalloneSearch for more papers by this authorA. Patriarca, A. PatriarcaSearch for more papers by this authorG. Menato, G. MenatoSearch for more papers by this author First published: 22 October 2012 https://doi.org/10.1016/S0020-7292(12)61085-6AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume119, IssueS3Abstracts of XX FIGO World Congress of Gynecology and ObstetricsOctober 2012Pages S491-S491 RelatedInformation

W180 ANTICARDIOLIPIN ANTIBODY IN WOMEN WITH RECURRENT SPONTANEOUS MISCARRIAGE

International Journal of Gynecology & ObstetricsVolume 119, Issue S3 p. S763-S763 Poster presentations W180 ANTICARDIOLIPIN ANTIBODY IN WOMEN WITH RECURRENT SPONTANEOUS MISCARRIAGE N.K. Mahdi, N.K. MahdiSearch for more papers by this author N.K. Mahdi, N.K. MahdiSearch for more papers by this author First published: 22 October 2012 https://doi.org/10.1016/S0020-7292(12)61905-5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume119, IssueS3Abstracts of XX FIGO World Congress of Gynecology and ObstetricsOctober 2012Pages S763-S763 RelatedInformation

C0112 Activated protein c resistance in Tunisian patients with thromboembolic complication or spontaneous recurrent miscarriage

Background: Particulate air pollution has been associated with increased risk of cardiovascular and pulmonary diseases. However, the underlying mechanisms are not fully understood. Methods: Here, we exposed mice with repeated doses of diesel exhaust particles (DEP, 15 μg/animal) every 2nd day for 6 days (a total of 4 exposures), and measured several cardiopulmonary endpoints 48 h after the end of the treatments. Moreover, the potential protective effect of curcumin (the yellow pigment isolated from turmeric) on DEP-induced cardiopulmonary toxicity was assessed. Results: DEP exposure increased macrophage and neutrophil numbers, tumor necrosis factor α (TNF α) in the bronchoalveolar lavage (BAL) fluid, and enhanced airway resistance to methacoline measured invasively using Flexivent. DEP also significantly increased plasma C-reactive protein (CRP) and TNFα concentrations, systolic blood pressure (SBP) as well as the pial arteriolar thrombosis. It also significantly enhanced the plasma D-dimer and plasminogen activator inhibitor-1 (PAI-1). Pretreatment with curcumin by oral gavage (45 mg/kg) 1 h before exposure to DEP significantly prevented the influx of inflammatory cells and the increase of TNF α in BAL, and the increased airway resistance caused by DEP. Likewise, curcumin prevented the increase of SBP, CRP, TNF α, D-dimer and PAI-1. The thrombosis was partially but significantly mitigated. Comment: In conclusion, repeated exposure to DEP induced lung and systemic inflammation characterized by TNFα release, increased SBP, and accelerated coagulation. Our findings indicate that curcumin is a potent anti-inflammatory agent that prevents the release of TNFα and protects against the pulmonary and cardiovascular effects of DEP.

Proinflammatory cytokines induced altered expression of cyclooxygenase-2 gene results in unreceptive endometrium in women with idiopathic recurrent spontaneous miscarriage

To investigate the expression pattern of proinflammatory, anti-inflammatory, and angiogenic cytokines and their effect on various mediators of endometrial receptivity in women with idiopathic recurrent spontaneous miscarriage (IRSM). A prospective study. Tertiary care hospital and reproductive health research unit. Thirty-six women with IRSM (<35 years) and 30 fertile women as controls matched by age and body mass index undergoing sterilization. Endometrial biopsies in all women corresponding to the window of implantation. Assessment of endometrial expression of proinflammatory, anti-inflammatory, and angiogenic cytokines, mediators of matrix turnover and angiogenesis, markers of receptivity. A statistical significantly higher level of proinflammatory cytokines, mediators of matrix turnover and angiogenesis, and a reduced expression of anti-inflammatory and angiogenic cytokines were observed in women with IRSM. Additionally, the markers of endometrial receptivity were poorly expressed in women with IRSM. Aberrant expression of proinflammatory, anti-inflammatory, and angiogenic cytokines during implantation window in women with IRSM is one of the key factors that adversely affect endometrial development, as evidenced by the inadequate expression of various endometrial receptivity markers.

