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Cohort:
Methodology
• RPL: ≥2 “unexplained” (miscarriages with chromosome errors excluded) pregnancy losses <10 wks size
• RPL evaluation: TSH, prolactin, cytogenetics of both , partners, antiphospholipid antibodies, hysteroscopy
• EB at 9-11 days after LH surge
– Negative histology
– Assessment of nCyclin E of gland cells
• ≥1 subsequent pregnancy without fertility drugs
Stephenson et al, 2017
Management
• Timed intercourse to LH surge
• Elevated nCyclin E (>20%)
– Vaginal micronized progesterone 100 mg q12hrs starting LH +3 days and continued until 10 weeks
– Recommended repeat EB; increase to 200 mg q12hrs if nCyclin E still elevated
• Normal nCyclin E
– Some women insisted on using empiric
vaginal micronized progesterone 100 mg q12hrs
Stephenson et al, 2017
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PRECONGRESS COURSE 06 I VIENNA, AUSTRIA – 23 JUNE 2019 55
