Cases reported "Abortion, Habitual"

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1/2. polycystic ovary syndrome, infertility, familial thrombophilia, familial hypofibrinolysis, recurrent loss of in vitro fertilized embryos, and miscarriage.

    OBJECTIVE: To study reversible determinants of infertility and recurrent loss of transferred embryos after failure of 7 of 10 embryo transfers, 1 live birth, and 2 miscarriages. DESIGN: Measures of thrombophilia, hypofibrinolysis, reproductive hormones, and androgenic steroids before and after metformin therapy. SETTING: Outpatient clinical research center. PATIENT(S): A 32-year-old amenorrheic, infertile woman with polycystic ovary syndrome (PCOS) who had 7 of 10 embryo transfers fail, 1 premature live birth, and 2 miscarriages at 8 and 17 weeks. INTERVENTION(S): metformin (2.55 g/d) was given to ameliorate the endocrinopathy of PCOS. MAIN OUTCOME MEASURE(S): Coagulation, insulin, reproductive hormones, and androgenic steroids. RESULT(S): The propositus had thrombophilia (familial protein s deficiency [free protein S 32%; normal >/=65%]). She also had familial hypofibrinolysis with 4G4G polymorphism of the plasminogen activator inhibitor (PAI-1) gene and high PAI-1 activity (PAI-Fx), 42.5 U/mL, normal <21.1. polycystic ovary syndrome was characterized by amenorrhea, polycystic ovaries, high fasting serum insulin (39 microU/mL, normal <20), androstenedione (763 ng/dL, normal <250), and testosterone (229 ng/dL, normal <83). After she received metformin for 4 months, PAI-Fx normalized (12.4 U/mL), as did insulin (12 microU/mL), androstenedione (185 ng/dL), and testosterone (39 ng/dL); weight fell from 109 to 91.3 kg (16%). CONCLUSION(S): metformin reversed the endocrinopathy of PCOS. Familial thrombophilia and hypofibrinolysis may lead to thrombosis-mediated uteroplacental vascular insufficiency, failure to achieve pregnancy after embryo transfer, and miscarriage.
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ranking = 1
keywords = polycystic ovary syndrome, ovary syndrome, polycystic ovary, polycystic, ovary
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2/2. metformin hydrochloride and recurrent miscarriage in a woman with polycystic ovary syndrome.

    OBJECTIVE: To report the effect of metformin treatment on a patient with recurrent miscarriage (RM) and polycystic ovary syndrome (PCOS). DESIGN: Case report. SETTING: University department of obstetrics and gynecology, italy. PATIENT(S): A woman complaining of RM who had PCOS and insulin resistance. INTERVENTION(S): Clinical, biochemical, and instrumental assessments. MAIN OUTCOME MEASURE(S): Administration of metformin hydrochloride before and throughout pregnancy. RESULT(S): After 3 months of treatment, the patient became pregnant. The pregnancy had a physiologic development, and at 39 weeks of gestation, the patient spontaneously delivered a healthy infant. CONCLUSION(S): metformin has shown to be effective in an insulin-resistant PCOS woman with RM.
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ranking = 2.7208724233551
keywords = polycystic ovary syndrome, ovary syndrome, polycystic ovary, polycystic, ovary
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