Methylation analysis of idiopathic recurrent spontaneous miscarriage cases reveals aberrant imprinting at H19 ICR in normozoospermic individuals

To study H19 ICR methylation levels in association with sperm parameters routinely analyzed in idiopathic recurrent spontaneous miscarriage cases. Case-control study. Academic research setting. Male partners of couples with a history of idiopathic recurrent spontaneous miscarriage (RSM group) and male partners of couples with proven fertility (control group). None. Paternal age, sperm concentration, motility, chromatin compaction status, morphology, and H19 ICR methylation were assessed in control and idiopathic RSM group participants. Paternal age and basic semen parameters analyzed did not show any significant difference between the two groups; however H19 ICR methylation levels were reduced significantly in the idiopathic RSM group compared with the control group. Significant reduction in the H19 ICR methylation without significant difference in the sperm parameters demonstrates aberrant imprinting to be associated with idiopathic RSM.

Increased expression of Toll-like receptor 3 in decidual natural killer cells of patients with unexplained recurrent spontaneous miscarriage

To investigate whether the expression of Toll-like receptor 3 (TLR3) in decidual natural killer (dNK) cells plays a role in the pathogenesis of unexplained recurrent spontaneous miscarriage (URSM). NK cells were isolated from human decidual tissue through magnetic cell sorting and analyzed for phenotypes through flow cytometry. TLR3 expression in dNK cells was detected by quantitative reverse-transcriptase polymerase chain reaction and western blotting. The cytotoxicity of dNK was detected using a lactate dehydrogenase release test. The CD56(+) dNK percentages varied between 85% and 96%. The expression of TLR3 mRNA and protein in dNK cells of URSM patients was statistically significantly higher than that in control women (p=0.005 and p=0.01, respectively). Meanwhile, the mean cytotoxicity percentage of freshly isolated dNK cells from the patients was significantly higher than that from normal controls (31.24 ± 7.46% vs. 16.20 ± 6.03%; p=0.03). The expression of TLR3 in dNK cells is abnormally higher in URSM patients, which indicates that TLR3 expression may be critical to the activation of dNK cells infiltrating the maternal-fetal interface and account for the loss of immune tolerance.

Anti-phosphatidylserine, anti-cardiolipin, anti-β2 glycoprotein I and anti-prothrombin antibodies in recurrent miscarriage at 8–12 gestational weeks

To investigate the association of antibodies to β2-glycoprotein I (anti-β2GPI), cardiolipin (ACA), phosphatidylserine (anti-PS) and prothrombin (anti-PT) with recurrent spontaneous miscarriage (RSM). Case-control study involving 277 RSM cases and 288 controls: autoantibody levels were measured by ELISA. Differences between cases and controls were analyzed by nonparametric Mann-Whitney test, and logistic regression was used in analyzing the association of autoantibodies with RSM. Anti-PS IgG, ACA IgM and IgG, and anti-PT IgM were significantly associated with RSM risk, and differential antibody association was noted according to BMI and primary and secondary RSM. Higher prevalence of elevated anti-PS IgG was seen in cases, with the strongest risk above the 99th percentile. For ACA IgM, 28 cases (10.1%) and 5 controls (1.7%) were positive, with increasing OR for increasing cut-off points, which was significant at antibody titers >99th percentile. For ACA IgG, 101 cases (36.5%) and 13 controls (4.5%) were positive, with graded increase in OR for increasing cut-off points, which was significant at titers >90th percentile (maximal at titers >99th percentile). For anti-PT, 23 cases (12.0%) and 9 controls (6.1%) were positive, with increased OR at titers >90th percentile. Regression analyses confirmed the independent association of anti-PS IgG, ACA IgM and IgG with RSM, and significant RSM risk was associated with high anti-PS IgG (P<0.001) and ACA IgM (P<0.001) titers, and a dose-dependent increase in RSM risk was seen with progressively increased ACA IgG titers. No significant association existed between anti-PT IgM and RSM. Elevated ACA IgM and IgG, and anti-PS IgG antibodies are positively associated with RSM.

