The Association Between Increase of Serum Fructosamine and Unexplained Recurrent Pregnancy Loss

Abstract

ecurrent pregnancy loss (RPL) is one of the most frustrating and difficult areas in reproductive medicine because the etiology is often unknown and there are few evidence-based diagnostic and treatment strategies. Studies on the etiology, evaluation, and management of RPL are often flawed. The definition of RPL varies, which makes studying the phenomenon, and determining which couples to counsel or treat, more challenging. As examples, varying definitions have included two or more failed clinical pregnancies as documented by ultrasonography or histopathologic examination as American Society for Reproductive Medicine defined or three consecutive pregnancy losses, which are not required to be intrauterine as Royal College of Obstetricians and Gynaecologists defined. In response to these varied definitions, the European Society of Human Reproduction and Embryology released a 2014 consensus statement proposing that RPL describes repeated pregnancy loss, regardless of anatomic location, but they did not recommend the number of losses required for the problem to be defined as recurrent. RPL can be further divided into primary or secondary processes. Primary RPL refers to pregnancy loss in women who have never carried to viability. In contrast, secondary RPL refers to pregnancy loss in a woman who has had a previous live birth. The prognosis for successful pregnancy is better with secondary RPL.