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MISCARRIAGE AND INFERTILITY ASSOCIATED WITH SERUM LH HYPERSECRETION.

Miscarriages can have a variety of causes, including maternal anatomic abnormalities, fetal genetic abnormalities, and impaired progesterone secretion early in pregnancy, but these factors do not explain many miscarriages. Extrapolating from previous observations that hypersecretion of luteinizing hormone (LH) before conception may account for infertility or miscarriages in specific cases (e.g., polycystic ovary syndrome), Regan and colleagues asked whether the same phenomenon might occur more generally.

The authors measured serum LH between days 3 and 9 of the menstrual cycle in 193 women planning pregnancy, 150 of whom had had one or more previous miscarriages. Over a minimum of 18 months of follow-up, the 147 women with normal serum LH levels (less than 10 IU/l) were significantly more likely to conceive than those with high LH levels (88 vs. 67 percent). Moreover, women in the normal-LH group who conceived had a dramatically lower miscarriage rate than those in the high-LH group (12 vs. 65 percent). These findings held regardless of whether a woman had had a miscarriage before the study.

The mechanism of this effect of LH is unclear. Nevertheless, these results may eventually have clinical applicability (e.g., administration of LH-suppressing agents to infertile women with high LH levels).

— ASB

Published in Journal Watch General Medicine December 4, 1990

Citation(s):

Regan L et al. Hypersecretion of luteinising hormone, infertility, and miscarriage. Lancet 1990 Nov 10 336 1141-1144.

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