A rare case of coagulation disorder presenting with unexpected bleeding non-responding to fresh frozen plasma replacement: Factor XIII deficiency

Factor XIII deficiency is a quite rare bleeding disorder in which detecting tests for coagulation are found in normal ranges. This disorder usually does not cause spontaneous bleeding but other than excessive bleeding after invasive procedures, impaired wound healing, abnormal scar formation, recurrent spontaneous miscarriages in women, oligospermia and infertility in men could be seen. Case Report: A thirty three years old male patient with previously diagnosed as factor XIII deficiency referred to emergency with serious stomachache which began after he fell down at his home. After recognition of a retroperitoneal hematoma and splenic rupture, laparotomic splenectomy with fresh frozen plasma (FFP) replacement was performed. Meanwhile factor XIII levels were detected <1%. Although FFP (15-20 ml/kg) and cryopresipitate was given postoperatively, bleeding from the incision and surgical drains continued. Until postoperative 15th day approximately 20 units of red blood cells were transfused. Because the bleeding couldn’t be stopped, plasma concentrate of factor XIII is brought from abroad and administered at a dose of 20 IU/kg (1500 U/day) weekly, for three weeks (totally three doses). After the administration of the first dose the amount of bleeding decreased progressively and eventually stopped. We reported this case because, besides factor XIII deficiency is a rare form of bleeding disorder; this patient had more severe and prolonged bleeding than expected and did not responded FFP or cryopresipitate therapy. So unexpected bleeding could not be stopped until plasma concentrate of factor XIII was administered, though to be worth for attention.

The comparison of insulin resistance frequency in patients with recurrent early pregnancy loss to normal individuals

BackgroundPatients with ≥ 3 recurrent spontaneous miscarriages are classified as having RSM. Polycystic ovary syndrome (PCOS) is associated with insulin resistance (IR). The purpose of this study is to evaluate the association of IR and RMS.MethodsPresent case- control prospective study was performed on 100 women in control group (with a history of at a live birth and no history of one more abortion) and study group (with a history of ≥ 3 RMS) who were not diabetes and PCOS. Two groups matched in base of age and body mass index. Blood was withdrawn from the case and control patients for the determination of the fasting blood glucose (FG), fasting insulin (FI) levels and ultrasonography was performed on all the patients.ResultsThe observed differences between age, FG and FG to FI ratio levels in case and control groups were not significant (p > 0.05) but it was significant about fasting insulin (p = 0.0119). FI of < 20 μu/ml or ≥ 20 μu/ml in case and control group was significant (Chi-square: 4.083, p: 0.0433, odds ratio: 4.4386, CI95% = 1.1541 to 17.0701), whereas the difference between absolute and proportional frequency of patients with FG to FI ratio of < 4.5 and ≥ 4.5 in case and control groups was not significant (Chi-square: 2.374, p = 0.123).ConclusionCurrent study showed that in women with RPL, in Iranian race like Americans, frequency of insulin resistance in high, therefore there is a probability of the degree of insulin resistance in women with RPL.

Identification of specific vascular endothelial growth factor susceptible and protective haplotypes associated with recurrent spontaneous miscarriages

