4.2 Article

Clinical Assessment and Management of the Endometrium in Recurrent Early Pregnancy Loss

Journal

SEMINARS IN REPRODUCTIVE MEDICINE
Volume 29, Issue 6, Pages 491-506

Publisher

THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0031-1293203

Keywords

Miscarriage; endometrium; endometriosis; luteal phase defect; hydrosalpinges; pregnancy loss

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Unexplained and recurrent loss of pregnancies is a heartbreaking and frustrating condition. The routine diagnostic workup for pregnancy loss includes hormonal evaluation, screening for genetic or chromosomal defects, immunologic and thrombophilic testing, and evaluation of congenital or acquired Mullerian defects. In cases of idiopathic pregnancy loss, defects in endometrial receptivity are increasingly being investigated. The role of the endometrium in pregnancy loss has historical roots but remains controversial. Exciting new directions based on microRNAs, proteomics, and epigenetics promises to keep this area of investigation both interesting and complex. With each new diagnostic and therapeutic biomarker identified comes a greater potential for diagnosis and treatment of women. The clinical assessment of the endometrium remains an important part of the investigation of couples with unexplained pregnancy loss.

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