We investigated the association of vascular endothelial growth factor (VEGF) gene polymorphism with recurrent spontaneous miscarriage (RSM). VEGF -2578C/A, -1154G/A, -634G/C, +936C/T single nucleotide polymorphisms (SNPs) were assessed in 304 RSM patients, and 371 age-and body mass index-matched control subjects using real-time PCR. Higher minor allele frequency of -1154G/A (P < 0.001) and +936C/T (P < 0.001), but not -2578C/A (P = 0.55) or -634G/C (P = 0.87) SNPs, were seen in patients. Significant differences in the distribution of -1154G/A (P = 0.006) and +936C/T (P = 0.015), but not -2578C/A (P = 0.473) or -634G/C (P = 1.000) genotypes, were seen in cases compared with control women. Of the possible 16 VEGF haplotypes, 9 were found to be common, and were included. A significantly lower frequency of C G C C (P = 0.008), and A G G C (P < 0.001) haplotypes, and a higher frequency C G C T (P = 0.020), and C G T (P = 0.004) haplotypes were seen in patients. These results strongly support that VEGF polymorphisms, in particular-1154G/A and +936C/T, are significantly associated with RSM. Our results confirm, in the largest sample to date, previous works in other populations on VEGF polymorphism in RSM.

Immunotherapy of Patients with Recurrent Spontaneous Miscarriage and Idiopathic Infertility: Does the Immunization-Dependent Th2 Cytokine Overbalance Really Matter?

Recurrent spontaneous miscarriage (RSM) and idiopathic infertility (IIF) are partially caused by immunologic disturbances. Paternal lymphocyte immunization (PLI) is proposed for restoration of the proper Th1/Th2 balance in these patients, but still there are controversies on PLI mechanism, its efficacy and identification of patients who may benefit from this therapy. The study group consisted of n=34 RSM and n=42 IIF women with unexplained miscarriage or IIF. PLI was offered as a treatment in both groups. Peripheral blood lymphocyte (PBL) populations (CD3(+), CD3(-)/CD19(+), CD3(+)/CD4(+), CD3(+)/CD8(+), CD3(-)/CD16(+)CD56(+)) were studied before immunization, while PBL cytokine secretion (IFN-γ, TNF-α, IL-10, IL-5, IL-4, IL-2), before and after immunization, pre-conceptionally in both groups. The reference PBL ratio and cytokine levels were adopted from previously studied normal fertile women. PBL populations, concentration and ratio of Th1/Th2 cytokines did not differ between RSM and IIF patients. Compared to the results observed in normal fertile women the levels of IFN-γ, TNF-α and IL-2 were higher, while IL-10 lower in both RSM and IIF patients (p<0.01). After immunization a decrease of IFN-γ (RSM and IIF groups) and IL-4 and IL-10 (RSM group) were observed, as well as an increase in TNF-α/IL-4 ratio (RSM group) (p<0.05). No differences in Th1/Th2 concentration and ratio between patients with successful and unsuccessful pregnancy were observed. No significant correlations between success and particular cytokine concentration were observed. Concentrations of Th1/Th2 cytokines and PBL populations did not differ between RSM and IIF women. Th1 shift in both RSM and IIF patients was observed in comparison to fertile women. Treatment with PLI-induced pre-conceptionally cytokine changes which neither indicated Th2 shift nor correlated with subsequent pregnancy success.

Endothelial protein C receptor 1651C/G polymorphism and soluble endothelial protein C receptor levels in women with idiopathic recurrent miscarriage

High levels of soluble endothelial protein C receptor (EPCR) induce coagulation dysfunction by inhibiting protein C activation, and activated protein C (APC) activity. We tested whether EPCR 1651C/G promoter variant and changes in plasma soluble EPCR levels are risk factors for idiopathic recurrent spontaneous miscarriage (RSM). A case-control study involving 283 RSM cases and 380 age and BMI-matched control women. EPCR 1651C/G genotyping was performed by PCR-RFLP method. Plasma-soluble EPCR levels were measured with ELISA. The 1651G allele frequency and C/G genotype were significantly higher in RSM cases than controls; none of the cases or control participants was a 1651G/G homozygote. Lower soluble EPCR levels were seen in RSM cases compared to controls, and higher soluble EPCR levels were seen in 1651C/G compared to 1651C/C carriers in cases and controls. Lower soluble EPCR levels were seen in cases, both in 1651C/C (P = 0.0046) and 1651C/G (P = 0.0032) genotype carriers. Multivariate analysis demonstrated strong association of EPCR 1651C/G [P = 0.011; adjusted odds ratio (aOR) (95% confidence interval [CI] = 3.13 (1.31-7.60)], but not soluble EPCR plasma levels [P = 0.067; aOR (95% CI) = 1.01 (1.00-1.10)], with increased RSM risk. In addition, smoking was independently associated with increased RSM risk [P = 0.002; aOR (95% CI) = 2.86 (1.48-5.52)]. EPCR 1651C/G polymorphism and elevated soluble EPCR levels but low soluble EPCR levels increase the risk of idiopathic RSM. Replication studies on other racial groups, and other EPCR gene variants, are warranted.

Antiphospholipid antibodies and pregnancy

Acquired thrombophilia is commonly associated with detection of autoantibodies against phospholipid-protein complexes that include lupus anticoagulant, anticardiolipin antibodies, anti-prothrombin and anti-beta-2 glycoprotein I antibodies. The anti-phospholipid syndrome is present when these autoantibodies are found in association with clinical manifestations that include venous or arterial thromboembolism or pregnancy morbidity, such as recurrent spontaneous miscarriages, fetal deaths, second or early third trimester fetal deaths or fetal growth retardation. Because the diagnosis of antiphospholipid syndrome is based on laboratory data, optimal performance and interpretation of the tests is essential. However, heterogeneity of the autoantibodies and absence of gold standard assays makes analysis of laboratory results a challenge for pathologists and clinicians alike. As a further complication to rational use and interpretation of the tests, the causal relationship of aPLs and thrombosis is difficult to establish as they are present in normal, asymptomatic individuals, with thrombotic events occurring only in approximately 30% of patients with antiphospholipid antibodies. Obstetric complications are also difficult to correlate meaningfully with test results because of heterogeneity in study populations, and changes in anti-coagulant management and the threshold for its use in everyday practice over time. Characterisation of the molecular basis of the pathogenic mechanisms involved in the syndrome will hopefully provide a more rational basis for definition of the syndrome, the use of diagnostic tests and management in the future.

Association of the R67X and W303X non-sense polymorphisms in the protein Z-dependent protease inhibitor gene with idiopathic recurrent miscarriage

Protein Z-dependent protease inhibitor (ZPI) is a 72 kDa single-chain serpin which inhibits the activated coagulation factors X and XI. Two non-sense polymorphisms of ZPI, R67X and W303X, were recently identified, and were linked with a prothrombotic state. Here, we investigated the association of the R67X (728C>T) and W303X (1438G>A) variants in the ZPI gene with recurrent spontaneous miscarriage (RSM). This was a case-control study involving a total of 288 women with a history of two consecutive or ≥3 non-consecutive pregnancy losses between 8 and 12th week of gestation, along with 304 age-matched and ethnically matched multiparous control women, with no personal or family history of pregnancy complications. The minor allele frequency of R67X (P = 0.003) and W303X (P = 0.014) were higher in RSM cases than in control women. Both single-nucleotide polymorphisms were significantly associated with RSM under the dominant genetic association model, and were in moderate linkage disequilibrium (D' = 0.412; P < 0.001). Taking the common (728)C/(1438)G haplotype as reference, multivariate analysis confirmed the positive association of (728)T/(1438)G [P = 0.043; odds ratio (OR) = 2.25; 95% confidence interval (CI) = 1.03-4.90], and (728)T/(1438)A (P = 0.022; OR = 3.93; 95% CI = 1.23-12.59) haplotypes with increased RSM risk. These differences remained significant after controlling for some covariates. These results demonstrate that both ZPI R67X and W303X non-sense variants and specific ZPI haplotypes are significantly associated with RSM.

Exaggerated inflammatory response affects endometrial receptivity in women with idiopathic recurrent spontaneous miscarriage

Exaggerated inflammatory response affects endometrial receptivity in women with idiopathic recurrent spontaneous miscarriage

Homocysteine correlation with angiogenic factors and uterine blood flows in idiopathic recurrent spontaneous miscarriage

Homocysteine correlation with angiogenic factors and uterine blood flows in idiopathic recurrent spontaneous miscarriage